notes from quesmed Flashcards
what are megaloblasts
large, oval shaped cells on blood film
abnormal, large and immature
when should prothrombin complex be administered
management of a raised INR in the presence of a major bleed. alongside iv vit k
macrocytic, megaloblastic anaemia
large red blood cells and immature redblood cell precursors
usually caused by impaired dna synthesis and abnormal maturation of red blood cells due to deficiencies in b12 or folate
think nutritional deficiencies, alcohol excess, pernicious anaemia
disseminated intravascular coagulopathy
haematological emergency
inappropriate activation of the clotting cascades, leading to thrombus formation (in microvasculature) and depletion of clotting factors and platelets, which then results in bleeding
bloods for DIC
thrombocytopenia
blood film may show shistocytes
raised D dimer
increased prothrombin time
increased APTT
decreased fibrinogen
polycythaemia rubra vera
increase in haematocrit, red cell count, haemoglobin concentration
spenomegaly
JAK2 mutation
how to tell hodgkins vs non hodgkins lymphoma
lymph node biopsy - reed sternberg cells present in hodgkins not non hodgkins
non hodkins more likely to associated with B symptoms
von willebrand disease
deficiency in vWF. also decreased factor VIII as vWF is necessary for stabilisation and transport of factor VIII
also normal PT time and prolonged APTT
increased risk of bleeding esp menstrual, pregnancy and childbirth
type 1 and type 2
type 1 VWD vs type 2
1- reduced quantity of vWF so increased bleeding often in adulthood
2- more severe as qualitative in vWF. presents earlier in life
myelofibrosis
myeloproliferative disorder with marrow fibrosis and pancytopenia
weight loss, fatigue, night sweats, splenomegaly, marrow failure, hepatomegaly, bone pain
poikilocytes (tear shaped RBCs)
platelet and WCC often high initially then pancytopenia
dry tap when aspirating due to fibrosis
JAK2 pos in 50% of cases
iron def and alcohol link
chronic liver disease, the liver cannot store or utilise iron properly, leading to decreased iron stores and eventual iron deficiency. Additionally, alcohol can impair iron absorption and cause gastrointestinal bleeding, further contributing to iron deficiency.
what is agranulocytosis
severe reduction in the number of granulocytes, a type of white blood cell, particularly neutrophils
absolute neutrophil count (ANC) of less than 0.5 × 10^9 per liter of blood.
increases risk of infections
drugs that cause thrombocytopenia
heparin, some antibiotics (penicillin), anti seizure meds, chemotherapy drugs
aplastic anaemia is
rare but serious medical condition characterized by a deficiency of all three major types of blood cells: red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes). This deficiency occurs because the bone marrow fails to produce enough of these blood cells.
myelodysplastic syndrome (myelodysplasia)
group of blood disorders presenting with signs and symptoms of anaemia, infections and bleeding depending on which cell lineages are most affected. The anaemia can be normocytic or macrocytic and can be associated with single or multilineage dysplasia of other cells. Classic blood film findings are spur cells or acanthocytes and clusters of megakaryocytes.
blood film may show myeloblasts, but this should be less than 10% of the film.
The production of blast cells can be a risk factor for transformation to leukaemia.
