random Flashcards
renal anaemia is an anaemia of chronic disease. Production of what goes down in most cases of renal failure?
EPO
Which anaemia - a multifactorial pathophysiology with inflammation as a central process ?
anaemia of chronic disease
what does supra vital stain stain?
rbosomal RNA (reticulocytes)
blue golf ball appearance
beta tetramers in HbH disease
how many functioning alpha genes in HbH disease?
1
spheric red cells which are destroyed in the spleen causing splenomegaly? which disease?
hereditary spherocytosis
macrocytosis without anaemia?
LAHM - liver cirrhosis, alcohol, hypothyroid, malignancy
causes of megaloblastic anaemia?
folate and b12
how long is b12 stored in body?
2-4 years, much more likely to be folate deficient
when do you get oxidative stress and heinz bodies?
g6pd deficiency
what are dietary floats converted into?
monoglutamate
in a transfusion reaction, what antibodies are involved in immediate and delayed reaction, and where do these reactions occur?
MG
Mimmediate IgM - intravascular
IgGextravascular
when do you get normocytic anaemia?
in chronic disease
what binds free haemoglobin?
haptoglobin
Inflammatory stimuli can activate monocytes and t cells. what can this inhibit which can cause anaemia?
EPO release and erythroid proliferation
what is anaemia of chronic disease driven by?
inflammatory cytokines induced by infection/malignancy
most chronic anaemias are primarily result of ?
impaired red cell production
difference in MCV between iron deficient anaemia and anaemia of chronic disease?
small in iron d, normal in chronic disease
ferritin in iron def anaemia and chronic disease?
reduced in iron deficient, normal or increased in chronic disease
Hodgkins lymphoma. characterised histologically by presence of?
multinucleated giant cells
young man with enlarged, asymptomatic lymph node, typically in lower neck/supraclavicular region?
hodgkins lymphoma
In hodkins lymphoma, why do you get chest discomfort with cough or dyspnoea?
mediastinal masses are frequent
symptoms of hodgkins lymphoma
fever, night sweats, weight loss. Alcohol induced pain at sites of nodal disease is uncommon, but is specific for hodgkins lymphoma.
presence of which cell characterises bodkins lymphoma?
reed sternberg cell (reed alcohol)
58 year old man has been admitted to the general medical ward with abdominal pain and fluctuating consciousness. On examination he has shifting dullness and is scleral icterus. A social history has been taken and he has been started on a reducing regime of chlordiazepoxide. Blood tests have been undertaken, which show: Hb 92 g/l (normal 135-180), MCV 130fl (80-102fl), platelet count 145 (140-450). What is the most likely cause for this patient’s anaemia?
Chronic alcohol use
chlordiazepoxide is a bento used for withdrawls
Haemophilia A is associated with deficiency in which factor?
8
A 22 year old female has presented with persistent fatigue. She is frustrated as her GP ‘keeps putting this down to depression’. She has not lost any weight and has not had any feverish symptoms. She remembers having a sore throat that wouldn’t go away a few months ago, but nothing since. On examination, you note cervical lymphadenopathy and mild splenomegaly. Her full blood count comes back as: Hb 120g/l (normal 115-165g/l), WCC 6.0 (normal 3.9-5.6), platelet count 310 (normal 140-450). What is the most appropriate next investigation to undertake?
infective mononucleosis
what is the test for infective mononucleosis?
monospot test
which protein is found in electrophoresis of urine in multiple myeloma?
bence jones
young girl, with symmetrical, macular rash, usually on buttocks or legs with abdominal pain?
henoch sconlein purpura
A 7 year old girl has presented with petechiae on her knees and shins and frequent nosebleeds. She had a viral infection 2 weeks ago from which she apparently recovered. She appears clinically well in herself, with no temperatures. She has no joint pain. PT, APTT, vW factor, factor VIII and factor IX are all normal. Her platelets are 100 (140-450). What is the most likely cause of these findings?
low platelets and patechiae
–> idiopathic thrombocytopaenic purpura
