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Yr 5 - Haematology > Revision > Flashcards

Revision Flashcards

1
Q

What antibody may be seen in antiphospholipid syndrome?

A

Anticardiolipin antibodies

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2
Q

What are anti-Ro antibodies seen in?

A

Sjogren’s syndrome

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3
Q

Why can WCC be low in ALL?

A

As the damaged bone marrow produces defective white cells that don’t contribute towards the WCC (this is also why they get infections etc), hence the neutropaenia.

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4
Q

What are the most common causes of massively splenomegaly in UK?

A

1) CML

2) Myelofibrosis

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5
Q

In what cancers is tumiur lysis syndrome most common?

A

In cancers with a high WCC, especially following aggressive chemo.

E.g. Burkitt’s lymphoma

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6
Q

What cancer is the most common cause of tumour lysis syndrome?

A

Burkitt’s lymphoma

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7
Q

What medication is used in ombination with conventional chemotherapy regimes for a variety of types of non-HL?

A

Rituximab

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8
Q

What should all patients be screened for prior to treatment with rituximab?

A

hepatitis B –> retuximab can cause reactivation

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9
Q

What cancer can myelodysplasia progress to?

A

AML

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10
Q

What genetic change is Burkitt’s lymphoma associated with?

A

C-myc gene translocation

This leads to overexpression of the c-myc protein, which promotes cell growth and proliferation - key features of malignancy.

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11
Q

Does HL cause an increase in the lymphocytes on blood tests?

A

No

But it can cause normocytic anaemia and eosinophilia.

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12
Q

Non-HL is associated with exposure to what chemical?

A

Pesticides

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13
Q

What gender is a poor prognostic factor for ALL?

A

Male

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14
Q

What is a characteristic blood film finding of CLL?

A

Smear/smudge cells –> these are the result of abnormally fragile lymphocytes in CLL.

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15
Q

What is a characteristic blood film finding of multiple myeloma?

A

Rouleaux formation

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16
Q

What do Auer rods on a blood film indicate?

A

AML

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17
Q

TIBC in anaemia of chronic disease vs iron def anaemia?

A

Anaemic of chronic disease –> low/normal TIBC

Iron def anaemia –> raised TIBC

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18
Q

Rituximab is used in combination with chemotherapy for a variety of types of non-Hodgkin’s lymphoma.

What receptor does this monoclonal antibody drug act against?

A

CD20 receptor (B lymphocyte antigen receptor)

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19
Q

1st line mx of warm autoimmune haemolytic anaemia?

A

Steroids +/- rituximab

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20
Q

What triad is seen in Felty’s syndrome?

A

1) RA
2) Splenomegaly
3) Low WCC (neutropenia)

This is an extra-articular manifestation of RA.

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21
Q

What is a pepperpot skull a characteristic X-ray finding of?

A

Hyperparathyroidism (due to increased osteoclast activity).

Also myeloma.

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22
Q

How can myeloma cause strokes?

A

Due to hyperviscosity (due to hyperparaproteinaemia)

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23
Q

FBC results in CML?

A

an increase in granulocytes at different stages of maturation +/- thrombocytosis

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24
Q

What condition is associated with ‘tear drop’ poikilocytes on blood film?

A

Myelofibrosis

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25
Q

How do steroids affect WCC?

A

Cause neutrophilia

26
Q

Give 3 haematological causes of pyoderma gangrensoum

A

1) myeloproliferative disorders

2) lymphoma

3) myeloid leukaemias

27
Q

PT & APTT in APS?

A

PT - normal

APTT - prolonged

28
Q

Reticulocytes in beta-thalassaemia?

A

Raised

29
Q

HbA2 in beta thalassaemia trait?

A

Raised (>3.5%)

30
Q

What type of Hodgkin’s lymphoma carries the worst prognosis?

A

Lymphocyte depleted

31
Q

What can cause pancytopaenia 5 years post-chemotherapy/radiotherapy?

A

Myelodysplastic syndrome (MDS)

32
Q

What medications can exacerbate plaque psoriasis?

A
  • beta blockers
  • lithium
  • antimalarials (chloroquine and hydroxychloroquine)
  • NSAIDs
  • ACE inhibitors
  • infliximab
33
Q

Iron def anaemia vs anaemia of chronic disease:

1) serum iron
2) TIBC
3) serum ferritin

A

iron def:
1) decreased
2) raised
3) decreased

anaemia of chronic disease:
1) decreased
2) low/normal
3) normal/increased

34
Q

What can mixed anaemia (co-presentation of iron deficiency anaemia and B12 deficiency anaemia) cause?

A

Normocytic anaemia

35
Q

What is polychromasia?

A

There are more immature RBCs than what’s considered normal.

It’s a finding a peripheral blood smear.

Usually, it’s a sign that RBCs are being destroyed more quickly than the body can replace them (haemolytic anemia).

36
Q

Mx of acute pain crisis in sickle cell?

A

Morphine

37
Q

1st line mx of superficial thrombophlebitis?

A

NSAIDs

38
Q

Cautery vs anterior packing in epistaxis?

A

Minor bleeding from an accessible site can be treated with cautery using a silver nitrate stick or electrocautery.

Anterior pack is for profuse bleeding with site difficult to localise.

39
Q

What is the most common type of myeloma?

A

IgG kappa

The myeloma cells produce an immunoglobulin made from two IgG heavy chains bound to two kappa light chains

40
Q

What is seen on serum electrophoresis in IgG kappa myeloma?

A

Monoclonal Ig kappa peak

41
Q

What is seen on bone marrow biopsy in myeloma?

A

Abnormally high % of plasma cells (>10%)

42
Q

When is a platelet transfusion indicated?

A

Patients with a platelet count <30 x 10^9 and clinically significant bleeding.

43
Q

What type of anaemia is associated with CLL?

A

Warm autoimmune haemolytic anaemia

44
Q

What investigation is required to confirm a diagnosis of G6PD deficiency?

A

G6PD enzyme assay at the time of presentation AND after 3 months –> to avoid false negatives.

45
Q

Mx of children and young people (0-24 y/o) with:

a) unexplained petechiae
b) hepatosplenomegaly

A

Immediate referral for specialist assessment –> rule out leukaemia

46
Q

1st line mx of ITP?

A

Oral prednisolone

47
Q

What is seen on a blood film in hyposplenism (e.g. post-splenectomy, coeliac disease)?

A
  • Howell-Jolly bodies
  • Target cells
48
Q

What is seen on a blood film in iron deficiency anaemia?

A
  • Target cells
  • ‘Pencil’ poikilocytes
49
Q

What is seen on a blood film in myelofibrosis?

A

‘Tear-drop’ poikilocytes

50
Q

What is seen on a blood film in intravascular haemolysis?

A

Schistocytes

51
Q

What is seen on a blood film in megaloblastic anaemia?

A

Hypersegmented neutrophils

52
Q

What is the most common type of lymphoma in the UK?

A

Diffuse large B cell lymphoma (type of non-Hodgkin lymphoma)

53
Q

What is the most common inherited clotting disorder?

A

Factor V Leiden –> results in activated protein C resistance

54
Q

What does the presence of haemolysis with blister cells on a blood film indicate?

A

G6PD deficiency

55
Q

FBC results in EBV?

A

Can cause increased lymphocytes but decreased neutrophils.

56
Q

DIC typical blood picture?

A
  • reduced platelets
  • reduced fibrinogen
  • raised PT & APTT
  • raised fibrinogen degradation products
57
Q

What is the 1st line imaging in suspected multiple myeloma?

A

Whole body MRI –> identifies both focal and diffusion bone marrow infiltration.

58
Q

1st line investigation in those aged ≥60 y/o with hypercalcaemia or leukopenia and a presentation that is consistent with myeloma?

A

Very urgent (<48h) protein electrophoresis and Bence Jones protein testing.

59
Q

What are mirror image nuclei?

A

Reed-Sternberg cells

60
Q
A

Yr 5 - Haematology (10 decks)

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