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Stage 4: CSIM 2 > Week 10: General blood disorders > Flashcards

Week 10: General blood disorders Flashcards

1
Q

What does a low ferritin saturation indicate

A

Iron deficiency (confirmed)

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2
Q

What does a high ferritin saturation indicate

A

Inflammation (acute phase protein)

-inflammation can cause high ferritin levels even in an iron deficient patient

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3
Q

What does a low transferrin saturation indicate

A
  1. Iron deficiency
  2. It’s been a while since eating (eg after sleeping)

Transferrin is very variable according to mealtimes

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4
Q

What does a high transferrin saturation indicate

A
  1. Just eaten

2. Haemochromatosis

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5
Q

Relationship between transferrin saturation and Total Iron Binding Capacity (TIBC)

A

Inverse relationship.

Low transferrin saturation means a high TIBC

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6
Q

What transferrin and ferritin saturations indicate haemochromatosis

A

Transferrin saturation >50%

High ferritin

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7
Q

Apart from transferrin and ferritin,

what other tests can be used to diagnose haemochromatosis

A
  1. HFE gene test
  2. PEARL liver scan (to see amount of iron in liver)
  3. Liver USS
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8
Q

What gene is associated with haemachromatosis

A

HFE gene

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9
Q

What 4 conditions are associated with haemachromatosis

A
  1. Diabetes
  2. Liver failure
  3. Chondrocalcinosis in knees
  4. Heart failure
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10
Q

Causes of microcytic anaemia

A
  1. Iron deficiency

2. Thalassaemia

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11
Q

Causes of macrocytic anaemia

A
  1. Low B12/folate
  2. Pregnancy
  3. Thyrotoxicosis
  4. Myelodysplasia (blood cancer)
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12
Q

Symptoms of B12 vs folate deficiency

A

B12 deficiency causes neuropathy

Folate deficiency is usually asymptomatic (except during pregnancy)

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13
Q

Causes of low reticulocytes (baby RBC)

A

Bone marrow problem (inability to make RBC)

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14
Q

Causes of high reticulocytes (baby RBC)

A

Haemolysis

Results in Bone Marrow releasing immature RBC earlier, to try to combat anaemia

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15
Q

Causes of low WBC

A
  1. Drugs
  2. Very bad sepsis
  3. Late stage leukaemia
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16
Q

Causes of high WBC

A
  1. Inflammation
  2. Infection
  3. Leukaemia (usually very very high)
17
Q

Which virus and bacteria are particularly associated with raised lymphocytes

A
  1. EBV virus

2. Pertussis bacteria

18
Q

Causes of low platelets due to decreased production

A
  1. Low B12/ folate
  2. Blood cancers (myeloproliferative neoplasms, leukaemia)
  3. Splenomegaly
19
Q

Causes of low platelets due to increased consumption

A
  1. Sepsis
  2. DIC
  3. Immune mediated conditions (idiopathic thrombocytopenic purpura)
20
Q

1st line management in someone whose test has come back with low platelets

A

REPEAT THE TEST

Platelet clumping on blood film is a normal occurrence in the lab and will cause decreased levels

21
Q

Causes of high platelets

A
  1. Active bleed
  2. Inflammation
  3. Post-splenectomy (nowhere to store the platelets)
22
Q

Causes of polycythaemia (high haematocrit)

A
  1. Smoking
  2. Alcohol (depletes plasma volume)
  3. Dehydration (low plasma volume)
  4. Steroid
  5. Epo-secreting tumour
23
Q

How does smoking cause polycythaemia

A

CO from smoke binds to Hb. Leads to chronic cyanosis

Kidneys make more haemoglobin to make up for it

24
Q

Which are myeloid cells

A
  1. Macrophages
  2. Neutrophils, basophils, eosinophils

amongst others

25
Q

Which are lymphoid cells

A
  1. T cells
  2. B cells
  3. NK cells

T and B cells are Lymphocytes

26
Q

Which vaccines should be given to someone BEFORE taking out their spleen

A
  1. Hib
  2. Pneumococcal
  3. Meningococcal

Must give prophylactic a/b for a few years

27
Q

Causes of normocytic anaemia due to decreased production

A

DECREASED PRODUCTION

  1. Bone marrow failure
  2. Multiple myeloma
  3. Anaemia of inflammation/ chronic disease
  4. Kidneys making insufficient epo
  5. Combination of low iron + low B12/folate
28
Q

Causes of normocytic anaemia due to increased consumption

A

INCREASED CONSUMPTION

  1. Acute bleed
  2. Haemolysis
29
Q

Complications of polycythaemia

A
  1. Stroke
  2. MI
  3. PVD
30
Q

Function of megakaryocytes

A

Making platelets (aka thrombocytes)

Stage 4: CSIM 2 (47 decks)

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