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Haematology > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What is the life span of neutrophils?

A

7-8 hrs

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2
Q

What is the precursor cell for platelets?

A

Megakaryocytes

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3
Q

Embryologicaly where do haemopoietic stem cells come from?

A

Mesoderm

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4
Q

What is the lifespan of platelets?

A

7-10 days

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5
Q

What are the primary lymphoid tissues?

A

Bone marrow

Thymus

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6
Q

What are the secondary lymphoid tissues?

A

Lymph nodes

Spleen

tonsils

Bone marrow

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7
Q

What happens in malignant haemopoiesis?

A

Increased numbers of abnormal and dysfunctional cells with loss of normal actiivity

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8
Q

Whithin a lymph node where is the lymph filtered?

A

Within the parenchyma

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9
Q

What is the structure of the spleen?

A

Red pulp - blood filtering

White pulp - periarteiolar lympoid sheath - Lymph

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10
Q

What is the triad for hypersplenism?

A

Splenomegaly

Fall in cellular components of blood

Correction of cytopenia by splenectomy

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11
Q

What is pancytopenia?

A

A deficiency of blood cells of all lineages

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12
Q

What are the two cause of pancytopenia?

A

Reduced production

or

increased destruction

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13
Q

What are the reduced production causes of pancytopenia?

A

Bone marrow failure

Inherited

Acquired primary

or

Acquired secondary

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14
Q

give examples of acquired primary bone marrow failure?

A

Idiopathic aplastic anaemia

Myelodysplastic syndromes

Acute leukaemia

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15
Q

What is the aname for the aneamia where there is autoimmune atack against haempopoietic stem cells?

A

Idiopathic aplastic anaemia

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16
Q

What happens in aplastic anaemia?

A

Auto-reactive T cells attack haemopoiectic stem cells

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17
Q

What is found in myelodysplastic syndrome?

A

Dysplasia

Hypercellular marrow

increased apoptosis of progenitor mature cells

(ineffective haemopoiesis)

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18
Q

What are the common causes of secondary bone marrow failure?

A

B12/folate dificiency

Drug induced - chloramphenicol, alcohol

HIV

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19
Q

What are some causes of hypersplenism?

A

Splenic congestion

Rheumatoid Arthritis

Splenic lymphoma

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20
Q

Draw the summary slide for Pancytopenia

A
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21
Q

How can you break down the symptoms of pancytopenia?

A

Anaemia

Neutropenia

Thrombocytopenia

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22
Q

What are the aneamic consequences of pancytopenia?

A

Fatigue

SoB

Cardiovascular compromise

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23
Q

What are the neutropenic symptoms of pancytopenia?

A

Increased infections

More severe and for longer

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24
Q

What are the thrombocytopeniaic consequences of pancytopaenia?

A

Bleeding

Purpura

Petechiae

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25
Q

What does hypocellular marrow in pancytopenia suggest?

A

Aplastic anaemia

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26
Q

What will the marrow show in B12/folate deficiency pancytopenia?

A

Hypercellular

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27
Q

What happens in acute myeloid leukaemia?

A

Proliferation of abnormal progenitors with block in differentiation/maturation

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28
Q

What happens in chronic myeloid leukaemia?

A

Proliferation of abnormal progenitors with no differentiation/maturation block

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29
Q

What is the concept of “clones” in relation to malignant haemopoiesis?

A

Clones are cells derived from one parent cell

Normal haemopoiesis = polyclonal

Malignant haemopoiesis = monoclonal

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30
Q

What does myeloid mean and what does lymphoid mean?

A

Myeloid = erythrocytes, plaelets, macrophages

Lymphoid = immune cells, T cells and B cells, lymphy stuff

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31
Q

What is acute leukaemia?

A

Rapidly progressive clonal malignancy of the marrow/blood with maturation defects.

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32
Q

What defines actue leaukaemia?

A

Excess of “blasts” in either blood or bone marrow of >20%

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33
Q

What are the two types of acute leaukaemia?

A

Acute myeloid leukaemia

Acute lymphoblastic leaukaemia

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34
Q

What is acute lymphoblastic leaukaemia?

A

Malignant disease of lymphoblasts

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35
Q

Who gets acute lymphoblastic leukaemia?

A

Children

its the most common childhood cancer

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36
Q

who gets acute myeloid leukaemia

A

Oldies

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37
Q

What does a blood film in acute leakaemia look like?

A

Blast cells with high nuclear:cytolasmic ratio

38
Q

Where do you find Auer rods and what do they mean?

A

Auer rods are found in acute myeloid leukaemia

39
Q

How do you treat acute leakaemia?

A

Months to years of Curative mutliagent chemotherapy

40
Q

What takes longer to cure ?

Acute lymphoblastic leakaemia ALL

or

Acute Myeloid Leaukaemia

A

AML - months

ALL - years

41
Q

What are the cure rates for ALL and AML?

A

Acute Lymphoblastic leakaemia

Child - 85%

Adult - 30%

Acute Myeloid Leakaemia

<60yrs = 50%

>60yrs = 10%

42
Q

What are the different mechanisimsins of action in low does chemo/RT vs High dose chemo/RT ?

A

Low dose - apoptosis

High dose- Chemo

43
Q

What killing method is better for lymphoma and acute leaukaemia?

A

Low power chemo

cells are ready for apoptosis

44
Q

What are the side effects of radiotherapy/chemotherapy ?

A

Hair loss,

Nausea,

Vomiting,

Neutropenic infection

Tiredness

long term, heart and lung dmg

45
Q

What should be given to all imunnosupressed cancer patients

A

Prophylactic antifungal drugs

intraconazole

Posaconazole

46
Q

What supportive therapys should haem cancer patients get?

A

Promped treatment of infections

broad spectrum antibiotics

red cell and platelet transfusions

growth factors

antifungals

47
Q

What are the targeted cancer therapies ?

A

Monoclonal antibodies

Biological agents

Molecularly targeted treatmens

48
Q

What on earth are monoclonal antiodies?

A

Cancer treatment which only affects the cel which possesses the target protein.

avoids side effects

49
Q

How are monoclonal antibodies usually used?

A

Normally in combination with chemothraphy

50
Q

When would you have raised lymphocytes?

A

Increased in viral diseases like glandular fever

51
Q

When would neutrophils be raised?

A

Increased in bacterial infections and inflamatory disorders

52
Q

in what conditions would you find increased Monocytes?

A

In chronic bacterial infections

Protozoan infections

Hodgkin’s disease

53
Q

When would you find increased basophils?

A

Hypothyroidisim

Ulcerative collitis

Chickenpox

54
Q

What are malignant lymphomas?

A

Cancers of normal lymphoid stuctures

55
Q

What kinds of malignant lymphomas are there?

A

Hodgkins disease

Non-hodgkin’s Low grade

or

Non-hodgkin’s high grade

56
Q

How do maliganant lymphomas present?

A

painless lymphadenopathy

Splenomegaly or hepatomegaly

Night sweats, weight loss, fevers

aneamia

57
Q

How do you diagnose malignant lymphoma?

A

Excision biopsy

58
Q

Where would you find Reed-Sternberg cells?

A

In Hodgkin’s disease

59
Q

What is the prognosis for Hodgkin’s disease?

A

70% cure rate

60
Q

What are the causes of hyposplenisim?

A

COngenital

Surgical

Trauma

Infaction - sickle cell

drugs

coeliac disease

61
Q

What infections are you worried about in peolpe with hyposplenisim?

A

Streptococcus pnemonia

Haemophilus influenzae

62
Q

What should all patients with hyposplenisim recieve ?

A

Pneumococcul immunisation

Haemophilus influenzae type B vaccine

if long term consider prophylaxic penicillin

63
Q

What is Hypersplenisim?

A

Ehanced cellular filtration functions, pathological pooling and increased plasma volume with modest shortening of blood cell life span

64
Q

What are myeloproliferative disorders?

A

Colonal malignant disorders characterised by overgrowth of one or more haematopoietic lineages

65
Q

What precursor cell has gone haywire in chronic myeloid leaukaemia?

A

Granulocyte precursor

66
Q

what type of hodgkin’s lymphoma has the best prognosis?

A

Classical Lymphocye predominant

67
Q

What does myeloproliferative mean?

A

Myelo = bone marrow lineages

Prolfierative = To grow or multiply

68
Q

What are myeloproliferative malignancies?

A

Clonal haemopoietic stem cell disorders

69
Q

What are the two sub types of myeloproliferative disorders?

A

BCR-ABL 1 positive

BCR-ABL 1 Negative

70
Q

What type of myeloproliferative disorder is BCR- ABL1 positive?

A

Chronic Myeloid Leukaemia

71
Q

What myeloproliferative disorders are BCR-ABL 1 negative?

A

Idiopathic myelofibosis

Polycythaemia Rubra Vera

Essential Thrombocythaemia

72
Q

What clinical signs would sugest a myeloproliferative disorder?

A

Raised granulocyte, red cell, platelet, eosinophil and basophil counts

Splenomegaly

Thrombosis

73
Q

What happens in chronic myeloid Leukaemia?

A

Proliferation of myeloid cells, in particular granulocytes and their precursors

74
Q

How does chronic Myeloid Leukaemia progress?

A

Chronic phase for 3-5 years

then accelerated phase when blasts begin to make their way in to the blood abit more

then Blast crisis when it all goes cray cray

75
Q

What weird symtpoms do people with chronic myeloid leukaemia get?

A

Priaprisim (prolonged erection)

gout

76
Q

How could you differentiate chronic myeloid leukaemia from a normal reactive polycythemia?

A

In reactive polycthemia the eosinophils and basophils must be raised.

Also there must be an indentifiable cause

77
Q

What gene defect is the hallmark of chonic myeloid leukaemia?

A

The philidelphia chromosome

BCR-ABL 1 gene

78
Q

How does the philidephia chromosome come about?

A

Translocation

79
Q

What does the BCR-ABL 1 gene?

A

Makes tyrosine kinase

abnormal phosphorylation

chronic myeloid leaukaemia

80
Q

What is Polycthaemia rubra vera?

A

Type of myloid proliferative malignancy where there is increased red cells

81
Q

What conditions must you also consider in someone with raised red blood cells?

A

Secondary polycythaemia ( chronic hypoxia, eryhtropoietin-secreting tumout)

Pseudopolycythaemia ( dehydration)

82
Q

What weird symptom do people with polcycthaemia rubra vera get?

A

Ithcy skin when it is wet

83
Q

What mutation is super key for diagnosing Polycythaemia rubra vera?

A

JAK2 mutation

84
Q

How can you diagnosie polycythaemia rubra vera?

A

JAK2 mutation

85
Q

How do you treat polycythaemia rubra vera?

A

Venesect to haematocrit <0.45

Aspirin

Cytotoxic oral chemotherapy - Hydroxycarbamide

86
Q

What is Essential Thrombocythaemia?

A

A myeloproliferative dissorder where there is uncontrolled overproduction of platelets

87
Q

How do you treat essential thrombocythaemia?

A

Anti-platelet agents - Aspirin

Cytroreductive therapy to control prolifeation

Hydroxycarbamide

Anagrelide

Interferon alpha

88
Q

What is myelofribrosis?

A

Fibrosis of the bone marrow

89
Q

In what condition do you find tear-drop shaped red blood cells?

A

In peripheral blood

90
Q

What are the causes of a leucoerythroblastic blood film?

A

Reactive (sepsis)

Marrow infiltration

Myelofibrosis

91
Q
A

Haematology (4 decks)

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