Haem 17: Interactive Cases Flashcards

1
Q

what condition do the following suggest:

  • mediastinal mass
  • no platelets
  • blast cells
  • high WCC
A

T lineage ALL - thymoma
= ALL of T lineage

immunophenotyping important
high WCC is a BAD prognostic feature

needs combination chemo and CNS-directed therapy

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2
Q

what condition does the following suggest:

  • 2 weeks bleeding gums
  • haematuria
  • minor bruising
  • L subconjunctival haemorrhage
  • no hepatosplenomegaly or enlarged LN
  • normal renal fn
  • granuels and Auer rods
A

granules and auer rods = myeloid
granular cells = acute promyelocytic leukaemia

confirm by cytogenetic analysis/ FISH/ molecular genetic analysis

15;17 translocation forming the PML-RARA fusion gene

tx - platelets, chemo, ATRA

can cause short APTT - activation of coagulation factors accelerated clotting of the plasma

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3
Q

what condition does the following suggest:

  • gradual onset fatigue, lethargy, exertional dyspnoea
  • pallor
  • mild ankle oedema
  • low Hb
  • high MCV
  • low neutrophils
  • high platelets
  • hypochromic macrocytes
A

diamorphic film

MDS

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4
Q

what condition does the following suggest:

  • vegetarian
  • SOBOE
  • fatigue
  • cant eat spicy food
  • pallor
  • WBC normal
  • Hb low
  • MCV high
  • n platelets
  • patietal Ab positive
  • IF Ab positive
  • low B12
A

megaloblastic anaemia due to pernicious anaemia

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5
Q

what condition do the following suggest:

  • gangrenous toes
  • SOBOE
  • reduced femoral and distal pulses
  • plethora
A

PV

JAK mutation investigation

Tx = venesection + hydroxycarbamide

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