haematology to work on COPY Flashcards
Give 3 signs of anaemia
- Conjunctival pallor
- Hyper-dynamic circulation
- Tachycardia
- Systolic flow murmur
What are the specific signs of B12 deficiency/pernicious anaemia?
Inflamed tongue (glossitis), angular stomatitis, mild jaundice
Neurological - paraesthesia, psychological problems, ataxia
- dementia and visual disturbances
Give 3 acquired causes of haemolytic anaemia
- Autoimmune
- Drug induced
- Secondary to systemic disease
- Malaria
Give 3 chronic complications of sickle cell disease
- Renal impairment
- Pulmonary hypertension
- Joint damage
- growth and development problems
- cardiomegaly, MI
- hepatomegaly
- retinopathy
- impaired placental blood flow
Describe the treatment for sickle cell disease
- Precipitating factors should be avoided - e.g. infection, dehydration, cold
- Folic acid
- Acute attacks:
- IV fluids
- Analgesia
- Oxygen - Possible blood transfusions
- Oral hydroxycarbamide to reduce frequency of crises
- Stem cell transplant
long term management
- hydroxyurea - increases HbF levels so is used as prophylaxis
- pneumococcal vaccine
what are the clinical features of G6PD deficiency?
Most are asymptomatic Pallor Fatigue Palpitations Shortness of breath Jaundice Exacerbated by ingesting fava beans
Name 3 things that can precipitate G6PD deficiency
- Broad beans / fava beans
- Infection
- Drugs - Primaquine, sulphonamide, quinolones
what are the secondary causes of absolute polycythaemia?
hypoxia
- Smoking - Lung disease - Cyanotic heart disease - High altitude - obstructive sleep apnoea
Excess EPO - renal disease
alcohol
what are the clinical features of polycythaemia?
Headaches and dizziness Itching Fatigue Tinnitus Erythromelalgia – burning sensation in fingers and toes Hypertension Angina Hepatosplenomegaly (distinguishes 1o from 2o)
What is the treatment for polycythaemia?
No cure Treatment aim is to maintain normal blood count Venesection - relieves symptoms Low does aspirin Radioactive phosphorus in those over 70
What can cause decreased platelet production?
- Congenital causes (e.g. malfunctioning megakaryocytes)
- Infiltration of bone marrow (e.g. leukaemia)
- Alcohol
- Infection (e.g. HIV/TB)
- Reduced TPO
- Aplastic anaemia
What can cause increased platelet destruction?
- Autoimmune (e.g. ITP)
- Hypersplenism
- Drug related (e.g. heparin induced)
- DIC and TTP –> increased consumption
What can cause reduced platelet function?
- Congenital abnormality
- Medications - aspirin
- VWF disease
- Uraemia
Give 3 things that can cause coagulation disorders
- Vitamin K deficiency
- Liver disease
- Congenital - haemophilia
What is thrombotic thrombocytopenia (TTP)?
- Widespread adhesion and aggregation of platelets leads to microvascular thrombosis and consumption of platelets
- Occurs due to a reduction in ADAMTS-13 – a protease that is normally responsible for the degradation of vWF
What is the treatment for thrombotic thrombocytopenia (TTP)?
- Plasma exchange (removed ADAMTS13 autoantibodies)
- Splenectomy
- IV steroids
- IV methylprednisolone
- IV rituximab
- folic acid
- platelet transfusion = contraindicated
Give 3 causes of immune thrombocytopenia (ITP)
Primary = viral infection (children) Secondary (chronic, adults) - Autoimmune conditions - Malignancies - CLL - Infections - HIV/Hep C
What is the management for immune thrombocytopenia (ITP)?
- first line = Corticosteroid (prednisolone) or IV immunoglobulin - IV IgG
- second line = Splenectomy or immunosuppression (rituximab)
Give 3 signs of haemolytic anaemia
- Pallor
- Jaundice
- Splenomegaly
Give 2 specific symptoms of iron deficiency anaemia
- Koilonychia - spoon nails
- Brittle hair and nails
- Atrophic glossitis
Give 3 causes of neutrophilia
- Infection
- Inflammation
- Cancer
- CML = primary cause
Give 3 causes of lymphocytosis
- Viral infection
- Inflammation
- Cancer
- CLL = primary cause
Give 3 causes of thrombocytosis
- Infection
- Inflammation
- Cancer
- Essential thrombocythaemia = primary cause
Give 3 causes of neutropenia
- Underproduction = marrow failure, marrow infiltration, marrow toxicity (e.g. drugs)
- Increased removal = autoimmune, Felty’s syndrome, cyclical