Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 2a Green Conditions > Haematology > Flashcards

Haematology Flashcards

1
Q

How is anaemia defined?

A
  • lower than normal concentration of haemoglobin/RBCs
  • Hb <130 in men
  • Hb <120 in women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different types of anaemia?

A
  • haemolytic = increased breakdown of RBCs
  • aplastic = decreased RBC, WBC, platelets
  • microcytic = reduced MCV
  • macrocytic = raised MCV
  • normocytic = normal MCV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is MCV?

A

mean corpuscular volume
- average size of RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

General symptoms of anaemia

A
  • fatigue
  • headache
  • dizziness
  • dyspnoea esp on exertion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

General signs of anaemia

A
  • tachycardia
  • skin pallor
  • conjunctiva pallor
  • intermittent claudication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are signs of iron deficiency?

A
  • koilonychia = spoon-shaped nails
  • angular stomatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are signs of B12 deficiency?

A
  • angular stomatitis
  • lemon-yellow skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are signs of haemolytic anaemia?

A
  • jaundice
  • dark urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of microcytic anaemia?

A
  • iron deficiency
  • anaemia of chronic disease
  • sickle cell
  • thalassemia
  • sideroblastic anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Investigations for iron deficiency microcytic anaemia

A

FBC → low Hb/MCV

Iron studies

blood film → small, hypochromic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of iron deficiency microcytic anaemia

A

reduced absorption

  • low intake
  • malabsorption
  • drugs eg PPIs and tetracyclines

increased utilisation → pregnancy

blood loss

  • stools
  • urine
  • trauma
  • surgery
  • menorrhagia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Investigations for chronic disease microcytic anaemia

A

FBC

  • low Hb
  • low/normal MCV
  • high ESR

Iron studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of chronic disease microcytic anaemia

A
  • chronic infection
  • chronic inflammation → connective tissue diseases
  • neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is thalassemia?

A
  • inherited alpha or beta globin mutations
  • varied presentation
  • generally microcytic, hypochromic cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is sideroblastic anaemia?

A
  • iron levels normal
  • body cannot insert iron into Hb
  • microcytic
  • increased iron, transferrin, ferratin
  • ringed sideroblasts on blood film
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Causes of normocytic anaemia

A
  • acute blood loss
  • bone marrow failure
  • pregnancy
  • haemolytic anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Presentation of haemolytic anaemia

A
  • jaundice
  • dark urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Investigations for haemolytic anaemia

A
  • raised reticulocytes (chronic)
  • raised bilirubin
  • raised urobilinogen
  • schistocytes on blood film
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Causes of haemolytic anaemia

A
  • autoimmune
  • sepsis
  • DIC
  • sickle cell
  • thalassemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the main cause of macrocytic anaemia?

A

B12 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of B12 deficiency in macrocytic anaemia

A
  • pernicious anaemia
  • malabsorption → coeliac, IBD, bowel resection, ileostomy
  • decreased dietary intake
  • chronic NO use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Investigations for B12 deficiency in macrocytic anaemia

A

bloods

  • raised MCV
  • low Hb, B12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Signs and symptoms of B12 deficiency in macrocytic anaemia

A
  • general anaemia presentation
  • range of neurological symptoms

presents as megaloblastic anaemia

  • cell changes on blood smear
  • oval shaped RBCs
  • hypersegmented neutrophils
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Causes of macrocytic anaemia

A
  • B12 deficiency
  • diseases of the liver and spleen
  • haematological malignancy
  • alcohol → chronic consumption affects bone marrow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is neutrophilia?

A

too many neutrophils

causes

  • infection
  • inflammation
  • CML
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is neutropenia?

A

not enough neutrophils

causes

  • Abs
  • chemo
  • marrow failure
  • liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is thrombocytosis?

A

too many platelets

causes

  • infection
  • inflammation
  • tissue injury
  • splenectomy
  • essential thrombocythemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is thrombocytopenia?

A

not enough platelets

causes

  • production failure → marrow failure, congenital
  • increased removal → ITP, TTP, DIC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is lymphocytosis?

A

too many lymphocytes

causes

  • EBV
  • cytomegalovirus
  • hepatitis
  • malignancy → CLL, ALL, lymphoma
  • stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is lymphocytopenia?

A

not enough lymphocytes

causes

  • steroids
  • HIV
  • post viral
  • marrow failure
  • chemo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is haemostasis?

A

process that stops bleeding

primary haemostasis

  • initiation and formation of platelet plug
  • platelet activation

secondary haemostasis

  • formation of fibrin clot
  • intrinsic and extrinsic coagulation cascade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the effects of platelet activation?

A
  • platelet shape change
  • dense granule release
  • alpha granule release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Inheritance of sickle cell

A
  • autosomal recessive
  • gene on Cr11 → glutamic acid substitution with valine → B-globin polymerisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is sickle cell disease

A
  • sickled cells
  • endothelial damage
  • reduced O2 carrying capacity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Acute presentation of sickle cell (7)

A
  • bone and joint pain
  • infection
  • dyspnoea
  • cough
  • hypoxia
  • stroke
  • sequestrian crisis → blood outflow from spleen is blocked → blood accumulates → splenomegaly
36
Q

Risk factors of sickle cell

A
  • low O2
  • cold weather
  • parvovirus B19
  • exertion
37
Q

Chronic complications of sickle cell

A
  • avascular necrosis of joints
  • silent CNS infarcts
  • retinopathy
  • nephropathy
  • ED
38
Q

Investigations for sickle cell

A
  • FBC → low MCV, Hb
  • blood smear → sickled erythrocytes
  • sickle solubility test → detects HbS → does not distinguish trait from disease
  • Hb electrophoresis → band of Hbs
39
Q

Management of sickle cell

A

acute

  • morphine
  • O2
  • IV fluids
  • transfusion exchange

chronic
- hydroxycarbamide → decreases DNA synthesis

40
Q

What is HIV?

A
  • human immunodeficiency virus
  • leads to AIDS
  • RNA retrovirus
  • virus enters and destroys CD4 T helper cells
41
Q

How is HIV transmitted?

A
  • unprotected anal, vaginal, oral sex
  • mother to child during pregnancy or breastfeeding → vertical transmission
  • exposure to blood or bodily fluids
42
Q

What are AIDS-defining illnesses?

A

occur when CD4 count drops to level that allows unusual infections and malignancies to appear

  • Kaposi’s sarcoma
  • PCP
  • cytomegalovirus
  • candidasis
  • lymphomas
  • TB
43
Q

Who should be screened for HIV

A
  • everyone admitted to hospital with an infectious disease should be tested
  • patients with risk factors
  • test initially then 3 months after exposure
44
Q

Investigations for HIV

A
  • antibody test
  • p24 antigen → quicker
  • PCR testing for HIV RNA gives viral load
45
Q

Monitoring HIV

A
  • CD4 count
  • viral load
46
Q

Treatment for HIV

A
  • antiretroviral therapy ART
  • aim is normal CD4 count and undetectable viral load
47
Q

Natural progression of HIV

A
  1. acute primary infection → acute seroconversion illness
  2. asymptomatic phase
  3. early symptomatic HIV
  4. AIDS
48
Q

Additional management of HIV

A
  • if AIDS, prophylactic septrin to protect against PCP
  • monitor and reduce CVD risk
  • annual cervical smears for women
  • up to date vaccines, but avoid live vaccines
49
Q

What is HAART?

A
  • highly active ART
  • 2 nucleotide reverse transcriptase inhibitors and 1 non-nucloetide reverse transcriptase inhibitor
  • 2 NRTIs and 1 protease inhibitor
50
Q

What is PEP?

A
  • post exposure prophylaxis
  • must be started within 72 hours
  • combination of ART therapy for 28 days
51
Q

What is PrEP?

A
  • pre exposure prophylaxis
  • Take ART before exposure as prevention
  • highly effective
52
Q

What is leukaemia?

A

cancer of the bone marrow

  1. immature blast cells uncontrollably proliferate
  2. take up space in bone marrow
  3. then infiltrate into other tissues

lack of space in bone marrow → fewer healthy cells can mature and be released into blood

53
Q

What are the 4 types of leukaemia

A
  • acute lymphoblastic
  • acute myeloid
  • chronic lymphoblastic
  • chronic myeloid
54
Q

Features of ALL

A
  • most common leukaemia in children → 0-4
  • proliferation of immature lymphoblasts
55
Q

Presentation of ALL

A
  • general anaemia symptoms
  • bleeding/bruising
  • infections
  • hepatosplenomegaly
  • lymphadenopathy
  • CNS infiltration → headaches, CN palsies
56
Q

Diagnosis of ALL

A
  • FBC → anaemia, thrombocytopenia, neutropenia
  • blood film
  • bone marrow biopsy
  • CT/chest xray → lymphadenopathy

lumbar puncture in cases of CNS involvement

57
Q

Management of ALL

A
  • blood/platelet transfusions
  • chemo → methotrexate
  • steroids
  • stem cell/bone marrow transplant
  • Abs
58
Q

Features of AML

A
  • mostly elderly
  • proliferation of immature myeloblasts
59
Q

Presentation of AML

A
  • general anaemia symptoms
  • bleeding/bruising
  • infections
  • hepatosplenomegaly
  • gum hypertrophy
60
Q

Diagnosis of AML

A
  • FBC → anaemia, thrombocytopnenia
  • blood film
  • bone marrow biopsy → auer rods
61
Q

Management of AML

A
  • blood and platelet transfusions
  • chemo
  • stem cell/bone marrow transplant
  • Abs
62
Q

Features of CLL

A
  • mostly 60+
  • most common type of leukaemia in adults
  • proliferation of B lymphocytes
63
Q

Presentation of CLL

A
  • often asymptomatic
  • lymphadenopathy
  • may have night sweats and weight loss
64
Q

Diagnosis of CLL

A
  • FBC → anaemia, thrombocytopenia, leukocytosis
  • blood film → smudge cells
  • bone marrow biopsy
65
Q

Management of CLL

A
  • watch and wait in early stages
  • chemo → rituximab
  • stem cell/bone marrow transplant
66
Q

Features of CML

A
  • most common in 40+
  • proliferation of myeloid blood cells
  • associated with philadelphia chromosome
67
Q

Presentation of CML

A
  • general anaemia symptoms
  • bleeding/bruising
  • infections
  • hepatosplenomegaly
  • weight loss, night sweats
  • gout
68
Q

Diagnosis of CML

A
  • FBC → anaemia, thrombocytopenia, leukocytosis
  • bone marrow biopsy
  • blood film
  • genetic testing
69
Q

Management of CML

A
  • chemo
  • stem cell/bone marrow transplant
  • tyrosine kinase inhibitors → imatinib
70
Q

Features of hodgkin lymphoma

A
  • proliferation of lymphocytes in lymph nodes
  • associated with EBV, immunosuppression
  • bimodal distribution → early 20s then 70s
71
Q

Presentation of hodgkin lymphoma

A
  • lymphadenopathy → painful upon drinking alcohol
  • B symptoms → fever, night sweats, weight loss
72
Q

Diagnosis of hodgkin lymphoma

A
  • ESR raised
  • CT/chest xray for staging
  • lymph node biopsy → Reed Sternberg cells
73
Q

Management of hodgkin lymphoma

A
  • ABVD chemo
  • radiotherapy
  • steroids
  • stem cell/bone marrow transplant
74
Q

What is ABVD chemo?

A
  • adriamycin
  • belomycin
  • vinblastine
  • decarbazine
75
Q

Features of non-hodgkin lymphoma

A
  • predominantly adults 40+
  • associated with EBV, immunosuppression
76
Q

Presentation of non-hodgkin lymphoma

A
  • painless lymphadenopathy
  • B symptoms
  • can get hepatosplenomegaly
77
Q

Diagnosis of non-hodgkin lymphoma

A
  • CT/chest xray for staging
  • lymph node biopsy → no Reed sternberg
78
Q

Management of non-hodgkin lymphoma

A
  • RCHOP chemo
  • radiotherapy
79
Q

What is RCHOP chemo?

A
  • rituximab
  • cyclophosphamide
  • hydroxy-danorubicin
  • oncovin
  • prednisolone
80
Q

What staging is used for lymphoma staging?

A

Ann Arbor staging

81
Q

What is Ann Arbor staging

A
  1. disease in only one area
  2. disease in 2 or more areas on same side of diaphragm
  3. disease in 2 or more areas on both sides of diaphragm
  4. disease spread beyond lymph nodes
82
Q

Features of multiple myeloma

A
  • predominantly 40+
  • close link to MGUS
83
Q

What is MGUS

A
  • monoclonal gammopathy of undetermined significance
  • too much immunoglobulin released by abnormal plasma cells
  • 1% develop into myeloma
84
Q

Presentation of multiple myeloma

A

CRAB

  • calcium elevation → polydipsia
  • renal impairment
  • anaemia
  • bone lesions → bone pain
85
Q

Diagnosis of multiple myeloma

A
  • FBC → anaemia
  • ESR raised
  • blood film → Rouleaux formation
  • serum and urine electrophoresis → Bence Jones protein in urine
  • bone marrow biopsy
  • CT/xray → bone lesions
86
Q

Management of multiple myeloma

A
  • chemo
  • stem cell transplant
  • analgesia
  • bisphosphonates → zoledronic acid
  • blood transfusions
87
Q

Common chemo combinations for multiple myeloma

A
  • VCD
  • VTD
  • MTP

Phase 2a Green Conditions (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions