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Y5 Pathology > Haem - General > Flashcards

Haem - General Flashcards

1
Q

Blood film: microcytic, hypochromic cells with anisocytosis, poikilocytosis and pencil cells

A

Iron Deficiency anaemia

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2
Q

Signs: Angular cheilosis, brittle hair/nails, Plummer-Vinson syndrome, koilonychia, atrophic glossitis

A

Iron deficiency anaemia

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3
Q

Blood results: Iron low, Ferritin low, TIBC raised, Saturation low

A

Iron deficiency anaemia

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4
Q

Blood film: basophilic stippling

A

Lead poisoning

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5
Q

Blood film: erythroid precursors with iron deposited in mitochondria in a ring around the nucleus, dimorphic RBCs

A

Sideroblastic anaemia

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6
Q

Blood results: Iron high, TIBC normal, Ferritin high

A

Sideroblastic anaemia

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7
Q

Blood results: iron high, TIBC low, ferritin high

A

Chronic haemolysis

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8
Q

Blood film: hypersegmented polymorphs, leucopenia, RBC precursors with immature nucleus and mature cytoplasm, macrocytosis,

A

Megaloblastic anaemia (B12/folate/cytotoxic drugs)

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9
Q

Mouth: Glossitis, angular cheilosis
Neuropsychiatric: Irritability, depression, psychosis, dementia.
Neurological: Paraesthesiae, peripheral neuropathy (loss of vibration and proprioception first, absent ankle reflex, spastic paraperesis, subacute combined degeneration of spinal
cord)

A

Vitamin B12 deficiency

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10
Q

Blood results: raised Hb, low haptoglobins, raised LDH, Raised reticulocytes, raised unconjugated bilirubin
+ dark red urine + haem and albumin in urine

A

Intravascular haemolysis

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11
Q

Blood results: raised Hb, raised LDH, Raised reticulocytes, raised unconjugated bilirubin
+ splenomegaly

A

Extravascular haemolysis

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12
Q

Aetiology of hereditary spherocytosis

A

Autosomal dominant
Deficiency in spectrin or ankyrin

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13
Q

Results:
Osmotic fragility test: raised
DAT coombs NEGATIVE

A

Hereditary spherocytosis

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14
Q

Aetiology of hereditary eliptocytosis

A

Almost all autosomal dominant
Spectrin mutation
Except for Hereditary Pyropoikilocytosis (erythrocytes are abnormally
sensitivity to heat) – autosomal recessive (small print)

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15
Q

What is the aetiology of Glucose-6-phosphate dehydrogenase (G6PD) Deficiency

A

X-linked recessive

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16
Q

Blood film: bite cells, heinz bodies (blue deposits, oxidised Hb)

A

G-6-PD deficiency

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17
Q

Investigations for G6PD deficiency

A

Film: Heinz bodies (Methyl violet stain) and bite cells
Fluorescent spot test (G6PD and NADP)
Methaemoglobin (Methylene blue)
Guthrie spot
G6PD activity

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18
Q

Blood film: Spherocytes, echinocytes (hedgehog-like)

A

Pyruvate kinase deficiency

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19
Q

What is Donath-Landsteiner antibodies

A

stick to RBCs in cold → complement-mediated haemolysis on rewarming (self-limiting as IgG so dissociate at higher temp than IgM).

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20
Q

Ham’s test +ve

A

Paroxysmal nocturnal haemoglobinuria

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21
Q

Blood film: schistocytes

A

MAHA

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22
Q

Antibodies against ADAMTS13

A

Thrombotic thrombocytopenic prupura

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23
Q

aetiology of Paroxysmal nocturnal haemoglobinuria

A

PIG A

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24
Q

Sickle cell disease aetiology

A

Autosomal recessive
Glu → Val on codon 6 of beta chain (Chr 11) → HbS

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25
Q

Skull bossing, maxillary hypertrophy, hairs on end skull X-ray

A

Beta thalassaemia

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26
Q

Blood film:
Teardrop RBCs (+Aniso and poikilocytosis)
Nucleated RBCs
Immature myeloid cells/myelocytes

A

Leucoerythroblastic anaemia

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27
Q

blood film: heavy toxic granulation of neutrophils, vacuoles seen

A

Reactive neutrophilia e.g. to infection

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28
Q

Coagulation results: APTT prolonged, PT/INR normal

A

Haemophilia OR VWD

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29
Q

Results:
Platelets low
Fibrinogen low
High fibrin degradation products/D-dimer
Long PT/INR

A

DIC

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30
Q

Results:
II, V, VII, IX, X, XI, fibrinogen low
VIII and VWF high

A

Liver disease

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31
Q

anti cardiolipin, lupus anticoagulant

A

APLS

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32
Q

BCR-ABL Ph Chr translocation t(9;22)

A

Chronic myeloid leukaemia

33
Q

Treatment for CML

A
  1. Imatinib
  2. Other tyrosine kinase inhibitor
  3. SCT
34
Q

CD34, CD33/13/117

A

Acute myeloid leukaemia

35
Q

Auer rods, sudan black stain, myeloperoxidase stain

A

Acute myeloid leukaemia

36
Q

Treatment for acute myeloid leukaemia

A
  1. Chemo
  2. Targeted e.g. anti-CD33 (Gemtuzumab)
  3. SCT
37
Q

t(15;17)

A

Acute promyelocytic leukaemia

38
Q

PML-RARA

A

Acute promyelocytic leukaemia

39
Q

> 20% blasts CD 19, 20, 22, CD34

A

B cell ALL

40
Q

> 20% blasts CD 3, 4, 8, CD34

A

T cell ALL

41
Q

CD5 + CD 23 +

A

CLL

42
Q

Smear cells on blood film

A

CLL

43
Q

Staging for CLL

A

Rai and binet
Binet:
A: <3 lymphoid tissues
B: >3 lymphoid tissues
C: Hb <100, Plt <100 (+ B symptoms)

Rai:
0: lymphocytosis only
1: lymphadenopathy
2: Hepatosplenomegaly
3: Hb <11
4: Platelets <100

44
Q

Flower cells on blood film

A

ATLL

45
Q

IgH-BCL2

A

Follicular B cell lymphoma

46
Q

IgH-Cyclin D1

A

Mantle cell B cell lymphoma

47
Q

IgH-MYC

A

Burkitt’s lymphoma

48
Q

t(14;18)

A

Follicular lymphoma

49
Q

Lymph node biopsy: neoplastic follicles, positive CD10 and bcl-2 staining, centroblasts

A

Follicular lymphoma

50
Q

Lymph node biopsy: small lymphocytes, arises from naive B cells, CD5 and CD23 positive

A

Small lymphocytic lymphoma (CLL but in lymph nodes)

51
Q

Lymph node biopsy: from germinal centre/post-germinal centre, sheets of large lymphoid cells

A

Diffuse large B cell lymphoma

52
Q

Lymph node biopsy: mantle zone, arising from pre-germinal centre cells, expression of CD5 and cyclin D1, clefted nuclei

A

Mantle cell lymphoma

53
Q

Molecular: t(11;14), cyclin D1 overexpression

A

Mantle cell lymphoma

54
Q

CD15, CD30 positive, CD20 negative

A

Classical Hodgkin’s lymphoma

55
Q

CD20 positive, CD15, CD30 negative

A

Nodular lymphocyte predominant lymphoma

56
Q

Hypercellular marrow, lack of separation between RBCs, ringed sideroblasts, bilobed nuclei, reduced granulation of granulocytes, micro-megakaryocytes with hypolobulated nuclei

A

Myelodysplasia

57
Q

Pelger-Huet anomaly

A

Hyposegmented neutrophils
Myelodysplasia

58
Q

Short stature, hypogonadism, cafe au lait spots, thumb abnormalities, microcephaly, developmental delay

A

Fanconi anaemia

59
Q

Marrow failure
Cancer predisposition
Somatic abnormalities: leukoplakia, nail dystrophy, skin pigmentation

A

Dyskeratosis congenita

60
Q

JAK2

A

Polycythaemia vera
Essential thrombocythaemia

61
Q

JAK2, calreticulin, MPL

A

Essential thrombocythaemia

62
Q

Tear drop poikilocytes

A

Myelofibrosis

63
Q

Dry tap bone marrow

A

Myelofibrosis

64
Q

Blood transfusion → hypotension + tachy ± laryngeal/facial oedema, wheeze, SOB in minutes

A

Anaphylaxis

65
Q

Blood transfusion → restless, chest/loin pain, fever, vomiting, flushing, collapse, haemoglobinuria (later)

A

ABO incompatibility

66
Q

Blood transfusion → mild urticarial or itchy rash sometimes with a wheeze

A

Allergic reaction

67
Q

Blood transfusion → rise in temperature by around 1 degree, chills and rigors

A

Non-haemolytic febrile reaction

68
Q

M-spike <30
BM plasma cells <10%
No CRAB symptoms

A

Monoclonal gammoglobulinopathy of unknown significance

69
Q

M spike <30
BM plasma cells >10%
No CRAB symptoms

A

Shouldering

70
Q

M spike <30
BM plasma cells >10%
CRAB symptoms

A

Multiple myeloma

71
Q

Bence Jones proteins in urine electrophoresis

A

Multiple myeloma

72
Q

Dense narrow band on serum electrophoresis

A

Multiple myeloma

73
Q

BM plasma cells >60%
Involved:uninvolved ratio >100
>1 focal lesion on MRI >5mm
CD138 +

A

Myeloma defining events

74
Q

Hepatosplenomegaly
Lymphadenopathy
Pancytopenia
Hyperviscosity Sc: peripheral neuropathy, visual Sx, headache, bleeding

A

Waldenstrom’s macroglobulinaemia

75
Q

Nephrotic syndrome
Heart failure
Sensory neuropathy
Macroglossia

A

AL amyloidosis

76
Q

Rash, diarrhoea, jaundice after transplant

A

Acute GvHD

77
Q

Rash, hepatitis, dry eyes, dry mouth, mouth ulcers, SOB, arthritis after transplant

A

Chronic (>100 days) GvHD)

78
Q

Blood film: Rouleaux

A

Multiple myeloma

78
Q

Blood film: Rouleaux

A

Multiple myeloma

Y5 Pathology (71 decks)

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