6. BAMS Haematology Flashcards Preview

BDS2 REVISION > 6. BAMS Haematology > Flashcards

Flashcards in 6. BAMS Haematology Deck (13):
1

List 3 functions of blood

Name 3 conditions caused by low numbers of blood components

What are they due to

Name 3 conditions caused by high numbers of blood components

What are they due to

List 2 functions of therapeutic coagulopathy

Transport nutrients, remove waste, transport host defences

Anaemia (low Hb), leukopenia (low WCC), thrombocytopenia (low PLT)

One - reactive change to environment; multiple - due to bone marrow failure

Polycythaemia (high Hb), leucocytosis (high WCC), thrombocythaemia (low PLT)

One - reactive change to environment; multiple - pre-neoplastic

Reduce platelet adhesion and function and reduce coagulation cascade activity

2

Porphyria

What is porphyria

List 2 types of porphyria

List 4 symptoms/signs

List 5 triggers

Abnormality in haem metabolism

Hepatic, erythropoietic

Photosensitive rash, neuropsychiatric disturbances, HTN, tachycardia

Drugs, pregnancy, alcohol, fasting, acute infection (possible cause of LA allergy)

3

Malignancies

List 4 stages of normal blood disorder process

List the 4 stages of tumour formation

List 4 treatments for blood malignancies

Induction, remission, maintenance and consolidation and relapse

Clonal proliferation, cancer cell formation by uncontrolled proliferation, loss of apoptosis, loss of normal functions/products

Chemotherapy, radiotherapy, stem cell transplants, monoclonal antibodies

4

Leukaemia

What is leukaemia

List 5 presentations of leukaemia

List and describe 4 different types of leukaemia

Neoplastic proliferation of white cells, usually a disseminated malignancy

Anaemia, neutropenia, thrombocytopenia, bone pain, lymphadenopathy, splenomegaly/hepatomegaly

Acute lymphoblastic leukaemia - younger patient, catabolic state, lymphadenopathy, tissue infiltration, fever
Acute myeloid leukaemia - similar to ALL but elderly patient
Chronic lymphoblastic leukaemia - elderly patient, B-cell lymphoproliferative disease, slow progression
Chronic myeloid leukaemia - older adults, neutrophils and precursors, weight loss, tired, bleeding, anaemia. 95% Philadelphia chromosome

5

Lymphoma

What is lymphoma

What does staging involve

List and describe 2 different types of lymphoma

Features of multiple myeloma

Neoplastic proliferation of white cells, usually a solid tumour

Number of nodes, extra-nodal involvement, systemic symptoms

Hodgkin's lymphoma - younger adults, lymphadenopathy, fever, night sweats, weight loss
Non-Hodgkins lymphoma - autoimmune disease, immunosuppression, microbial factors, lymphadenopathy, marrow failure

Malignant proliferation of plasma cells, lytic bone lesions, marrow failure, elderly, infection, bone pain, renal failure

6

Anaemia

What is anaemia

What are the 3 main causes of anaemia

What are the 3 types of anaemia and give an example of a cause for each type

List 4 symptoms

List 2 main types of treatment

List 3 causes of iron deficiency

List 4 intra-oral side effects of iron deficiency

List 2 causes of vitamin B12 deficiency

List 2 causes of folate deficiency

What can a folate deficiency in foetus cause

Reduction in haemoglobin

Increased demand, increased loss, decreased production

Microcytic (iron deficiency), microcytic (folate/vitamin B12 deficiency), normocytic (reduced number - bleeding)

SoB, tired, dizzy, weak, pale, increased HR

Replace haematinics, blood transfusion

Gastric ulcers/erosion, IBDs, bowel cancer

Mucosal atrophy, candidiasis, ROU, burning mouth syndrome

Lack of intake, lack of intrinsic factor

Lack of intake, absorption failure

Defect in neural tube --> spina bifida

7

Thalassemia and Sickle Cell Anaemia

What is thalassemia

What can thalassemia cause

How is it managed

What is sickle cell anaemia

How can it lead to ischaemia

List 2 main causes of blood loss

Globin chain mutation

Chronic anaemia, marrow hyperplasia, splenomegaly, cirrhosis, gallstones

Blood transfusion (prevent iron overload)

Abnormal global chains - curved RBCs due to low Hb and oxygen environments

RBCs cannot pass through capillaries, leading to ischaemia, pain and necrosis

Gastritis (alcohol) and NSAIDs

8

Drugs

What does warfarin do

How is it measured

List 3 warfarin potentiating 'drugs'

List 1 warfarin inhibiting 'drug'

List 2 contraindications of warfarin

Name 1 major risk of warfarin

List 3 antiplatelets and what they do

Which 2 are often used together and why

Inhibits synthesis of vitamin K-dependent clotting factors

INR - target of 1.0 (<3.5/4.0 for dental treatment)

Antibiotica, NSAIDs, alcohol with liver disease

Alcohol without liver disease

Aspirin, antifungals

Haemorrhage

Aspirin - reduces platelet aggregation
Clopidogrel - reduces ADP-induced platelet aggregation
Dipyridamole - inhibits platelet phosphodiesterase

Aspirin and clopidogrel - to enhance their effect and secondary to MI

9

Haemophilia

What type of genetic condition is haemophilia and what are the requirements to develop it

What are the 3 types of haemophilia, with their associated deficiencies

How are main types treated

Sex-linked recessive (males affected, females carriers) - both parents must have it (mother carrier, father affected)

Type A (FVIII deficiency), Type B (FIX deficiency), Type C (FXI deficiency)

A - if severe/moderate with recombinant FVIII, if mild/carriers - DDAVP, if very mild - oral tranexamic acid (prevents blood loss). B - do not respond to DDAVP so prophylactic cover requires recombinant FIX

10

Von Willebrand Disease

What type of genetic condition is it and what are the requirements to develop it

What effect does von Willebrand disease have

What are the 3 types and describe the presentation

Treatment

Autosomal dominant, both sexes equally affected

Reduced FVIII and platelet aggregation

Types 1 and 2 (dominant and mild), type 3 (recessive and severe)

Majority to DDAVP, some only require oral tranexamic acid

11

Thrombophilia

What is this

What does it cause

What can it lead to

List 4 exacerbating factors

Acquired disease superimposed on genetic condition

Increased risk of clotting/excessive tendency to clot (DVT)

Pulmonary embolism

Smoking, immobility, surgery, pregnancy

12

Haemostasis

List the three stages involved in clotting

Describe each stage

Bleeding and vasodilation, platelet plug formation, coagulation

Bleeding and vasodilation
Platelet plug formation - platelets aggregate and form a temporary seal in broken BV wall, activated by von Willebrand factor in plasma
Coagulation - fibrin reinforces platelet plug. Clotting factors (coagulation cascade) --> insoluble fibrin formation

13

Inherited Syndromes

What does antithrombin III do

What are protein C and S and what do they do

Name 2 types of bleeding tests

Name 2 types of clotting tests

Inactivates coagulation system enzymes

Vitamin K-dependent glycoproteins - co-factors that inactivate FVa and FVIIIa --> regulate anticoagulation, inflammation, cell death and maintains BV permeability

FBC, PLT

INR, APPT