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Final year > Haematology > Flashcards

Haematology Flashcards

1
Q

Guidelines for giving fresh frozen plasma (FFP)?

A

in patients with a prothrombin time (PT) ratio or activated partial thromboplastin time (APTT) ratio > 1.5

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2
Q

Guidelines for giving cryoprecipitate?

A

most suited for patients for ‘clinically significant’ but without ‘major haemorrhage’ who have a fibrinogen concentration < 1.5 g/L

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3
Q

Investigation of choice for myeloma?

A

serum protein electrophoresis or urinary Bence-Jones protein should be the investigations of choice.

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4
Q

What is myeloma?

A

Neoplasm of the bone marrow PLASMA cells. (hence plasmacytoma being one of the major criteria to diagnose).

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5
Q

Name the main features of myeloma?

A

C- calcium raised
R- renal failure and raised ESR
A- anaemia
B- bone pain- osteoporosis + fractures

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6
Q

Name some other features of myeloma?

A

amyloidosis e.g. Macroglossia, carpal tunnel syndrome; neuropathy; hyperviscosity

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7
Q

What is raised in the blood in myeloma? (think auto-inflamm)

A

ESR

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8
Q

How can you confirm DIC?

A

prothrombin time is prolonged suggesting a tendency to bleed
fibrinogen levels have been used up for clot formation
significantly high D-dimer level suggest that the patient’s body is working hard to disperse clots

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9
Q

What does warfarin prolong- blood test wise?

A

PT (when someone is having a bleed you give prothrombin complex remember so just think of the opposite of this)

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10
Q

What does heparin prolong- blood test wise?

A

APTT

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11
Q

What clues may indicate a diagnosis of von willebrand?

A

Bleeding post operatively, epistaxis and menorrhagia may indicate a diagnosis of vWD. So increased bleeding time + increased APTT = von willebrand.

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12
Q

What test is key to diagnosing acquired haemophilia?

A

Prolonged APTT

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13
Q

What tests are prolonged in vitamin K deficiency?

A

Prolonged PT and APTT

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14
Q

How do you investigate an unprovoked DVT?

A

Offer all patients diagnosed with unprovoked DVT or PE who are not already known to have cancer the following investigations for cancer:
a physical examination (guided by the patient’s full history) and
a chest X-ray and
blood tests (full blood count, serum calcium and liver function tests) and urinalysis.
consider testing for antiphospholipid antibodies if unprovoked DVT or PE

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15
Q

In sickle cell, what does a sudden anaemia and a low reticulocyte (immature RBC) indicate?

A

Infection with parvovirus

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16
Q

Diagnosis of hereditary spherocytosis?

A

Osmotic fragility test

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17
Q

Why are irradiated blood products used in transplant patients?

A

They are depleted of T lymphocytes.

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18
Q

What is cryoprecipitate made up of?

A

Factor 8 (majority), fibrinogen, vwb factor and factor 13

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19
Q

Treatment of von willebrand?

A

Desmopressin, tranexamic acid for mild bleeding.

20
Q

What is the most useful test to establish whether someone has polycythaemia vera?

A

JAK2 mutation screen

21
Q

Threshold for transfusion in patients with or without ACS?

A

Without- 70

With- 80

22
Q

How do apixaban and rivoroxiban work?

A

Factor 10A inhibitors

23
Q

What type of infection is most likely to occur following a platelet transfusion?

A

Bacterial- because platelets are stored at room temp

24
Q

What condition are ‘tear-drop’ poikilocytes seen on blood film?

A

Myelofibrosis

25
Q

In what condition would you see smudge cells?

A

Chronic lymphocytic leukaemia

26
Q

What is myelofibrosis?

A

abnormal clone of haematopoietic stem cells in the bone marrow and other sites results in fibrosis, or the replacement of the marrow with scar tissue.

27
Q

In what age group do you CT scan patients who have had an unprovoked DVT/PE?

A

Over 40

28
Q

Disproportionate microcytic anaemia ( ie really low MCV but not that low Hb)

A

Think beta thal trait

29
Q

The translocation t(9:22)/ philadelphia chromosome is seen in which condition?

A

Chronic myeloid leukaemia

30
Q

What is the most commonly inherited thrombophilia?

A

Factor V leiden/Activated protein C resistance deficiency. NICE recommends testing for thrombophilia in unprovoked DVTs

31
Q

Low platelets + raised fibrin degradation products =?

A

DIC

32
Q

Which type of leukaemia causes splenomegaly?

A

CML M for MEGALY

33
Q

Causes of thrombophilia?

A

Protein S deficiency
Antithrombin 3 deficiency
Protein C deficiency
Activated protein C resistance/ factor V leiden

34
Q

Turn over

A

CML- neutrophila

CLL- lymphocytosis

35
Q

Side effects of heparin?

A

Osteoporosis and heparin induced thrombocytopenia

36
Q

What is hess test?

A

A test for capillary fragility in scurvy. A slight pressure is applied to the arm for 5 minutes and a shower of petechiae (small blood spots) appear on the skin below the area of application.

37
Q

Side effect of chloramphenicol?

A

Grey baby syndrome

38
Q

What are the causes of restless leg syndrome?

A

Low ferriten and hyperthyroid?

39
Q

Roughly how low does your platelet count have to be before you start spontaneously bleeding?

A

<20

40
Q

Causes of splenomegaly?

A 
Myelofibrosis
Chronic myeloid leukaemia
Sickle cell/ spherocytosis (due to increased turnover and breakdown of faulty RBCs)
Malaria/mumps
Portal hypertension
Amyloid
41
Q

Most common cause of B12 deficiency?

A

Pernicious anaemia

42
Q

Age presentations in hodgkins and non?

A

Hodgkins peaks at 20-30, where as non-hodgkins increases with age.

43
Q

INR target for for VTE?

A

2.5

44
Q

INR target for recurrent VTE?

A

3.5

45
Q

Target INR in AF?

A

2.5

Final year (16 decks)

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