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(SG) Phase 2A lectures > haem > Flashcards

haem Flashcards

1
Q

what are the 2 main types of leukaemia?

A

acute myeloid leukaemia

acute lymphoblastic leukaemia

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2
Q

the acute leukaemia present with signs of what?

A

bone marrow failure

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3
Q

define neutropaenia

A

low neutrophil count in the blood

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4
Q

what is thrombocytopaenia?

A

condition characterized by abnormally low levels of thrombocytes (aka platelets) in the blood

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5
Q

what are signs of bone marrow failure? (3)

A

anaemia

neutropaenia

thrombocytopaenia

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6
Q

what are the additional signs of acute leukaemia?

A

high temp

weight loss

sweats

bony pains

headaches

seziures

swelling of lymph glands

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7
Q

list some risk factors of acute leukaemia?

A

radiation

benzene

smoking

prior blood disorders

genetic conds eg DW

previous chemo/radio

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8
Q

diagnosis of acute leukaemia is mainly based on what?

A

more than 20% blasts on bone marrow exam

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9
Q

taking which blood test may be all it takes to diagnose leukaemia?

A

FBC

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10
Q

what does AML stand for?

A

acute myeloid leukaemia

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11
Q

what is AML?

A

a type of cancer in which the bone marrow makes abnormal myeloblasts (type of WBC), RBC or platelets

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12
Q

what is AML a cancer of

A

the blood n bone marrow

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13
Q

AML can develop from which cells?

A

myeloid stem cell or myeloid blast

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14
Q

how can AML be diagnosed?

A

blood tests or bone marrow aspirate/trephine biopsy

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15
Q

how can AML be treated?

A

chemotherapy supportive measures

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16
Q

what are some symptoms of lymphomas?

A

LN enlargement

loss of appetite

loss of weight

night sweats

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17
Q

what are signs of lymphoma?

A

LN enlargement

hepatosplenomegaly

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18
Q

what are some investigations of lymphoma?

A

biopsy

blood tests

scan

bone marrow biopsy

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19
Q

what is LN?

A

lymph node

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20
Q

define lymphoma

A

a malignant growth of WBC (predominantly in lymph nodes) but also can be in blood/bone marrow, liver, spleen

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21
Q

cancer affecting blood/bone marrow = ?

A

leukaemia

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22
Q

cancer affecting blood cells = ?

A

lymphoma

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23
Q

how are lymphomas diagnosed?

A

blood film n bone marrow or lymph node biopsy (diagnosis is complex)

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24
Q

how do u assess bloods of a lymphoma patient

A

fbc

u&es

LFT

viral serology (HIV, hep B, hep C)

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25
Q

what are the 2 types of lymphoma

A

hodgkin’s

NHL

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26
Q

what are the types of NHL

A

low grade

high grade

v high grade

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27
Q

how can we quantify cancer patients’ general well-being and activities of daily life?

A

(WHO) performance status

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28
Q

why is performance status used?

A

to determine whether patient can receive chemotherapy, whether dose adjustment is necessary, and as a measure for the required intensity of palliative care

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29
Q

what are the different categories of performance status?

A

0 - asymptomatic

1 - symptomatic but completely ambulatory

2 - symptomatic, <50% in bed during the day

3- symptomatic, >50% in bed, but not bed bound

4 - bedbound

5 - death

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30
Q

what is stage 0 of the WHO performance status?

A

asymptomatic

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31
Q

what is stage 1 of the WHO performance status?

A

symptomatic but completely ambulatory (restricted strenuous activity but able to carry out work of a light nature)

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32
Q

what is stage 2 of the WHO performance status?

A

symptomatic, <50% in bed during the day (ambulatory and capable of all self care but unable to carry out any work activities. up n about for more than 50% of waking hrs)

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33
Q

what is stage 3 of the WHO performance status?

A

symptomatic, >50% in bed, but not bedbound (limited self-care, confined to bed or chair 50%+ of waking hrs)

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34
Q

what is stage 4 of the WHO performance status?

A

bedbound (cannot carry on any self-care. totally confined to bed or chair)

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35
Q

what is stage 5 of the WHO performance status?

A

death :/

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36
Q

how many clinical stages in Hodgkin’s lymphoma?

A

4

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37
Q

what is diff btwn A and B Hodgkin’s lymphoma

A

A = absence of symptoms

B = presence of ‘B’ symptoms

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38
Q

how do u treat Hodgkin’s lymphoma?

A

depends on clinical stage

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39
Q

what are some late effects of Hodgkin’s lymphoma

A

infertility

second cancers

psych issues

drug side effects

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40
Q

what is non-hodgkin’s lmyphoma like?

A

more varied

more categories

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41
Q

what is an example of low grade NHL

A

follicular lymphoma

42
Q

can low-grade NHL be cured

A

no its usually advanced at presentation can’t do nothing

43
Q

what does ABVD stand for

A

adriamycin

bleomycin

vinblastine

dacarbazine

44
Q

what is the chemotherapy regimen used in 1st line treatment for Hodgkin’s lymphoma

A

ABVD

45
Q

where are most non-hodgkin’s lymphoma derived from

A

B cell lines

46
Q

DEFINE anaemia

A

reduced cell mass (with or without Hb concentration)

47
Q

what is the normal range of Hb for men?

A

131-166g/L

48
Q

what is the normal range of Hb for women?

A

110-147g/L

49
Q

what are some consequences of anaemia?

A

reduced oxygen transport

tissue hypoxia

compensatory changes

50
Q

what are some compensatory changes as a result of anaemia

A

increased tissue perfusion

increase oxygen transfer to tissues

increased rbc production

51
Q

what are some pathological consequences of anaemia :(

A

myocardial fatty change

fatty change in liver

aggravated angina/claudication

skin n nail atrophic changes

CNS cell death

52
Q

what is the lifespan of rbc

A

approx 120days

53
Q

how are rbc removed from the body?

A

spleen

liver

bone marrow

blood loss

54
Q

where are rbc produced?

A

bone marrow

55
Q

in clinical practice, how do we approach anaemia? (3 types)

A
  1. microcystic
  2. normocytic
  3. macrocytic
56
Q

why may microcytic anaemia happen?

A

iron deficiency

chronic disease

thalassaemia

57
Q

why may normocytic anaemia occur?

A

acute blood loss

anaemia of chronic disease

combined haematinic deficiency

58
Q

why may macrocytic anaemia occur?

A

b12/folate deficiency

alcohol excess/liver disease

hypothyroid

haematological causes: anti met therapy, haemolysis, bone marrow failuer

59
Q

how do u investigate B12 deficiency?

A

IF antibodies

schilling test

coeliac antibodies

60
Q

what are IF antibodies?

A

proteins produced by the immune system that are associated with pernicious anemia.

this test detects IF antibody circulating in blood

61
Q

when may a schilling test be done? (procedure to see whether or not ur absorbing vii D properly)

A

vit D deficiency

pernicious anaemia

62
Q

what are reticulocytes

A

RBC precursor

63
Q

a small decease in red cell survival can be compensated by what?

A

increased EPO

reduced apoptosis

64
Q

a large decrease in red cell survival can be compensated by what?

A

can’t –> haemolytic anaemia

65
Q

what are haemoglobinopathies

A

genetic defect that results in a disorder of Hb structure can be a disorder of quality or quantity

66
Q

name a disorder of Hb quality (haemoglobinopathies)

A

sickle cell disease

67
Q

name a disorder of Hb quantity (haemoglobinopathies)

A

alpha/beta thalassaemia

68
Q

what is the diff btwn alpha n beta thalassaemia?

A

alpha - reduced or absent synthesis of alpha globin chains

beta - reduced or absent synthesis of beta globin chains

69
Q

which ethnic pops are more likely to get alpha thalassaema?

A

eastern mediterranean, far east

70
Q

what are the diff types of thalassaemia?

A

major (transfusion dependent)

intermedia (less severe anaemia, can survive w/o transfusions regularly)

carrier/heterozygote (asymptomatic)

71
Q

what is the age of presentation for beta thalassaemia (major)?

A

6-12m

72
Q

what are some complications of beta thalassaemia?

A

transfusion-transmitted infections

hypopituitarism/hypothyroidism/parathyroidism

pul hypertension/embolism

cardiomyopathy

splenomegaly

DM

osteoporosis

short stature

73
Q

what is some supportive therapy for beta thalassaemia?

A

transfusion

hormone replacement

vitamin d (osteoporosis)

74
Q

which organs may be affected by iron overload?

A

pit/thyroid/parathyroid/adrenal gland

heart n circulation

liver

pancreas

testis

ovary

75
Q

carriers of HbS (sickle cell) are what?

A

symptom free

76
Q

carriage of HbS (sickle cell) offers protection against what?

A

falciparum malaria

77
Q

sickle cell diseases arise when

A

homozygous state (SS) combined heterozygotes (SC or Sbeta thalassaemia)

78
Q

what are some acute complications of sickle cell?

A

painful crisis

sickle chest syndrome stroke :/

79
Q

what are some chronic complications of sickle cell?

A

renal impairment

pulmonary hypertension

joint damage

80
Q

what is the most common inherited disease in england

A

sickle cell

81
Q

where are platelets produced

A

bone marrow

82
Q

what is platelet production regulated by??

A

thrombopoietin

83
Q

where is thrombopoietin produced

A

liver

84
Q

what is the lifespan of platelets?

A

7-10days

85
Q

what are some surface proteins of platelets

A

ABO

HPA

HLA

class I glycoproteins

86
Q

what are platelets activated by?

A

adhesion to collagen via GPIa

adhesion to vWF via GPIb and IIb/IIIa

87
Q

what does platelet activation lead to

A

release of alpha granules containing eg fibrinogen, vWF release of dense granules

88
Q

cross-linking of activated platelets that have aggregated together is mediated by what?

A

fibrin

89
Q

activated platelets provide a neg charged phospholipid surface. this allows what?

A

coagulation factors to bind enhances clotting cascade

90
Q

how can the number of platelets be tested?

A

FBC

91
Q

how can appearance of platelets be tested?

A

blood film

92
Q

list some problems that cause bleeding

A

injury

vascular disorders

LOW PLATELETS

ABNORMAL PLATELET FUNCTION

defective coagulation

93
Q

what are some clinical features of platelet dysfunction?

A

mucosal bleeding (nose/gum bleeds)

easy bruising

traumatic haematomas

94
Q

what is epistaxis?

A

nose bleed

95
Q

what is menorrhagia?

A

excessive menstrual bleeding

96
Q

what are some causes of low platelets?

A

production failure (congenital/acquired eg drugs, marrow failure)

increased removal (immune, consumption, splenomegaly)

artifactual

97
Q

what are some causes of impaired platelet function?

A

congenital (platelet disorders, von willebrand disease)

acquired (uraemia, drugs)

98
Q

define uraemia

A

raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys

99
Q

what is thrombocytopenia?

A

abnormally low levels of platelets

100
Q

what are thrombocytes?

A

platelets

101
Q

b12 and folate contribute to what?

A

DNA synthesis

102
Q

what are some types of thrombocytopenia?

A

decreased production

increased destruction

(SG) Phase 2A lectures (14 decks)

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