Brainscape's Knowledge GenomeTM

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


See full index

WFH > Haematology + oncology > Flashcards

Haematology + oncology Flashcards

1
Q

causes of microcytic anaemia

A

Iron deficiency (hypochromic microcytic)
Thalassaemia
Anaemia of chronic disease (rarely)

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

causes of normocytic anaemic

A 
Acute bleeding
Haemolysis
- congenital
- acquired
Aplastic anaemia
Anaemia of chronic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

causes of macrocytic anaemia

A

Vitamin B12 deficiency, folate deficiency = both may cause pancytopenia

Macrocytosis without anaemia:

  • liver disease
  • hypothyroidism
  • alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

acute leukaemia is due to…

A

failed differentiation of cells, leads to large numbers of malignant precursor cells in the bone marrow

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

chronic leukaemia is due to…

A

chronic leukaemia is the result of excessive proliferation of mature malignant cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

acute lymphoblastic leukaemia features

A

abnormal clinical proliferation of lymphoid progenitor cells

  • typically affects children
  • bone marrow failure: anaemia, leukopenia, thrombocytopenia
  • organ infiltration: lymphadenopathy, hepatosplenomegaly, bone pain, CNS involvement (eg. nerve palsy), testicular swelling
  • high blast cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

differentiating ALL from AML

A

blood film shows different precursor cells

AML cells have Auer rods on microscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

features of acute myeloid leukaemia

A

abnormal clinical proliferation of myeloid progenitor cells

  • typically affects adults + elderly
  • associated with myelodysplastic syndromes
  • bone marrow failure: anaemia, leukopenia, thrombocytopenia
  • organ infiltration: hepatosplenomegaly, bone pain, gum hypertrophy
  • high blast cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

features of myelodysplastic syndrome

A

“Premalignant” condition of haematopoietic precursors

  • affects elderly
  • may present with anaemia, thrombocytopenia, pancytopenia, may be asymptomatic
  • may become acute myeloid leukaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

features of chronic myeloid leukaemia

A
  • typically affects middle-aged patients (men more commonly)
  • usually associated with Philadelphia chromosome
  • symptomatic anaemia eg. SOB, fatigue
  • weight loss
  • massive splenomegaly
  • bleeding/bruising
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

investigations for chronic myeloid leukaemia

A
  • leukocytosis (high neutrophils/basophils/eosinophils/monocytes)
  • Philadelphia chromosome (t9:22)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

management of chronic myeloid leukaemia

A
  • presence of Philadelphia chromosome = imitanib

- chemotherapy

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

features of chronic lymphocytic leukaemia

A

proliferation of functionally incompetent malignant B cells
- most common in male patients over the age of 60
- often asymptomatic
- may have symptoms of
> bone marrow failure eg. anaemia, infection prone, bleeding
> cancer: weight loss, night sweats
> infiltration: hepatosplenomegaly, lymophadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

investigations for chronic lymphocytic leukaemia

A

FBC: lymphocytosis, anaemia
blood film: smudge cells
immunophenotyping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

features of Hodgkin’s lymphoma

A
  • typically young adults
  • painless lymphadenopathy
  • B symptoms: night sweats, weight loss, fever
  • may be pain on drinking alcohol
  • peaks at 15-35yrs and >55
  • Reed-Sternberg cell diagnostic on biopsy of lymph node
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

RFs for Hodgkin’s lymphoma

A
  • Epstein-Barr Virus
  • HIV
  • immunosuppression
  • smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

types of Non-Hodgkin’s lymphoma

A
  • indolent or low grade eg. follicular lymphoma
    > gradual onset, usually advanced at presentation
    > may be asymptomatic
    > incurable but treatable (use for watchful waiting), median survival 10 years
  • aggressive or high grade eg diffuse large B cell lymphoma
    > rapidly progressive
    > usually symptomatic: painless lymphadenopathy, B symptoms, extranodal (gastric, bone marrow, CNS symptoms)
    > potentially curable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

management of lymphoma

A

manage symptoms

  • chemotherapy
  • radiotherapy
  • stem cell transplantation
19
Q

associations with non-Hodgkin’s lymphoma

A
  • Helicobacter pylori with gastric MALT (mucosa-associated lymphoma tissue)
  • Epstein Barr virus with Burkitt’s lymphoma and AIDS-related CNS lymphoma
  • Hepatitis C virus with diffuse large B-cell lymphoma and splenic marginal zone lymphoma
  • Human T cell lymphotropic virus type 1 with T-cell lymphoma
20
Q

poor prognostic markers of lymphoma

A

low haemoglobin and raised LDH (high red cell turnover)

21
Q

blood markers of tumour lysis syndrome

A
  • U&E:
    > high: potassium, phosphate, uric acid, creatinine
    > low: calcium
  • ECG may have arrhythmias related to hyperkalaemia
22
Q

prophylaxis of tumour lysis syndrome

A
  • IV allopurinol
  • OR IV rasburicase
  • if TLS develops:
    > fluids
    > electrolyte balance
    > supportive
23
Q

features of multiple myeloma

A 
CRABBI
Calcium (hypercalcaemia)
Renal failure (high creatinine and urea)
Anaemia
Bone lesions (lytic)
Bleeding
Infections
24
Q

markers of multiple myeloma

A
  • Bence Jones proteins (in urine)
  • monoclonal IgA/G in serum
  • raised monoclonal plasma cells on bone marrow biopsy
  • blood film = rouleaux formation
  • whole body MRI done to check for bone lesions (pepperpot skull)
25
Q

management of multiple myeloma

A
  • stem cell transplant in young/few comorbidities
  • chemotherapy
  • supportive
    > analgesia, bisophosphonates, surgery/physiotherapy for bone disease, EPO for anaemia
26
Q

diagnosis of amyloid

A

rectal tissue biopsy and apple-green birefringence when stained with Congo red and viewed under polarised light

27
Q

normal haemostasis

A
  • localized vasoconstriction at the site of injury
  • adhesion of platelets to damaged vessel wall and
    formation of a platelet aggregate or plug
  • activation of the coagulation cascade leading to fibrin formation, reinforcing the platelet plug
  • activation of the fibrinolytic system which digests the
    haemostatic plug, re-establishing vascular patency
28
Q

management of thrombosis

A

Arterial thrombosis – Antiplatelet drugs

Venous thrombosis – Anticoagulant drugs

29
Q

causes of DIC

A
  • sepsis
  • obstetric
  • malignancy
  • trauma
30
Q

management of DIC

A

treat underlying cause

- plasma and platelets if bleeding

31
Q

warfarin acts on:

A

Vit K antagonist

- factors X IX VII II remember as 1972

32
Q

symptoms of ITP (immune thrombocytopenia)

A
  • petichae, purpura

- bleeding (e.g. epistaxis)

33
Q

management of ITP (immune thrombocytopenia)

A
  • oral prednisolone
  • IVIG
  • splenectomy in refractive
34
Q

features of TTP (thrombotic thrombocytopenic purpura)

A

deficiency of ADAMTS13 leads to vWF causing clumping of platelets

  • fever
  • fluctuating neuro signs (microemboli)
  • microangiopathic haemolytic anaemia
  • thrombocytopenia
  • renal failure
35
Q

mutation in polycythaemia rubra vera

A

JAK2

36
Q

constituents of haemoglobin

A 
HbA = 2α + 2β
HbA2 = 2α + 2𝛿
HbF = 2α + 2γ
37
Q

management of sickle cell crisis

A
  • high flow oxygen
  • IV fluids
  • analgesia
  • top-up transfusions may be required in severe cases
38
Q

long term sickle cell anaemia management

A
  • hydroxycarbamide: increases the HbF levels and is used in the prophylactic management of sickle cell anaemia to prevent painful episodes
  • pneumococcal vaccine every 5 years
39
Q

iron deficiency further investigations

A

if unexplained (eg. men and post-menopausal women), endoscopy and colonoscopy required (gastro referral within 2 weeks if Hb <100 in women or <110 in men

40
Q

management of iron deficiency anaemia with no findings on further investigations

A
  • PO ferrous sulfate (until normal Hb then for 3 months beyond)
  • iron-rich diet
41
Q

management of von Willebrand’s disease

A
  • desmopressin (DESMOnd von Willebrand): raises levels of vWF
  • factor VIII concentrate
  • tranexamic acid for mild bleed
42
Q

aplastic anaemia features

A

typically in young people ~30yrs

  • pancytopenia and a hypoplastic bone marrow
  • normochromic, normocytic anaemia
  • leukopenia, with lymphocytes relatively spared
  • thrombocytopenia
43
Q

features of pernicious anaemia

A

antibodies to intrinsic factor +/- gastric parietal cells leads to B12 deficiency

  • anaemia: lethargy, pallor, dyspnoea
  • neurological: peripheral neuropathy, numbness, degeneration of the spinal cord (progressive weakness, ataxia and paresthesias that may progress to spasticity and paraplegia)
  • neuropsychiatric features: memory loss, poor concentration, confusion, depression
  • other features: mild jaundice: combined with pallor results in a ‘lemon tinge’, glossitis
44
Q

management of pernicious anaemia

A

IM B12 supplementation

WFH (18 decks)

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