Bloody hell more questions? Flashcards
Haemoglobin
- Low
- High
~primary vs secondary
Low = anaemic Look at MCV High = polycythaemia - primary = polycythaemia rubra vera - secondary = dehydration, hypoxia (COPD, Smoking, obesity, altitude) or excess EPO (renal cell carcinoma)
MCV
- Micro
- Normo
- Macro
Micro - iron deficiency - thalassemia - sideroblastic Normo - ACD - acute bleed - haemolysis Macro - B12/folate deficiency - hypohyroidism - pregnancy - alcohol/liver disease - Myelodysplastic syndrome - methotreaxate
What do high reticulocytes indicate? Examples
What do low reticulocytes indicate?
Examples
Bone marrow still working, trying to replace loss RBC, bleeding, haemolytic anaemia, haemolytic disease of the newborn
Bone marrow failure, low EPO (kidney disease), alcoholism, Fe deficiency
What does the RDW mean? What does anisocytosis mean?
Examples of disease causing high RDW
Red cell distribution width, the average variation in size of RBC.
RBC of unequal size.
Sickle cell beta thalassemia, Iron deficiency, myelodysplastic syndrome
What is high platelets called?
What causes high platelets? (Primary vs secondary/reactive)
Thrombocytosis Primary - polycythaemia rubra vera Secondary - reactive = stress/Infection/Inflammation, haemorrhage, malignancy (essential thrombocytosis, CML), post-splenectomy/surgery
What is low platelets called?
What causes low platelets?
Thrombocytopenia
Production
- DRUGS! (ace-i, penicillins, cephalosporins)
- b12/folate deficiency
- Leukaemia
- viral illness
Destruction
- immune = drug-induced, ITP, rheumatological
- non-immune = DIC, splenomegaly, mechanical heart valves
What is a high WCC called?
What are some causes?
Leukocytosis
- Infection
- Malignancy = ALL, lymphoma
What is low WCC called?
What are some causes?
(Production vs destruction)
Leukopenia
- no production = bone marrow failure (drugs, malignancy, fibrosis)
- destruction = viral (HIV)
What is low neutrophils called?
What are some causes?
Treatment?
Neurtropenia - splenomegaly - viral - drugs (chemo, steroids) - malignancy Treatment = colony stimulating factors, prophylactic antibiotics
What is high neutrophils called? What are some causes?
Neutrophillia / left shift
- bacterial infection
- CML
- trauma/stress
What is high lymphocytes called?
What are some causes?
What is low lymphocytes called?
What’s are some causes?
Lymphocytosis - viral (EBV) - ALL/leukaemia - CLL (most common adult haem disease) Lymphopenia - steroids - autoimmune
What causes high eosinophils?
What causes high basophils?
Nucleated RBC causes?
Eo = Allergy / atopy or Vasculitis Baso = Parasitic infections Nuc = Responding to bleed
Megaloblastic anaemia - what does it mean?
Causes
Large nucleus
Folate and B12 deficiency
What does Poikilocytosis mean?
Different shapes of red blood cells
Macrocytes - oral vs round causes
Hypersegmented neutrophils - causes?
Oval = megaloblastic b12/folate deficiency
Round = liver disease/alcohol/myelopdysplasia
B12 Deficiency & myelodysplasia
Target cells causes?
Types?
Tear drop cells - causes
Pencil cells?
Target = Thalassaemia,
Alpha and Beta
Myelofibrosis = squeezing out of RBC. Cause = Tumour metastasis
Pencil = iron deficiency
Rouleaux cells causes?
Spherocytes causes?
Roul = Inflammation, Autoimmune and Plasma cell disorders Sphero = Autoimmune Haemolytic Anaemia or hereditary spherocytosis
What is measured on iron studies?
What can go up in infection on iron studies and why?
What’s the difference between iron deficiency and anaemia of chronic disease on iron studies?
Iron, transferrin, transferrin saturation, ferritin
Ferritin, as it’s an acute phase reactant
Iron deficiency has increased transferrin levels and low ferritin levels, where as chronic disease has lowered transferrin and normal ferritin
Polycythaemia rubra vera
- Mutation
JAX 2 mutation
What is the incubation for Malaria?
How long should you take prophylactic antibiotics for?
What is the investigation of choice?
12 days
One week before leaving and one month after
Microscopy thick and thin smear
What disorders is Desmopressin (DDAVP) used for?
What are the effect of Desmopressin?
What is it used for?
von Willebrand disease, haemophilia A and platelet function defects
Stimulates cAMP-stimulated endothelial cells to secrete von Willebrand factor and factor VIII.
Used for acute bleeding episodes or to prevent bleeding in surgery