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Path Week 2 > Ha - Leukaemia Cases & Quiz > Flashcards

Ha - Leukaemia Cases & Quiz Flashcards

1
Q

how is a haematalogical diagnosis made

A

clinical sx
blood film
immunophenotyping
imaging

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2
Q

5 year old indian boy with lymphadenopathy & mediastinal mass on CXR.
High WCC, low Hb, low platelets. Dx?

A

ALL

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3
Q

5 year old indian boy with lymphadenopathy & mediastinal mass on CXR.
High WCC, low Hb, low platelets. what is the mediastinal mass?

A

thymus enlargement due to ALL

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4
Q

how is a diagnosis of ALL confirmed?

A

Immunophenotyping

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5
Q

is a high WCC in ALL good or bad?

A

BAD indicator for prognosis

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6
Q

48 year old with bleeding gums, haematuria and bruises. No hepatospelenomegaly. Low Hb and platelets. Dx?

A

acute promyelotic leukaemia –> DIC

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7
Q

48 year old with bleeding gums, haematuria and bruises. No hepatospelenomegaly. Most likely Ix to give Dx?

A

blood count, film and coagulation screen

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8
Q

Is APTT and PT long or short in DIC?

A

APTT is short
PT is normal

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9
Q

how do you identify myeloid and lymphoid cells?

A

granules suggest myeloid

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10
Q

how do you confirm diagnosis of acute promyelocytic anaemia

A

cytogenic analysis /FISH /molecular genetic analysis

all the cells look the same as they stopped at same stage of differentiation

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11
Q

what is CD117 a marker of

A

leukaemia

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12
Q

68 year old with gradual fatigue, lethargy, exertional syncope. pallor, oedema. low neutrophils, low anaemia. Dx?

A

myelodysplastic syndrome

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13
Q

68 year old with gradual fatigue, lethargy, exertional syncope. pallor, oedema. which is the most important Ix to diagnose?

A

blood film

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14
Q

what cell is seen in myelodysplastic syndrome

A

ring sideroblasts
blast cells

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15
Q

72 year old indian woman, veggie, t total. SoB on exertion, fatigue, painful gums/tongue, unable to eat spicy food. pallor. macrocytic anaemia. best Ix?

A

vitamin b12 and folate

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16
Q

what cell type is classic of pernicious anaemia / megaloblastic anaemia

A

hypersegmented neurtrophils
tear drop poikilocytes
macrocytes inc oval macrocytes

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17
Q

72 year old indian woman, veggie, t total. SoB on exertion, fatigue, painful gums/tongue, unable to eat spicy food. pallor. macrocytic anaemia. Dx?

A

megaloblastic anaemia

18
Q

giant metamyelocyte and megaloblast in BM. Hypersegmented neutrophils. Dx?

A

pernicious anaemia

19
Q

70 year old woman with gangrenous toes. No DM, smoker with breathlessness. large spleen. Ix?

A

blood gas
FBC

20
Q

70 year old woman with gangrenous toes. No DM, smoker with breathlessness. large spleen. high platelet, high Hb. Dx?

A

polycythaemia vera

21
Q

Ix to diagnose polycythaemia vera

A

molecular analysis for JAK2 mutation

22
Q

Tx of polycythaemia vera

A

venesection plus hydroxycarbamide

23
Q

cause of lymphocytosis in elderly man with no Sx or abnormal blood findings. Dx?

A

CLL

24
Q

high RBC, HB and HCt. Dx?

A

polycythaemia

25
Q

when polycythmaemia is diagnosed, what question needs to be asked and how is this done?

A

is this a true or pseudo PC?
check if theres hypoxia / blood loss which can drive up HCt
or bone marrow disease

26
Q

most likely cause of high WCC in an ICU pt ?

A

reactive neutrophilia

27
Q

spanish woman in her 60s with high WCC, normal Hb and splenomegaly. Dx?

A

CML

28
Q

spanish woman in her 60s with high WCC, normal Hb and splenomegaly. why is this not AML?

A

because of normal Hb

29
Q

elderly man in haematology OPD with bruising and bleeding. low plts, normal everything else. Dx?

A

immune thrombocytopenia

30
Q

pale, bruised child. DDx?

A

NAI
thrombocytopaenia - ALL, immune
haemophillia

31
Q

causes of microcytosis

A

iron def
thalassaemia

32
Q

beta thalassaemia trait blood film results

A

normal Hb
increased RCC
low MCV

33
Q

what is a good initial test for ?iron def

A

ferritin

34
Q

what blood results are seen in rheumatoid arthritis

A

anaemia of chronic disease
low neutrophils / platelets due to drug toxicity
felty syndrome
increased ESR

35
Q

10 year old girl with R painful swollen knee after knocking it. prev fever but afebrile now. High WCC and CRP. DDx?

A

osteomyelitis

36
Q

1 year old boy with pain and swelling of joint after minor injury. most likely Dx?

A

haemophilia

37
Q

what Ix would you do for haemophilia?

A

coagulation screen - PT, APTT

38
Q

coagulation screen results of haemophilia

A

normal PT
long APTT

39
Q

red cell fragments
microangiopathic haemolytic anaemia
Dx?

A

TTP

40
Q

TTP pentad

A

microangiopathich haemolytic anaemia
thrombocytopenia
fever
neurological abnormalities
renal impairment

41
Q

what is the defect in TTP

A

deficiency of von willebrand factor cleaving protease (ADAMTS13)

Path Week 2 (18 decks)

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