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4th Year Revision > Haem > Flashcards

Haem Flashcards

1
Q

Acute Myeloblastic Leukaemia (AML)…

Diagnostic blood film has?

Treatment?

A

Auer Rods

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2
Q

Presents as pale child who is lethargic with a history of recurrent infections and a new onset bruise across trunk.

Numerous blasts in bone marrow are seen on blood film

Diagnosis?

Management?

A

Diagnosis - Acute lymphoblastic leukaemia (ALL)

Management - Pegaspargase

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3
Q

70 year old male presents with tiredness, weight loss and night sweats. His bloods reveal a very high neutropenia and genetic testing reveals a Philadelphia chromosome.

Diagnosis?

Management?

A

Diagnosis - Chronic Myeloid Leukaemia (CML)

Management -

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4
Q

56 year old female presents comes in for routine bloods which finds lymphocytosis. No PMH, and feels okay in herself.

Diagnosis?
What cells would be seen on blood film?
Management?

A

Chronic Lymphoblastic leukaemia (CLL)

Smudge cells seen on blood film

Management -

Associated immune thrombocytopenia Purpura (ITP)

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5
Q

Which is the most common leukaemia in children?

A

ALL

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6
Q

35 year old male presents with rapidly enlarging lump on neck, fever, drenching night sweats and weight loss. His PMH includes HIV and T1DM.

Diagnosis?
Management?

A

Burkitts lymphoma

Management -

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7
Q

35 year old Afro-caribbean male presents with fever, drenching night sweats, weight loss and back pain. His PMH asthma which is well controlled.

Diagnosis?
What markers would be found in further investigations?
Management?

A

Diagnosis - Multiple myeloma

Marker - Bence jones proteins

Management -

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8
Q

ITP
How does it present?
Diagnosis?
Management?

A

Antibodies are created against platelets

Presents as:

  • Nose and gum bleeds
  • Isolated low platelets (thrombocytopenia)
  • purpuric rash

Diagnosed - urgent FBC to find isolated thrombocytopenia

Mx 
Usually will resolve itself if mild/no symptoms 
If platelets < 10 or severe symptomatic 
- Prenisolone 
- IV immunoglobulins 
- Rituximab 
- Splenectomy
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9
Q

TTP

How does it present?
Management?

A
  • Tiny blood clots throughout small vessels
  • Deficiency in ADAMTS13 protein
  • Presents after a viral infection

Presents as haemolytic anaemia

Mx

  • Steroids
  • Plasma exchange
  • Rituximab
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10
Q

Monitoring
Warfarin
Heparin

A

PT

APTT

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11
Q

DIC

How do you managed DIC?

A 
Low platelets 
Low fibrinogen 
APTT is up 
PT is up 
D dimer is up

Mx - Treat underlying cause

  - Cross match 
  - if sepsis/infection - Do Sepsis 6
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12
Q

What factors does warfarin act on?

A

2, 7, 9, 10

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13
Q

TACO

What complication from transfusion?

A

Transfusion associated circulatory overload
Due to excessive rate of infusion

Stop transfusion
Give furosemide if overloaded

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14
Q

Antiphospholipid syndrome
Presentation

Management

A

Recurrent miscarriages
Hypercoaguable state

Warfarin then enoxaparin if preggers

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15
Q

How low do platelets need to be for transfusion?

A

Under 30

Unless bleeding from CSF site (then under 100)

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16
Q

Macrocytic anaemia
Megaloblastic

Non-megaloblastic

A

Megaloblastic - Vit B12 & Folate deficiency

Pernicious anaemia - loss of the intrinsic factors - unable to absorb Vit B12
Linked to damage small bowel (autoimmune)
Mx - hydroquthalamine

17
Q

Normocytic anaemia causes

A 
Alcohol 
Hyperthyoridism 
Liver disease 
Drugs 
Anaemia of Chronic Disease
18
Q

Types of Haemolytic anaemias

A

Hereditary Spherocytosis
Thalasaemia
Sick cell anaemia
G6PD deficiency

19
Q

Hereditary Spherocytosis

Presents as…
Diagnosis?
Management?

A

Autosomal dominant
Causes sphere shaped RBC that are easily broken down when passing through spleen

Presents as:

  • Aplastic crisis in Parvovirus
  • Jaundice, gallstones, splenomegaly

Dx - spherocytes on blood film

  - high reticulocyte count 
  - raised unconjugated bilirubin

Mx - folate supplements & splenectomy

20
Q

Thalassemia

Presents as…
Diagnosis?
Management?

A

Autosomal recessive
Genetic defect in protein chains that make Hb
Alpha Thal - Chromosome 16, Beta thal - Chromosome 11

Fatigue, Pallor, Jaundice, Splenomegaly, Poor growth
Pronounced forehead & molar eminences

Dx - FBC - microcytic anaemia
Hb electrophoresis
DNA testing

Mx - Regular iron transfusions, iron chelation & splenectomy

21
Q

Sickle cell anaemia

A

Autosomal recessive genetic condition causes RBC to be present shaped

Dx

  • newborn screening heel prick
  • schisotocytes on blood film

Mx - Antibiotic prophylaxis

  • Hydroxycarbamide
  • blood transfusion
  • DEFINITIVE: bone marrow transplant
22
Q

G6PD deficiency

A

X -linked recessive condition where the enzyme G6PD is deficient
More common in Med or African patients

Presents as jaundice (in neonatal period), gallstones, anaemia, splenomegaly and HEINZ bodies on blood film

Dx - G6PD enzyme assay
Mx - Remove the trigger

Exam style question: patient who turns jaundice and anaemia after eating broad beans/developing infection/being treated with antimalarials

4th Year Revision (14 decks)

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