- Acute myeloid leukaemia (can transform from myeloproliferative disorder) - Acute lymphoblastic leukaemia (children) - Chronic myeloid leukaemia - Chronic lymphocytic leukaemia (assoc with warm haemolytic anaemia)

- Hodgkin’s lymphoma - Non-Hodgkin’s lymphoma

Haem Flashcards by Sikandar Khan

mnemonic for remembering the causes of microcytic anaemia

T – Thalassaemia
A – Anaemia of chronic disease
I – Iron deficiency anaemia
L – Lead poisoning
S – Sideroblastic anaemia

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causes of normocytic anaemia

3 As and 2 Hs for normocytic anaemia:

A – Acute blood loss
A – Anaemia of chronic disease
A – Aplastic anaemia
H – Haemolytic anaemia
H – Hypothyroidism

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caused of macrocytic anaemia

Megaloblastic anaemia is caused by:
- B12 deficiency
- Folate deficiency

Normoblastic macrocytic anaemia is caused by:
- Alcohol
- Reticulocytosis (usually from haemolytic anaemia or blood loss)
- Hypothyroidism
- Liver disease
- Drugs, such as azathioprine

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Mx of pernicious anaemia

IM hydroxocobalamin alternate days is initially given to all patients with B12 deficiency

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Do you treat b12 or folate deficiency first

B12
to prevent subacute degeneration of the spinal cord

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Inherited haemolytic anaemic conditions

Hereditary spherocytosis
Hereditary elliptocytosis
Thalassaemia
Sickle cell anaemia
G6PD deficiency

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acquired haemolytic anaemic conditions

Autoimmune haemolytic anaemia
Alloimmune haemolytic anaemia (e.g., transfusions reactions and haemolytic disease of newborn)
Paroxysmal nocturnal haemoglobinuria
Microangiopathic haemolytic anaemia
Prosthetic valve-related haemolysis

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different thalassemias

alpha: defect in alpha globin chain
beta: defect in beta globin chains

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alpha thalassaemia featuer

chr16
Mx
Monitoring
Blood transfusions
Splenectomy may be performed
Bone marrow transplant can be curative

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beta thalassaemia features

chr11
minor, intermedia, major
Mx
intermedia and major: blood transfusion, iron chelation

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what is a sickle cell crisis

an occur spontaneously or triggered by dehydration, infection, stress or cold weather
Mx supportively, keep warm, good hydration, analgesia strong e.g. morphine

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what is an aplastic crisis

caused by parvovirus b19
supportive mx

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general mx of sickle cell

avoid triggers
up to date vaccines
abx prophylaxis with pen V
hydroxycarbamide
crizanlizumab
blood transfusion
bone marrow transplant

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types of leukaemia

Acute myeloid leukaemia (can transform from myeloproliferative disorder)
Acute lymphoblastic leukaemia (children)
Chronic myeloid leukaemia
Chronic lymphocytic leukaemia (assoc with warm haemolytic anaemia)

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what condition is ALL associated with

Downs syndrome

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what can CLL transform into

high-grade B-cell lymphoma (Richter’s transofrmation) (smear cells)

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features of AML and acute promyelocytic leukaemia

auer rods

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General mx of leukaemia

chemo + radio
ALL: imatinib
AML: ATRA
CML: TKIs (imatinib), monoclonal antibodies e.g. rituximab

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what is tumour lysis syndrome

due to chemicals released when cells are destroyed by chemo
High uric acid
hyperkalaemia
High phosphate
Low calcium (as a result of high phosphate)
need good hydration

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types of lymphoma

Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma

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RF for Hodgkin’s lymphoma

HIV
EBV
RA and sarcoidosis
FH

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types of non hodgkin lymphoma

diffuse large B cell
Burkitt
MALT

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presentation of lymphoma

Study These Flashcards

lymphadenopathy
Hodgkin: worse on alcohol, reed stenberg
fever, weight loss, night sweats

what is myeloma

Study These Flashcards

cancer affecting plasma cells
MGUS, smouldering and multiple myeloma
CRAB mnemonic
pepper pot skull on XR
Mx: chemo, SCT, bisphosphonates, radio

myeloproliferative disorders

- can transform into AML - Primary myelofibrosis - Polycythaemia vera - Essential thrombocythaemia

features of myelodysplastic syndrome

- anaemia - neutropenia - thrombocytopenia - can see blasts on film

conditions that can cause thrombocytopenia

- Certain viral infections (e.g., EBV, CMV and HIV) - B12 deficiency - Folic acid deficiency - Liver failure, causing reduced thrombopoietin production by the liver - Leukaemia - Myelodysplastic syndrome - Chemotherapy

causes of increased platelet destruction

- sodium valproate - methotrexate - alcohol - ITP - TTP - HIT - HUS

Features of TTP

Thrombocytopenia Purpura Tissue ischaemia and end-organ damage

Features of ITP

- antibodies against platelets - purpura - Mx: prednisolone, IVIG, splenectomy

Features of VWD

- bleeding gums - epistaxis - easy bruising - menorrhagia - Mx: desmopressin, tranexamic acid, VWF infusion, Factor 8 + VWF

Haemophilia features

- X linked recessive - A (8) and B (9) - risk of spontaneous bleeding - Mx: IV infusion of clotting factors

Thrombophilia conditions

- Antiphospholipid syndrome - Factor V Leiden - Antithrombin deficiency - Protein C or S deficiency - Hyperhomocysteinaemia - Prothombin gene variant - Activated protein C resistance

Ix for DVT

Wells score likely: leg vein USS unlikely: D-dimer

what is Budd-Chiari syndrome

obstruction to the outflow of blood from the liver caused by thrombosis in the hepatic veins or IVC. It is associated with hypercoagulable states It presents with a triad of: - Abdominal pain - Hepatomegaly - Ascites Mx: LMWH and warfarin, thrombolysis, TIPS, liver transplant

granulomatosis with polyangitis

- cANCA- directed against proteinase 3 - URT (nosebleeds) - LRT (haemoptysis) - Renal (rapidly progressive glomerulonephritis) - chest signs - red cell casts

Eosinophilic Granulomatosis with Polyangiitis

pANCA- directed against myeloperoxidase  Allergic asthma

Microscopic Polyangiitis

pANCA- directed against myeloperoxidase  LRT (haemoptysis)  Renal (rapidly progre

organisms causing post splenectomy sepsis:

Streptococcus pneumoniae Haemophilus influenzae Meningococci (encapsulated organisms)

DIC typical blood picture

↓ platelets ↓ fibrinogen ↑ PT & APTT ↑ fibrinogen degradation products

hodgkin lymphoma features

- reed stenberg cells - painless lymphadenopathy - pain in nodes after drinking alcohol - B sx : fever, weight loss - Mx- chemo

type of warm autoimmune haemolytic anaemia

SLE lymphoma CLL methyldopa Mx: steroids, splenectomy, immunosuppression

types of cold agglutinin disease

lymphoma infections: EBV, mycoplasma Mx: treat condition, avoid cold, chemo

how to manage acute haemolytic transfusion reaction

generous fluid resuscitation and termination of the transfusion.

what can CLL transform to

high-grade lymphoma (Richter's transformation) making patients suddenly unwell --> diffuse large B cell non Hodgkin lymphoma

what can be seen in the blood film in coeliac disease

Target cells and Howell-Jolly bodies may be seen in coeliac disease → hyposplenism

feature of B12/folate deficiency

hypersegmented neutrophils

what are schisctocytes associated with

they are fragmented RBC assoc with thrombotic microangiopathies.

cahracteristic blood film sign of myelofibrosis

tear drop poikilocytes

leukaemia with massive splenomegaly

CML (other condition is myelofibrosis)

what is given to patients with polycythaemia vera to reduce thombosis

aspirin

mx of polycythaemia

venesection hydroxycarbamide aspirin

mx of ITP

- 1st line: prednisolone - 2nd line: Pooled normal human immunoglobulin (IVIG)

blood film in DIC

schistocytes due to microangiopathic haemolytic anaemia

conditions with heinz bodies

- alpha-thalassaemia - glucose-6-phosphate dehydrogenase deficiency - chronic liver disease

sign of ABO incompatability

- hyperacute - loin pain

Haem Flashcards

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