Haem Flashcards
(46 cards)
Which cells are affected in Myeloma?
Plasma cells
Which two types of immunoglobulin are released in myeloma?
IgG and IgA.
What is MGUS?
Monoclonal Gammopathy - progressive build up of M protein (monoclonal protein). Over years this can result in other conditions such as other blood cancers.
Give three symptoms of myeloma?
- Back ache (vertebral collapse and spinal compression).
- Bone fractures
- Infections
- Weight loss
- Neurological (due to high calcium).
What are some of the clinical signs of myeloma?
‘CRAB’
- Calcium (elevated)
- Renal failure
- Anaemia
- Bone lesions
What type of anaemia does myeloma cause?
Macrocytic (impaired production in bone marrow).
What is the most common early investigation done if myeloma is suspected?
X-ray (looking for osteolytic lesions).
What is ESR?
Erythrocyte Sedimentation Rate
- A measure of inflammation.
Time for RBCs to sediment out of a blood sample is quicker if there is inflammation as the cells clump together. Therefore, shorter ESR = more inflammation.
Why might you avoid giving a patient with myeloma NSAIDs for analgesia?
Risk to renal system.
Myeloma causes renal impairment in 20% of cases and NSAIDs also can damage the kidneys.
What are Rouleaux?
Linear aggregates of RBCs which is often a sign of blood disorders like myeloma and lymphoma as well as diabetes (contributes to retinopathy).
What are an enlarged tongue and bruising around the eyes a classic sign of?
Amyloidosis.
What cells are primarily involved in lymphoma?
Lymphocytes
What are the symptoms of lymphoma?
- Lymphadenopathy [75% cases]
- Fever
- Night Sweats
- Weight Loss
- Fatigue
- Anaemia
What is meant by B symptoms?
Systemic symptoms:
- Night sweats
- Fever
- Weight loss
Indicative of cancer.
What constitutes worrying weight loss?
+10% body weight in 6 months without trying/an alternative explanation.
What is pancytopenia?
Reduction in RBC, WBC and platelets.
What is a common site of extra-nodal disease in lymphoma?
Mucosa Associated Lymphoid Tissue (MALT) involvement.
What investigations would you perform to help diagnose lymphoma?
- History & Examination
- Lymph node biopsy
- Bone marrow biopsy
- Blood film
- CT/PET (staging/spread).
Histologically, what differentiates Hodgkin from Non-Hodgkin Lymphoma?
Reed-Sternberg cells = Hodgkins.
How do you sub-categorise Non-Hodgkin Lymphoma?
Low-Grade (indolent, often incurable).
High Grade: Aggressive (often curable) - ‘kill or cure’
Give an example of a common paediatric high grade NH-lymphoma.
Burkitt’s lymphoma.
NB: Burkitt’s Lymphoma has a characteristic jaw lymphadenopathy.
What is the treatment of lymphoma?
- Radiotherapy (if focal)
- Chlorambucil (if diffuse)
- R-CHOP
What drugs are included in R-CHOP chemotherapy?
Rituximab Cyclophosphamide Hydroxydaunorubicin Vincristine (Oncovin) Prednisolone
What type of drug is Rituximab?
Monoclonal Antibody used to treat cancer and some immune disorders.
Targets CD20 surface protein on B lymphocytes.
