Haem Flashcards
(115 cards)
1
Q
Blasts > 20%
A
Acute leukemia
2
Q
Myeloperoxidase
A
Myleoblasts (AML)
3
Q
Auer rod
A
AML
4
Q
C10, C19 and C20
A
Surface markers in B-ALL
5
Q
C2-C8
A
Surface markers in T-ALL
6
Q
t(15;17)
A
acute promyelocytic leukemia
7
Q
Why is acute promyelocytic leukemia a medical emergency?
A
Risk of DIC due to lots of Auer rods
8
Q
Tx of acute promyelocytic leukemia
A
ATRA
9
Q
Swollen gums?
A
Acute monocytic leukemia
10
Q
What kind of cancer do down’s kids get before the age of 5?
A
Acute megakaroblastic leukemia
11
Q
What kind of cancer do down’s kids get after the age of 5?
A
ALL
12
Q
Sudan Black B stains
A
AML
13
Q
BCR-ABL
A
Philidelphia chromosome which activates tyrosine kinases
14
Q
Richter’s transformation
A
Collection of lymphomas that can damage the body - derived from CLL
15
Q
Which haematological cancer is associated with AIHA?
A
CLL
16
Q
Smudge/smear cells?
A
CLL
17
Q
Tx of CML
A
Imatinib (Tyrosine kinase inhibitor)
Dasatinib (used for resistance)
Oral hydroxyurea
18
Q
Binet staging?
A
Used in CLL
Stage A - high WBC, less than 3 groups of enlarged lymph nodes
Stage B - more than 3 groups of enlarged lymph nodes
Stage C - anaemia or thrombocytopenia
19
Q
Tx of CLL
A
Chlorambucil
SCT
Alemtuzumab
20
Q
Asymmetrical painless lymphadenopathy and EBV associated
A
Hodgkins lymphoma
Seen in teens and old people
21
Q
Pain in lymph nodes after drinking alcohol
A
Hodgkins lymphoma
22
Q
Pel-Ebstein fever
A
Hodgkins lymphoma
23
Q
Mneumonic for HL - GOLDWATER
A
GOLDWATER
Good prognosis (90% survival in 10 year prognosis) Old (over 55) Lymphnode Different types (classic types and nodular lymphocyte predominant) WBC (lymphocyte) Ann-Arbor Staging (I-IV) Teenager & young adults (15-35) EBV (40% of patients; mononucleosis) Reed-Sternberg cells
24
Q
Reed-Sternberg cells
A
Hodgkins lymphoma
25
Owl -eye
Hodgkins lymphoma
26
LN and BM biopsy - cells stained with CD15 and CD30
Hodgkins lymphoma
27
Chemo used in HDL (ABVD)
Adriamycin
Bleomycin
Vinblastine
Dacarbazine
28
When do we use autologous SCT?
More used in lymphoma and multiple myeloma esp with relapses
29
When do we use allogenic SCT?
Used more in leukemia
| Risk of GVHD
30
Starry sky
Burkitt's lymphoma
31
Types of NHL
```
Burkitt's
Diffuse large B-cell lymphoma
Follicular
Mantle cell
Marginal zone
```
32
Thick and viscous blood associated with lymphoma?
Waldenstrom macroglobulinemia
33
Cerebriform nucleus
looks like a brain
| Seen in T-cell lymphoma of skin - mycosis fungoides
34
Sezary syndrome
Itchy red rash related to t-cell lymphoma of the skin
35
Rituximab
Anti-CD20, seen in NHL
36
No pain after drinking alcohol
NHL
37
HTLV-1 infection seen in japanese and carribean peeps
Adult T-cell lymphoma
38
Enteropathy-associated T-cell lymphoma
Patients with coeliac disease at risk
39
t(2;5), kids and teens
Anaplastic large cell lymphoma
40
t(8;14) c-myc
Burkitt's lymphoma
41
t(11;14)
Mantle cell lymphoma
42
t(14;18)
Follicular lymphoma
43
Malt-B lymphoma associated with...
H.pylori
| Sjogren's syndrome
44
CRAB
Multiple myeloma :
Calcium high
Renal failure
Anaemia
Bones : osteoporosis, lytic lesions, fractures, pepper pot skull
45
Neoplasia of the plasma cells
Multiple myeloma
46
Rouleux formation
Multiple myeloma (RBC stacking)
47
High ESR
Multiple myeloma
48
Bence-jones protein in urine
Multiple myeloma
49
Paraprotein > 30
Multiple myeloma
50
<20%
Could be myelodysplastic syndrome
51
Ring sideroblasts
Defective RBCs seen in myelodysplastic syndrome
52
Pseudo-pelger-huet
Defective WBCs
53
Erythroid dysplasia with <5% blasts
Refractory anaemia
54
Erythroid dysplasia with >15% ringed sideroblasts
Refractory anaemia with ringed sideroblasts
55
Dysplasia in >10% cells in >2 or 2 cell lines
Refractory cytopenia with multilineage dysplasia
56
Dysplasia 5-9% blasts
Refractory anaemia with excess blasts (RAEB-1)
57
Dysplasia 10-19% blasts or auer rods
Refractory anaemia with excess blasts 2 (RAEB-2)
58
Megakarocytes with hypolobated nuclei and <5% blasts
MDS with 5q deletion
59
Absent thumb, radii, short and pigmented skin
Fanconi anaemia (AUTOSOMAL RECESSIVE)
Risk of MDS and AML
Pancytopenia
60
pigmented skin, white patches in mouth, BM failure and nail dystrophy
Dyskeratosis congenita (telomere shortening) - X-liked
61
Pure red cell aplasia - WCC and plts normal
Diamond-Blackfan syndrome
62
Jak2 mutations
seen in myeloproliferative disorder but Ph-ve
| PRV
63
Low serum EPO but raised Hb and itchy and plethoric
PRV
64
Tx of PRV
Venesection
Hydroxycarbamide
Aspirin
65
Blood film in myelofibrosis
Tear drop poikilocytes
| Leukoerythroblasts
66
Platelet count more than 600
Think essential thrombocytopenia
67
Tx of essential thrombocytopenia
Aspirin
Anagrelide
Hydroxycarbamide
68
Acanthocytes (spike/spur cells)
Hyposplenism
Abetalipoproteinemia
Liver disease
69
Basophilic RBC stippling
```
Lead poisoning
Haemoglobinapathies (thalassemia)
Liver disease
Megablastic anaemia
Myelodysplasia
```
70
Burr cells
GI bleed
Gastric carcinoma
Uremia
71
Heinz bodies
G6PD
| Chronic liver disease
72
Howell-Jolly bodies
```
Hyposplenism/post-splenectomy
Sickle cell disease
Coeliac disease
UC/IBD
Myeloproliferative disease
Hereditary spherocytosis
Megaloblastic anaemia
```
73
Pelger huet
Hyposegmented neutrophil
Congenital
Myelodysplastic disease
74
Right shift
Hypermature white cells
Hypersegmented polymorphs (>5 lobes to nucleus)
Seen in megaloblastic anaemia
75
Rouleux formation
Seen in multiple myeloma, paraproteinaemia, chronic inflammation
76
Schistocytes
Seen in MAHA, DIC, HUS, TTP and pre-eclampsia
77
Spherocytes
Hereditary spherocytosis
| AIHA
78
Stomatocytes
Excessive alcohol intake
Hereditary stomatocytosis
Liver disease
79
Target cells
```
4Hs:
Happy meal - IDA
Hyposplenism
Hepatic - liver disease
Haemoglobinaemia - thalassemia
```
80
Causes of microcytic anaemia (FAST)
Fe deficiency
Anaemia of chronic disease
Sideroblastic anaemia
Thalassemia
81
Causes of normocytic anaemia
```
Blood loss
Haemolysis
Hypothyroidism
Bone marrow failure
Renal failure (EPO deficiency)
ACD
```
82
Causes of macrocytic anaemia FATRBC
```
Fetus
Anit-folate (phenytoin)
Thyroid (hypo)
Reticulocytosis
B12 or folate def.
Cirrhosis
Myelodysplatic syndrome
```
83
How does anaemia of chronic disease work?
Cytokine driven inhibition of red cell production
Inflammatory markers reduce EPO receptor
IL6 and LPS stimulate liver to make hepcidin which decreases iron absorption from gut by inhibiting transferrin and also causes iron accumulation in macrophages
84
Tx of sideroblastic anaemia
Doesnt respond to iron
Give pyridoxine (vit B6 - promotes RBC production)
Treat underlying cause
85
Why does pernicious anaemia cause megaloblastic anaemia
lack of instrinic factor so less B12 absorption
86
Tx of megaloblastic anaemia
IM hydroxocobalamin (B12)
87
Intravascular haemolysis leads to ...
Dark urine
88
Beta-thalassemia
High HbA2 and HbF
89
Hairs on end skull x-ray
Beta-thalassemia
90
Warm, my G for AIHA
Warm - IgG
| 37 degrees
91
Men are cold so AIHA
Think IgM
| Less than 37 degrees
92
Tx of warm AIHA
Steriods
Immunosuppresion
Splenectomy
93
Tx of cold AIHA
Tx underlying cause
Avoid cold
Chloramabucil (chemo)
94
Donath Landsteriner antibodies
Paroxysmal cold haemoglobinuria
| Viral related - syphilis measles and VZV
95
Measures the function of the intrinsic pathway
APTT (monitors heparin therapy)
96
Measures the function of the extrinsic pathway
PT (monitors warfarin therapy)
97
Haemophilia A factor??
VIII
98
Haemophilia B factor?? X-mas disease
IX
99
Resistance to protein C
Factor V Leiden
100
1st VTE with known cause
3 months warfarin
101
Cancer VTE
3-6 months warfarin
102
1st VTE unknown cause
3-6 months warfarin
103
Recurrent VTE
Lifelong warfarin
104
How does heparin work?
Potentiates anti-thrombin III
105
What happens if the patient takes too much heparin?
Protamine sulphate
106
Target INR
1st VTE : 2.5
| Recurrent : 3.5
107
Ham's test
PNH
108
Tear drop cells
Myelofibrosis
109
Dry bone marrow tap/aspirate
Myelofibrosis
110
What does protein C inhibit?
Factor 5
111
Corkscrew appearance of arteries
Buerger's disease - associated with smoking - vasculitis
112
What does protein S inhibit?
Factor 5a and Factor 8a
113
What does anti-thrombin inhibit?
Thrombin
| Factor 10
114
BCL-1
Mantle-cell lymphoma
115
BCL-2
Follicular lymphoma
