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haem continued Flashcards

1
Q

what are the lymphoid cells

A

t cells b cells nk cells

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2
Q

what cells produces platelets

A

megakaryocytes

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3
Q

embryological origin of stem cells

A

mesoderm

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4
Q

how does liver disease cause thrombocytopenia

A

thrombopoeiten regulates growth adn is produced by liver

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5
Q

how do you identify lymphoid cell type

A

immunophenotyping

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6
Q

where are b cells and t cells produced

A

b cells- bone
t cells - thymus

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7
Q

blood film findings in hypospelnism

A

howell jolly bodies

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8
Q

causes of hypospleinis

A

sick cell
graves
coeliac
SLE
amyloid

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9
Q

what cells does AML come from

A

common myeloid proginator

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10
Q

what cells does CLL - chronic lymphocytic leukaemia come from

A

b cells

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11
Q

what cell does myeloma come from

A

myeloma

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12
Q

what cells does acute lymphoblstic leukaemia come from

A

common lymphoid precusor

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13
Q

what does leukaemia and lymphoma cause in terms of loss of fuction

A

leaukaemia - loss of haempoeisis
lymphoma - loss of immune function

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14
Q

difference in AML and CML

A

both have proliferation of abnormal projinators
AML = block in differentiation or maturation
CML = no block in differentiation or maturation

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15
Q

what mutation cause haematological cancers

A

driver mutations

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16
Q

signs of high grade haemotological cancer on histology

A

large cells with high nucelus:cytoplasmic ration
prominent nucleoli and rapid prolif

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17
Q

what percentage of blasts in blood/bone is indicative of acute leukaemia

A

> 20%

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18
Q

what is the most common chidhoos cancer

A

Acute lymphoblastic leukaemia (CLP)

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19
Q

what is involved in pancytopenia

A

anaemia-
thrombocytopenia
leukopenia

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20
Q

differentials for non blanching petechia

A

meningococcal septicaemia
Leukaemia
HSP
NAI
ITP
vasculitis

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21
Q

what haemotological cancer is downs syndrome assoc with

A

acute lymphoblastic leukaemia

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22
Q

features of ALL

A

those assoc with marrow failure
thrombocytopenia- petechia
neutropenia- infections
anaemia - pallor, fatigue

bone pain (secondary to bone marrow infiltration)
splenomegaly
hepatomegaly
fever is present in up to 50% of new cases (representing infection or constitutional symptom)
testicular swelling

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23
Q

what genetics can be seen in ALL

A

phildelphia chromosome 9:22 trasnlocation

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24
Q

transformation of a myeloproliferative disorder causes what cancer

A

acute myeloid leukaemia

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25
Q

what haemotological malignancy can present with DIC

A

acute myeloid leukaemia

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26
Q

auer rods

A

AML

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27
Q

blast cells indicate

A

an acute leukaemia

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28
Q

what are auer rods

A

abnormal granules in blast cells

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29
Q

what neurophil count is seen in neutropenic sepsis

A

<0.5

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30
Q

most common cause of neutropenic sepsis

A

coag neg gram pos

STAPH EPIDERMIDIS

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31
Q

Treatment of neutropenic spesis

A

pipraciilen adn tazobactam

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32
Q

prophylaxis of tumour lysis syndrome adn when given

A

IV Allopurinol or IV rasburicase
immediately prior and during first days

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33
Q

findings in tumour lysis syndrome

A

AKI
high potassium, high phosphate, high uric acid
low calcium

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34
Q

what chemo agents casue dilated cardiomyopathy

A

anthracyclines

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35
Q

what are b symptoms

A

night sweats
fever
weigth loss

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36
Q

utch without rash adn alcohol induced pain

A

hodgekins

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37
Q

is lymphadenopathy tender in cancer

A

no

38
Q

how is CLL diagnosed

A

immunophenotyping

39
Q

what cell does hodkins come from

A

b-cell

40
Q

reed sternberg cells

A

hodgkins

41
Q

what leukemia can transform to lymphoma and what is this called

A

CLL - richters trasnformation

42
Q

smear or smudge cells

A

CLL

43
Q

what blood test is a good marker of rpognosis in lymphoma

A

LDH

44
Q

what are reed sternberg cells and where are they seen

A

hodgkins lymphoma
binucelated cells - ‘owl eyes”. with eosinphilic inclusions

45
Q

most common type of hodgkins lymphoma

A

nodular sclerosing

46
Q

risk factors for hodgkins lymphoma

A

HIV EBV

47
Q

staging system in lymphoma + describe

A

ANN ARBOUR
1- 1 lymph node
2- 2 lymph nodes on same side
3- nodes on both sides
4- spread

48
Q

whats more common hodgkins or non hosgkins

A

non hodgkins

49
Q

what cell is involved in burkitts lymphoma

A

b-cell high grade

50
Q

genetic association of burkitts

A

c-myc trasnlocation (t18:4)

51
Q

starry sky lymphoma

A

burkitts lymphoma

52
Q

inherited causes of pancytopenia

A

fanconis anaemia

53
Q

acquired causes of bone marrow failure/pancytopenia

A

idiopathic aplstic anaemia - autoimmune
myelodysplastic syndrome
acut emyeloid/lymphoblastic leukaemia

54
Q

hypercellular marrow and marrow failure

A

myelodysplastic syndrome
b12/folate deficiency
hypersplenism

55
Q

hypocellular marrow

A

aplastic anaemia

56
Q

what can myelodysplastic syndrome progress to

A

AML

57
Q

what ig is a pentamer adn what one is a dimer

A

pentamer - igM
dimer
IgA

58
Q

in the body should antibodys be monoclonal or polyclonal. what is a monoclonal anitbody also called

A

polyclonal
monoclonal- undelying b cell plasma cell disorder
= paraprotein

59
Q

what test is used to detect immunoglobulins

A

electrophoresis

60
Q

what test is used to classify paraproteins

A

immunofixation

61
Q

where would you find bence jones protein

A

urine

62
Q

causes of paraproteinaemia

A

MGUS
myeloma
Amyloid
waldstrom
others eg lymphoma

63
Q

what is MGUS

A

Monoclonal gammopathy of undetermined significance

an asymptomatic paraproteinaemia that can progress to myeloma

64
Q

what is rouleoux formation and when is it seen

A

stacks of rbc seen in myeloma

65
Q

how is myeoma classified adn whats most common

A

based on what Ig it produced - IgG most common

66
Q

what monoclonal antibodies are raised in myeloma

A

IgA and IgG - called bence jones in urine

67
Q

symptoms of myeloma

A

CRABBI
calicum - hypercalcaemia
Renal - failure due to light chain accumulation
A- anaemia (marrow failure)
B- bone lytic lesion
B-bleeding -thrombocytopenic -marrow failure
i infection reduced norm ig

68
Q

how do lytic lesions occur in myeloma

A

plasma cells produce IL-6 which upregs osteoclasts

69
Q

what can be given to stop light chain production

A

steroids

70
Q

what can be used to measure response in myelom atx

A

paraprotein levels

71
Q

tx for bone pain in myeloma

A

OPIATES not NSAIDS

72
Q

what is the paraportien level seen in MGUS

A

<30

73
Q

apple green bifringement on congo red stain

A

amyloid

74
Q

what is walderstorms

A

neoplasm producing IgM paraprotein

75
Q

why does waldenstroms cause hyperviscosity

A

IgM pentamer thickens serum

76
Q

what is th ephiladelphia chromososme

A

t(9:22)

77
Q

types of myeloproliferative neoplasm

A

CML
Essential thrombocythaemia
polucthaemia rubra vera
primary myelofibrosis

78
Q

what is a myeloproliferative disorder

A

increase in one or more type of haemopoietic cells

79
Q

what gene is involved i myeloproliferative disorders

A

BRC-ABL 1

80
Q

what myeloproliferative disorder is BCR-ABL1 positive

A

CML

81
Q

what is there too much f in chronic myeloid leukaemia

A

too many granulocytes/WCC

82
Q

first line treatment of CML

A

imatinib

83
Q

diagnostic testing for CML

A

genetic testign fro philadelphia chromosome

84
Q

features of polcythaemia rubra vera

A

headache, fatigue, itch post shower
hyperviscosity therefor srterial and venou thrombosis

85
Q

mutation seen in polycythaemia rubra vera

A

JAK2

86
Q

treatment of polycythaemia

A

venesect till haematrocrit is <0.45
aspirin
hydroxycarbamine

87
Q

essential thrombocytossi characteristic symptom

A

burning in hands

88
Q

treatment of essential thromboytosis

A

hydroxyurae/carbamine

89
Q

tear drop poikilocytes

A

myelofibrosis

90
Q

treatment of autoimmune haemolytic anaemia

A

steroids

91
Q

most common inherites thrombophilia

A

Factor V leiden

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