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Y5 Pathology > Haem - General > Flashcards

Haem - General Flashcards

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1
Q

Blood film: microcytic, hypochromic cells with anisocytosis, poikilocytosis and pencil cells

A

Iron Deficiency anaemia

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2
Q

Signs: Angular cheilosis, brittle hair/nails, Plummer-Vinson syndrome, koilonychia, atrophic glossitis

A

Iron deficiency anaemia

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3
Q

Blood results: Iron low, Ferritin low, TIBC raised, Saturation low

A

Iron deficiency anaemia

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4
Q

Blood film: basophilic stippling

A

Lead poisoning

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5
Q

Blood film: erythroid precursors with iron deposited in mitochondria in a ring around the nucleus, dimorphic RBCs

A

Sideroblastic anaemia

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6
Q

Blood results: Iron high, TIBC normal, Ferritin high

A

Sideroblastic anaemia

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7
Q

Blood results: iron high, TIBC low, ferritin high

A

Chronic haemolysis

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8
Q

Blood film: hypersegmented polymorphs, leucopenia, RBC precursors with immature nucleus and mature cytoplasm, macrocytosis,

A

Megaloblastic anaemia (B12/folate/cytotoxic drugs)

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9
Q

Mouth: Glossitis, angular cheilosis
Neuropsychiatric: Irritability, depression, psychosis, dementia.
Neurological: Paraesthesiae, peripheral neuropathy (loss of vibration and proprioception first, absent ankle reflex, spastic paraperesis, subacute combined degeneration of spinal
cord)

A

Vitamin B12 deficiency

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10
Q

Blood results: raised Hb, low haptoglobins, raised LDH, Raised reticulocytes, raised unconjugated bilirubin
+ dark red urine + haem and albumin in urine

A

Intravascular haemolysis

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11
Q

Blood results: raised Hb, raised LDH, Raised reticulocytes, raised unconjugated bilirubin
+ splenomegaly

A

Extravascular haemolysis

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12
Q

Aetiology of hereditary spherocytosis

A

Autosomal dominant
Deficiency in spectrin or ankyrin

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13
Q

Results:
Osmotic fragility test: raised
DAT coombs NEGATIVE

A

Hereditary spherocytosis

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14
Q

Aetiology of hereditary eliptocytosis

A

Almost all autosomal dominant
Spectrin mutation
Except for Hereditary Pyropoikilocytosis (erythrocytes are abnormally
sensitivity to heat) – autosomal recessive (small print)

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15
Q

What is the aetiology of Glucose-6-phosphate dehydrogenase (G6PD) Deficiency

A

X-linked recessive

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16
Q

Blood film: bite cells, heinz bodies (blue deposits, oxidised Hb)

A

G-6-PD deficiency

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17
Q

Investigations for G6PD deficiency

A

Film: Heinz bodies (Methyl violet stain) and bite cells
Fluorescent spot test (G6PD and NADP)
Methaemoglobin (Methylene blue)
Guthrie spot
G6PD activity

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18
Q

Blood film: Spherocytes, echinocytes (hedgehog-like)

A

Pyruvate kinase deficiency

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19
Q

What is Donath-Landsteiner antibodies

A

stick to RBCs in cold → complement-mediated haemolysis on rewarming (self-limiting as IgG so dissociate at higher temp than IgM).

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20
Q

Ham’s test +ve

A

Paroxysmal nocturnal haemoglobinuria

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21
Q

Blood film: schistocytes

A

MAHA

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22
Q

Antibodies against ADAMTS13

A

Thrombotic thrombocytopenic prupura

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23
Q

aetiology of Paroxysmal nocturnal haemoglobinuria

A

PIG A

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24
Q

Sickle cell disease aetiology

A

Autosomal recessive
Glu → Val on codon 6 of beta chain (Chr 11) → HbS

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25
Skull bossing, maxillary hypertrophy, hairs on end skull X-ray
Beta thalassaemia
26
Blood film: Teardrop RBCs (+Aniso and poikilocytosis) Nucleated RBCs Immature myeloid cells/myelocytes
Leucoerythroblastic anaemia
27
blood film: heavy toxic granulation of neutrophils, vacuoles seen
Reactive neutrophilia e.g. to infection
28
Coagulation results: APTT prolonged, PT/INR normal
Haemophilia OR VWD
29
Results: Platelets low Fibrinogen low High fibrin degradation products/D-dimer Long PT/INR
DIC
30
Results: II, V, VII, IX, X, XI, fibrinogen low VIII and VWF high
Liver disease
31
anti cardiolipin, lupus anticoagulant
APLS
32
BCR-ABL Ph Chr translocation t(9;22)
Chronic myeloid leukaemia
33
Treatment for CML
1. Imatinib 2. Other tyrosine kinase inhibitor 3. SCT
34
CD34, CD33/13/117
Acute myeloid leukaemia
35
Auer rods, sudan black stain, myeloperoxidase stain
Acute myeloid leukaemia
36
Treatment for acute myeloid leukaemia
1. Chemo 2. Targeted e.g. anti-CD33 (Gemtuzumab) 3. SCT
37
t(15;17)
Acute promyelocytic leukaemia
38
PML-RARA
Acute promyelocytic leukaemia
39
>20% blasts CD 19, 20, 22, CD34
B cell ALL
40
>20% blasts CD 3, 4, 8, CD34
T cell ALL
41
CD5 + CD 23 +
CLL
42
Smear cells on blood film
CLL
43
Staging for CLL
Rai and binet Binet: A: <3 lymphoid tissues B: >3 lymphoid tissues C: Hb <100, Plt <100 (+ B symptoms) Rai: 0: lymphocytosis only 1: lymphadenopathy 2: Hepatosplenomegaly 3: Hb <11 4: Platelets <100
44
Flower cells on blood film
ATLL
45
IgH-BCL2
Follicular B cell lymphoma
46
IgH-Cyclin D1
Mantle cell B cell lymphoma
47
IgH-MYC
Burkitt's lymphoma
48
t(14;18)
Follicular lymphoma
49
Lymph node biopsy: neoplastic follicles, positive CD10 and bcl-2 staining, centroblasts
Follicular lymphoma
50
Lymph node biopsy: small lymphocytes, arises from naive B cells, CD5 and CD23 positive
Small lymphocytic lymphoma (CLL but in lymph nodes)
51
Lymph node biopsy: from germinal centre/post-germinal centre, sheets of large lymphoid cells
Diffuse large B cell lymphoma
52
Lymph node biopsy: mantle zone, arising from pre-germinal centre cells, expression of CD5 and cyclin D1, clefted nuclei
Mantle cell lymphoma
53
Molecular: t(11;14), cyclin D1 overexpression
Mantle cell lymphoma
54
CD15, CD30 positive, CD20 negative
Classical Hodgkin's lymphoma
55
CD20 positive, CD15, CD30 negative
Nodular lymphocyte predominant lymphoma
56
Hypercellular marrow, lack of separation between RBCs, ringed sideroblasts, bilobed nuclei, reduced granulation of granulocytes, micro-megakaryocytes with hypolobulated nuclei
Myelodysplasia
57
Pelger-Huet anomaly
Hyposegmented neutrophils Myelodysplasia
58
Short stature, hypogonadism, cafe au lait spots, thumb abnormalities, microcephaly, developmental delay
Fanconi anaemia
59
Marrow failure Cancer predisposition Somatic abnormalities: leukoplakia, nail dystrophy, skin pigmentation
Dyskeratosis congenita
60
JAK2
Polycythaemia vera Essential thrombocythaemia
61
JAK2, calreticulin, MPL
Essential thrombocythaemia
62
Tear drop poikilocytes
Myelofibrosis
63
Dry tap bone marrow
Myelofibrosis
64
Blood transfusion → hypotension + tachy ± laryngeal/facial oedema, wheeze, SOB in minutes
Anaphylaxis
65
Blood transfusion → restless, chest/loin pain, fever, vomiting, flushing, collapse, haemoglobinuria (later)
ABO incompatibility
66
Blood transfusion → mild urticarial or itchy rash sometimes with a wheeze
Allergic reaction
67
Blood transfusion → rise in temperature by around 1 degree, chills and rigors
Non-haemolytic febrile reaction
68
M-spike <30 BM plasma cells <10% No CRAB symptoms
Monoclonal gammoglobulinopathy of unknown significance
69
M spike <30 BM plasma cells >10% No CRAB symptoms
Shouldering
70
M spike <30 BM plasma cells >10% CRAB symptoms
Multiple myeloma
71
Bence Jones proteins in urine electrophoresis
Multiple myeloma
72
Dense narrow band on serum electrophoresis
Multiple myeloma
73
BM plasma cells >60% Involved:uninvolved ratio >100 >1 focal lesion on MRI >5mm CD138 +
Myeloma defining events
74
Hepatosplenomegaly Lymphadenopathy Pancytopenia Hyperviscosity Sc: peripheral neuropathy, visual Sx, headache, bleeding
Waldenstrom's macroglobulinaemia
75
Nephrotic syndrome Heart failure Sensory neuropathy Macroglossia
AL amyloidosis
76
Rash, diarrhoea, jaundice after transplant
Acute GvHD
77
Rash, hepatitis, dry eyes, dry mouth, mouth ulcers, SOB, arthritis after transplant
Chronic (>100 days) GvHD)
78
Blood film: Rouleaux
Multiple myeloma
78
Blood film: Rouleaux
Multiple myeloma

Y5 Pathology (71 decks)

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