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Medicine (Y4) > Haematology > Flashcards

Haematology Flashcards

1
Q

basophilic stippling of red blood cells is found in…

A

Sideroblastic anaemia

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2
Q

polycythaemia rubra vera may transform to…

A

AML or myelofibrosis

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3
Q

What is the most common inherited blood disorder?

A

Von Willebrand’s disease

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4
Q

Which antibody type rises in acute infection?

A

IgM

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5
Q

Raised inflammatory markers & osteoporosis suggests…

A

Multiple myeloma

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6
Q

What is the general Hb threshold for RBC transfusion?

A

70g/L

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7
Q

leukoerythroblastic blood suggests…

A

CML

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8
Q

What is the duration of anticoagulation for unprovoked VTE?

A

6 months

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9
Q

What is the duration of anticoagulation after provoked VTE?

A

3 months

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10
Q

‘Bite cells’ suggests..

A

G6PD deficiency

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11
Q

How is G6PD deficiency inherited?

A

X-linked recessive

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12
Q

Which patients should be given irradiated blood life-long?

A

Those with Hodgkin’s Lymphoma

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13
Q

Hypersegmented neutrophils are typical of…/

A

Vit B12/Folate deficiency

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14
Q

Which medication can be used to reduce the risk of tumour lysis syndrome?

A

Allopurinol

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15
Q

rouleaux formation is characteristic of…

A

Myeloma

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16
Q

What is the most common type of NHL?

A

Diffuse large B cell lymphoma

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17
Q

What is meant by primary haemostasis?

A

formation of platelet plug

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18
Q

Problems with which components could cause a problem of primary haemostasis?

A

Platelets, vascular, vWF

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19
Q

What is meant by secondary haemostasis?

A

formation of fibrin clot

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20
Q

What are the Vit K dependent clotting factors?

A

II, VII, IX and X

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21
Q

Raised PT and APTT suggests…

A

Multiple clotting factor deficiency

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22
Q

Give causes of multiple clotting factor deficiency.

A

Liver failure, DIC, Vit K deficiency

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23
Q

Which is the most common Haemophilia?

A

Haemophilia A

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24
Q

Haemophilia A occurs due to…

A

Factor VIII deficiency

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25
Q

Haemophilia B occurs due to…

A

Factor IX deficiency

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26
Q

Isolated raised APTT suggests…

A

Intrinsic problem - likely haemophilia

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27
Q

How are Haemophilia A and B inherited?

A

X-linked recessive

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28
Q

Give an example of an extrinsic pathway problem.

A

Factor VII deficiency

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29
Q

Myelodysplasia may transform to…

A

AML

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30
Q

What is the major component of cryoprecipitate?

A

Factor VIII

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31
Q

In suspected DVT, what is the management if D-dimer positive but doppler negative?

A

stop anticoagulation and repeat scan in 1 week

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32
Q

an increase in granulocytes at different stages of maturation +/- thrombocytosis suggests…

A

CML

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33
Q

Which blood component have the highest risk of bacterial contamination?

A

Platelets

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34
Q

Where is Vit B12 absorbed?

A

Ileum

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35
Q

Where is folate absorbed?

A

Duodenum & jejenum

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36
Q

Where is iron absorbed?

A

Duodenum & jejenum

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37
Q

What can be given before surgery to reduced bleeding in vWF deficiency?

A

Desmospressin

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38
Q

What is the treatment for beta-thalassaemia major?

A

Lifelong blood transfusions

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39
Q

Which kind of clotting do antiplatelets target and which conditions?

A

Arterial clotting involving primary haemostasis (platelets)

Used in cerebrovascular disease, coronary & peripheral artery disease

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40
Q

Which kind of clotting do anticoagulants target and which conditions?

A

Venous clotting involving secondary haemostasis (clotting factors)
Used in PE, DVT and AF

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41
Q

What is the MOA of Aspirin?

A

COX-1 inhibitor → blocking TXA2 and reducing platelet aggregation

42
Q

What is the MOA of Ticagrelor/Clopidogrel?

A

P2Y12 receptor blockers on platelet surface

43
Q

What are the main uses of antiplatelet agents?

A

Acute CVA/ACS

Secondary prevention cardiovascular

44
Q

What is the MOA of warfarin?

A

Inhibits production of Vit K-dependent clotting factors - II, VII, IX and X

45
Q

What is the MOA of Heparins?

A

Inhibit factors IIa (Thrombin) and Xa

46
Q

What is important to remember when starting Warfarin for VTE treatment?

A

Initially pro-thrombotic effect - for VTE treatment, give with heparin initially

47
Q

Dabigatran belongs to which class of medications?

A

DOAC - Direct Thrombin inhibitors

48
Q

What is the MOA of Rivaroxaban, Edoxaban, Fondaparineux etc?

A

Xa inhibitors

49
Q

Which agents can be used in stroke prevention in AF?

A

Warfarin or DOACs

50
Q

Which anticoagulant should be used in valvular AF?

A

Warfarin

51
Q

Which medications are used in secondary prevention of stroke?

A

Clopidogrel 75mg

High-dose statin

52
Q

What is the treatment for ITP?

A

Oral steroids

53
Q

What is the definitive test for sickle cell disease?

A

Hb electrophoresis

54
Q

How is Heparin monitored?

A

Unfractionated - APTT

LMWHs - usually none, can do Xa assay

55
Q

How is Warfarin monitored?

A

INR

56
Q

What is the reversal agent for Heparin?

A

Protamine sulphate

57
Q

What is the standard therapeutic range for INR?

A

2-3

58
Q

What INR is usually required for surgery?

A

< 2.5

59
Q

Give examples of hereditary thrombophilias.

A

Factor V Leiden, Protein C/S deficiency

60
Q

Anaemia with raised reticulocyte count suggests…

A

Haemolysis or blood loss

61
Q

What are the most common causes of hypochromic microcytic anaemia?

A

Iron deficiency anaemia and thalassaemia

62
Q

Give causes of Normochromic normocytic anaemia.

A

Anaemia of chronic disease
Bone marrow failure or infiltration
Renal impairment

63
Q

Pernicious anaemia increases the risk of which cancer?

A

Gastric

64
Q

What is the problem in thalassaemia?

A

Reduced globin chain production

65
Q

What are the severities of alpha thalassamia?

A

alpha thalassemia trait - asymptomatic/mild anaemia
HbH disease - moderate to severe anaemia
Hydrops foetalis - fatal

66
Q

In which areas is thalassaemia more common?

A

Around equator in malaria-endemic areas

67
Q

What is the diagnostic test for beta thalassaemia trait?

A

Raised HbA2

68
Q

When does beta-thalassaemia major tend to present?

A

Age 6 - 24 months (as HbF falls)

69
Q

How is beta-thalassaemia major managed?

A

Blood transfusions at target Hb 95 - 105

70
Q

What is the biggest cause of mortality in beta-thalassaemia major?

A

Iron overload

71
Q

What is the cause of sickle cell anaemia?

A

Point mutation in Hb which polymerises to change shape of RBC surface

72
Q

What is the management of sickle cell crisis?

A 
Opiate analgesia 
Hydration 
Rest
Oxygen 
Antibiotics if evidence of infection 
Red cell exchange transfusion in severe crisis eg (lung) chest crisis or (brain) stroke
73
Q

Which complication of sickle cell disease increases risk of infection?

A

Splenic infarction leading to hyposplenism

74
Q

Which medication may reduce the severity of sickle cell disease?

A

Hydroxycarbamide

75
Q

D-dimer positive, doppler negative - what is the management?

A

Stop anticoagulation and offer repeat scan

76
Q

What type of blood can rhesus negative patients receive?

A

Rhesus negative only

77
Q

What is the threshold for platelet transfusions in bleeding?

A

30 if bleeding, 100 in massive haemorrhage

78
Q

What is the platelet threshold for prophylactic infusion (for example bone marrow failure, autoimmune thrombocytopaenia)?

A

10

79
Q

What is the platelet target for patients undergoing surgery?

A

50

80
Q

What does FFP contain?

A

clotting factors, fibrinogen, albumin, natural anticoagulants etc

81
Q

Under what circumstances would cryoprecipitate be indicated?

A

Major haemorrhage with Fibrinogen < 1.5g/L

82
Q

What are the indications for Prothrombin complex concentrate?

A

emergency reversal of warfarin in severe bleeding, head injury or emergency surgery

83
Q

Give potential alternatives to blood transfusion.

A

Do nothing
Iron replacement - oral or IV
EPO injections
Tranexamic acid to reduce bleeding risk eg. during surgery or menorrhagia

84
Q

Why are some patients given irradiated blood?

A

Reduce the chance of graft-versus-host disease

85
Q

Which patients should receive irradiated blood?

A

Lifelong - Hodgkin’s Lymphoma
Bone Marrow Transplant
Aplastic anaemia
Treatment with purine chemotherapy for haem cancer

86
Q

Which patients should receive CMV negative blood?

A

Pregnant women and neonates up to 6 months

87
Q

When should observations be taken when administering a blood transfusion?

A

Before, after 15 mins and within 60 mins of completion

88
Q

What signs would suggest a massive haemorrhage clinically?

A

BP < 90 or HR > 110

89
Q

Which infusions would be given in major haemorrhage?

A

Initially 2:1 red cells: FFP, 1:1 in trauma/PPH

90
Q

CLL may transform to…

A

High-grade NHL

91
Q

What is the main differentiating feature between acute and chronic leukaemias?

A

Acute - block in differentiation/maturation so excess of blasts
Chronic - no block in differentiation/maturation - cells at all stages

92
Q

> 20% lymphoblasts suggests…

A

ALL

93
Q

> 20% myeloblasts suggests…

A

AML

94
Q

Presence of Auer Rods suggests…

A

AML

95
Q

Which testing can differentiate ALL vs AML.

A

Immunophenotyping

96
Q

Philadelphia translocation – t(9:22) suggests….

A

CML

97
Q

‘Smudge cells’ suggests…

A

CLL

98
Q

‘Reed Steenberg cells’ suggests…

A

Hodgkin’s Lymphoma

99
Q

How long is a unit of RBCs usually transfused over?

A

90 - 120 mins

100
Q

‘Heinz bodies’ suggests…

A

G6PD deficiency

Medicine (Y4) (13 decks)

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