Haematology Flashcards

1
Q

Why can PPIs reduce iron absorbtion

A

Need acid to keep iron in soluble fe2+ form

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2
Q

4 Main causes of iron deficiency

A

Blood loss, Dietary insufficiency, poor absorption, pregnancy (requirements)

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3
Q

Microcytic anaemia causes

A

T - Thalassaemia
A - Anaemia of chronic disease
I - Iron deficiency
L - Lead poisoning
S - Sideroblastic anaemia

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4
Q

Causes of normocytic anaemia

A

3 As, 2 Hs
A - Acute blood loss
A - Anaemia of chronic disease
A - Aplastic anaemia
H - Haemolytic anaemia
H - Hypothyroidism

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5
Q

Causes of Macrocytic anaemia (megaloblastic)

A

B12 deficiency
Folate deficiency

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6
Q

Causes of macrocytic anaemia (normoblastic)

A

Alcohol
Reticulocytosis
Hypothyroid
Liver disease
Drugs (e.g. azathioprine)

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7
Q

First line mx for iron deficiency anaemia

A
  1. Correct cause
    Then depending on severity either:
    - Blood transfusion (corrects anaemia not deficiency)
    - Oral ferrous sulfate tablets.
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8
Q

Name 5 Inherited Haemolytic anaemias (HHTSG)

A

Hereditary Spherocytosis
Hereditary Elliptocytosis
Thalassaemia
Sickle cell anaemia
G6PD deficiency

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9
Q

5 Acquired haemolytic anaemias (AAPMP)

A

Autoimmune haemolytic anaemia
Alloimmune haemolytic anaemia (tranfusion reactions + rhesus shenanigans)
Paroxysmal nocturnal haemoglobinuria
Microangiopathic Haemolytic anaemia
Prosthetic valve related haemolysis

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10
Q

Features of haemolytic anaemia

A

Anaemia
Splenomegaly (full of dead blood cells)
Jaundice (loads of bilirubin)

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11
Q

Investigations for haemolytic anaemia

A

FBC
Blood film
Direct coombs test

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12
Q

Describe hereditary spherocytosis + classic presentation

A

Sphere shaped RBCs that are easily destroyed, presents with jaundice, gallstones, splenomegaly & aplastic crisis (parvovirus)

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13
Q

Management of hereditary spherocytosis

A

Folate supplementation + splenectomy

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14
Q

Describe hereditary elliptocytosis

A

Same as spherocytosis but instead of sphere shaped RBCs are ellipse shaped

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15
Q

Commonest leukaemia in kids

A

ALL

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16
Q

Blood film for ALL + associated disease

A

Circulating lymphoblasts with little cytoplasm, associated with Down syndrome.
Good prognosis

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17
Q

Commonest leukaemia in adults

A

AML + CLL

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18
Q

Blood film of AML + associated disease

A

Auer rods in cytoplasm
Commonly transforms from other disorders e.g. myelofibrosis + polycythaemia)

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19
Q

Complications of AML

A

Leukostasis & Tumour lysis syndrome

20
Q

Commonest leukaemia in adults

A

CLL

21
Q

Blood film CLL

A

Smear/smudge cells, richters transformation

22
Q

Rarest leukaemia

A

CML

23
Q

Blood film of CML

A

Eoisinophilia, basophilia, immature granulocytes

24
Q

Chromosome commonly present in CML

A

Philadelphia chromosome

25
Q

Lymphoma presentaion

A

Fatigue, pruittus, non tender lymphadenopathy, cough, SOB, recurrent infections.

26
Q

Hodgkins lymphoma cell finding

A

Reed sternberg cells (Googly eyes)

27
Q

Hodgkins vs non-hodgkins

A

Hodgkins have better prognosis however less common.

28
Q

Non-hodgkins lymphoma risk factors

A

EBV, HIV, H. Pylori.

29
Q

What is myeloma

A

Cancer of plasma cells

30
Q

Myeloma on blood film

A

Rouleax formation, RBCs stick together

31
Q

Diagnosis of myeloma

A

Inc plasma cells on biopsy, monoclonal paraprotein, evidence of end organ damage
Calcium
Renal failure
Anaemia
Bone pain & lesions

32
Q

Most common monoclonal paraprotein in myeloma

A

IgG

33
Q

Thrombotic inherited clotting disorder
(most common clotting disorder)

A

Factor V leiden
Factor V cant be broken down by APC
More clotty

34
Q

Acquired thrombotic clotting disorder

A

Antiphospholipid syndrome
C coagulation defect
L Livedo reticularis (mottled skin)
O obstetric complications
T Thrombocytopenia

35
Q

Test for antiphospholipid syndrome

A

Anticardiolipin antibodies

36
Q

Haemorrhagic inherited clotting disorder

A

Von willebrand disease (dont treat)

Haemophilias (x-linked recessive) most pts boys
A - factor 8
B - factor 9

37
Q

Haemorrhagic acquired clotting disorder

A

Liver disease (less clotting factors produced)

DIC (sepsis, trauma, pregnancy all causes)
use up clotting factors so give heparin + consider platelets

38
Q

What clotting disorder associated with SLE

A

Antiphospholipid syndrome

39
Q

Reactions to transfusion

A

Febrile non-haemolytic, TACO, TRALI

40
Q

What is TACO

A

Transfuision associated circulatory overload
Acute LVF too much fluid or given too quickly.
Mx, diuretics, oxygen, STOP

41
Q

What is TRALI

A

transfusion related acute lung injury
Within 6 hrs of transfusion
ARDS, cough, SOB, Batwing on CXR
Mx, stop transfusion, senior help, supportive

42
Q

Inheritance pattern of thalassaemia

A

Autosomal recessive

43
Q

What is sickle cell disease

A

RBCs normal until they are stressed (hypoxia, infection, cold etc) then will transform to sickle shape.

44
Q

Sickle cell prevents what

A

Malaria, therefore selective pressure for sickle cell

45
Q

Complicatipns of sickle cell

A

Vaso-occlusive crisis, can block microcirculation anywhere => pain and ischaemia.
Aplastic crisis, temporary cessation of erythropoeisis
Sequestration crisis, sudden splenomegaly due to haemorrhage within it

46
Q

Mx of sickle cell

A

Preventative
Prevent triggers
Prevent infection etc