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Finals HH > Haematology > Flashcards

Haematology Flashcards

1
Q

What can Myeloid stem cell become?

A

Platelets
RBC
Basophil, Neutrophil, Eosinophil, Macrophage

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2
Q

What can lymphoid stem cell become?

A

B cell
T cell
NK cell

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3
Q

What is a reticulocyte?

A

An immature red blood cell

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4
Q

Lifespan of a RBC?

A

3 months

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5
Q

What are target cells on a blood film seen in?

A

Iron deficiency anaemia
Post-splenectomy

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6
Q

What are Heinz Bodies on a blood film seen in?

A

G6PD
Alpha-thalassameia

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7
Q

What are Howell-Jolly bodies on a blood film seen in?

A

Post-splenectomy
Severe anaemia

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8
Q

What are Howell-Jolly bodies?

A

Blobs of DNA material is seen in RBC. This should be removed by spleen.

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9
Q

When are there high levels of reticulocytes?

A

Haemolytic anaemia

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10
Q

What are schistocytes?

A

Fragments of RBC

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11
Q

What are schistocytes and causes?

A

Fragments of RBC due to trauma

Causes:
- Haemolytic uraemic syndrome
- Disseminated intravascular coagulation (DIC)
- Thrombotic thrombocytopenia purpura
- Metal heart valves
- Haemolytic anaemia

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12
Q

What are sideroblasts and what do they indicate?

A

Sideroblasts are immature RBC

Indicate myelodysplasic syndrome

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13
Q

What are smudge cells on a blood film seen in?

A

Chronic lymphocytic leukaemia

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14
Q

What are spherocytes on a blood film seen in?

A

Spherocytes are spherical red blood cells

Seen in autoimmune haemolytic anaemia or hereditary spherocytosis

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15
Q

Causes of microcytic anaemia acronym?

A

TAILS

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

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16
Q

Causes of normocytic anaemia causes?

A

3As and 2Hs

A – Acute blood loss
A – Anaemia of Chronic Disease
A – Aplastic Anaemia
H – Haemolytic Anaemia
H – Hypothyroidism

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17
Q

Macrocytic megaloblastic anaemia causes?

A

B12 deficiency
Folate deficiency

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18
Q

Macrocytic normoblastic anaemia causes?

A

Alcohol
Reticulocytosis - new RBC turnover
Hypothyroidism
Liver disease
Drugs such as azathioprine

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19
Q

Ix of iron deficient anaemia if no clear cause?

A

OGD - oesophago-gastroduodenoscopy
+
Colonscopy

(look for cancer of GI tract)

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20
Q

Mx of iron deficient anaemia?

A

Oral iron (ferrous sulfate) for 3 months
Iron infusion - avoid in sepsis
Blood transfusion

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21
Q

Iron studies in iron deficient anaemia?

A

Serum ferritin Low
TIBC High
Transferrin High

However, high/normal ferritin can’t rule out iron deficient anaemia could be concurrent inflammation and inflammation increases ferritin

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22
Q

Causes of B12 deficienct?

A

Insufficient dietary intake
Pernicious anaemia

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23
Q

What is pernicious anaemia?

A

Antibodies attack the parietal cells or intrinsic factor which are responsible for B12 absorption

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24
Q

Ix for pernicious anaemia?

A
  1. Intrinsic factor antibody
  2. Gastric parietal cell antibody
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25
Q

Mx of B12 deficinecy?

A

If dietary insufficiency -> oral replacement iwth Cyanocobalamic

If pernicious anaemia -> IM hydroxycobalamin

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26
Q

Why always mx B12 deficiency before folate deficinecy?

A

Treating patients with folic acid when they have a B12 deficiency can lead to subacute combined degeneration of the cord

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27
Q

Features of haemolysis? (3)

A

Anaemia
Splenomegaly
Jaundice

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28
Q

What does a positive direct coomb’s test indicate?

A

Autoimmune haemolytic anaemia

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29
Q

Mx of hereditary spherocytosis?

A

Folate supplementation + splenectomy

30
Q

Jaundice after broad beans, infections or antimalarial mx?

A

G6PD deficiency

31
Q

Ix to diagnose globin abnormalities?

A

Haemoglobin electrophoresis

(Diagnostic test for thalassaemia & sickle-cell disease)

32
Q

Iron studies in thalasaemia?

A

Serum ferritin High
Transferrin High
TIBC High

33
Q

What is thalassaemia?

A

Reduced globin chain synthesis

34
Q

Sickle cell disease + parvovirus?

A

Aplastic crisis - sudden fall in haemoglobin
Reduced reticulocyte count

35
Q

What is sequestration crisis?

A

Sickle cell crisis where sickling within organs such as lungs or spleen -> blood pooling

Increased reticulocyte count & anaemia

36
Q

Sickle cell crisis triggers?

A

Infection
Dehydration
Deoxygenation (High altitude)

37
Q

Mx of sickle cell crisis?

A

Analgesia
Rehydrate
Oxygen
Consider:
- Antibiotics
- Blood transfusion
- Exchange transfusion

38
Q

General mx of sickle cell disease?

A

Avoid dehydration and triggers
Antibiotic prophylaxis - Penicillin V (phenoxymethylpenicillin)

Hydroxycarbamide can increase HbF production

39
Q

Leukaemia Ix & Dx?

A

Ix - FBC within 48hours

Dx - Bone marrow biopsy

40
Q

Where is a bone marrow biopsy normally taken from?

A

Iliac crest

41
Q

Blood film of ALL?

A

Blast cells
No B- or T-cells
Lots of lymphocyte precursors

42
Q

Who gets ALL?

A

Children <5years of adults >45
Down syndrome
Philadelphia chromosome

43
Q

Px of ALL

A

Pancytopenia:
Anaemia - lethargy and pallor
Neutropenia - infections
Thrombocytopenia - easy brusiing, petechiae

Hepatosplenomegaly
Fever
Bone pain

44
Q

Blood film of chronic lymphocytic leukamia

A

Smear or smudge cells

45
Q

FBC of CLL?

A

Lymphocytosis - raised WCC
Anaemia
Thrombocytopenia

46
Q

What are Auer rods seen in?

A

Acute myeloid leuakemia

47
Q

FBC of Chronic myeloid leukemia?

A

Lots of neutrophils, RBC, platelets

48
Q

What is Richter’s transformation?

A

CLL -> Lymphoma (non-Hodgkin’s lymphoma)

Patient with CLL becomes unwell very suddently

49
Q

What is tumour lysis syndrome?

A

Release of uric acid from cells being destroyed by chemotherapy -> AKI

50
Q

S/e of bleomycin?

A

Lung fibrosis

51
Q

Chronic myeloid leukaemia mx?

A
  1. Imatinib (tyrosine kinase inhibitor)

Others:
- Hydroxyurea
- Interferon-alpha
- Allogenic bone marrow transplant

52
Q

What is a Reed-sternberg cell seen in?

A

Hodgkin’s lymphoma

53
Q

Lymphoma with alcohol-induced pain in the node?

A

Hodgkin’s lymphoma

54
Q

Diagnostic test of lymphoma?

A

Lymph node biopsy

55
Q

Staging system for Hodgkin’s and Non-Hodgkins lymphoma?

A

Ann Arbor staging

56
Q

B symptoms of lymphoma?

A

Fever
Weight loss
Night sweats

57
Q

Non-Hodgkin’s lymphoma associated with EBV, malaria and HIV?

A

Burkitt lymphoma

58
Q

Non-Hodgkin’s lymphoma associated with H.pylori infection?

A

MALT lymphoma

59
Q

Mx of Hodgkin’s lymphoma?

A

Chemotherapy is mainstay

+/- Radiotherapy

60
Q

Mx of non-Hodgkin’s lymphoma?

A

Watchful waiting
Chemo +/- radiotherapy
Rituximab - monoclonal antibodies

61
Q

Microscopy appearance of Burkitt’s lymphoma?

A

“Starry sky” appearance

62
Q

What are the three myeloproliferative disorders?

A

Primary myelofibrosis
Polycythaemia vera
Essential thrombocythaemia

63
Q

What is myelofibrosis?

A

When proliferation of a cell line -> fibrosis of bone marrow

64
Q

What is extramedullary haematopoiesis?

A

When the bone marrow is replaced with scar tissue the production of blood cells (haematopoiesis) starts to happen in other areas such as the liver and spleen

-> Hepatomegaly & Splenomegaly

65
Q

What is raised in polycythaemia vera?

A

Haemoglobin

(Erythroid cells - RBC)

66
Q

What is raised in primary thrombocythemia?

A

Raised platelet count

(Megakaryocyte)

67
Q

What are the FBC findings in Myelofibrosis?

A

Anaemia
Leukocytosis or leukopenia
Thrombocytosis or thrombocytopenia

68
Q

What would a blood film of myelofibrosis show?

A

Teardrop-shaped RBCs
Poikilocytosis - RBCs varied in size
Blasts - immature red and white cells

69
Q

Dx for myeloproliferative disorders?

A

Bone marrow biopsy

Bone marrow aspiration is normally dry due to scar tissue

70
Q

Mx of primary myelofibrosis?

A

Allogenic stem cell transplant
Chemotherapy
Supportive

71
Q

Mx of polycythaemia vera?

A

Venesection
Aspirin
Consider chemotherapy

72
Q

Mx of primary thrombocythaemia?

A

Aspirin
Chemotherapy

Finals HH (21 decks)

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