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Path Mega Deck > Haematology > Flashcards

Haematology Flashcards

1
Q

Philadelphia +ve

A

CML

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2
Q

Tear drop poikilocyte
Nucleated RBC
Myelocyte

A

Leucoerythroblastic Anaemia

immature WBC and RBC in anaemia

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3
Q

Stain for reticulocytes

A

Methylene Blue

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4
Q

Hereditary Spherocytosis caused by defect in…

A

Spectrin

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5
Q

Increased LDH and haptoglobins

A

Haemolysis

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6
Q

Which cancer causes MAHA?

A

Adenocarcinoma (prostate)

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7
Q

Haemolytic Uraemic Syndrome caused by which bug?

A

E. coli

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8
Q

Auer Rods

A

AML

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9
Q

Which virus causes Adult T Cell Lymphoma

A

Human T-Lymphotrophic Virus 1 (HTLV1)

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10
Q

Adult T Cell Lymphoma in which ethnicities?

A

Caribbean and Japan carriers

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11
Q

Alcohol-induced pain

A

Hodgkin Lymphoma

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12
Q

L&H Cells (“popcorn cells”)

A

Nodular Lymphocyte Predominant Hodgkin = “non-classical Hodgkin)
L = lymphocytic and histiocytic cells

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13
Q

t(14;18) –> overexpression of bcl2 by cancerous B cells

A

Follicular Non-Hodgkin

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14
Q

H. pylori causes which NHL?

A

Gastric MALToma

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15
Q

Coeliac Disease associated with which NHL?

A

Enteropathy Associated T Cell Lymphoma (EATL)

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16
Q

Reed-Sternberg Cells

A

Hodgkin Lymphoma

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17
Q

t(11;14) –> over-express cyclin D1

A

Mantle Cell Lymphoma

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18
Q

Starry-sky appearance on lymph node biopsy

A

Burkitt’s Lymphoma

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19
Q

Burkitt’s Lymphoma caused by which virus?

A

EBV

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20
Q

Large “epitheloid” lymphocytes on lymph node biopsy

A

Anaplastic Large Cell Lymphoma

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21
Q

t(2;5) –> Alk-1 protein expression

A

Anaplastic Large Cell Lymphoma

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22
Q

Smear/Smudge Cells (fragile cells which open up = purple splodges)

A

Autoimmune Haemolytic Anaemia (including CLL!)

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23
Q

Pelger-Huet: bilobed neutrophils

A

Myelodysplasia

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24
Q

Infection causing bone marrow failure

A

Parvovirus

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25
Q

Ringed Sideroblasts: iron accumulation in ring around nucleus

A

Myelodysplasia (and AML)

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26
Q

Anaemia with abnormal thumbs and Cafe au lait spots

A

Fanconi Anaemia

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27
Q

DKC1 and TERC mutations

A

Dyskeratosis Congenita = reduced tolemere length

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28
Q

Itchy after warm water on skin

A

Polycythaemia Vera

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29
Q

Massive splenomegaly, causing Budd-Chiari Syndrome (hepatic veins draining liver are blocked)

A

Myelofibrosis

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30
Q

Skin pigmentation, nail dystrophy and leukoplakia

A

Dyskeratosis Congenita

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31
Q

JAK2 V617F mutation

A

Polycythaemia Vera

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32
Q

Myelocytes

A

CML

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33
Q

Leukaemia which is emergency as die from rapid haemorrhage/DIC

A

Acute Promyelocytic Leukaemia

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34
Q

t(9;22) in Philadelphia chromosome

A

Chronic Myeloid Leukaemia

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35
Q

Philadelphia-positive cases treated with…

A

Imatinib

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36
Q

Tear drop cell and macrocytes

A

Pernicious Anaemia (vit B12 and folate deficiency)

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37
Q

Antibodies in Pernicious Anaemia

A

Parietal Cell and Intrinsic Factor antibodies

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38
Q

Leading cause of mortality in pregnancy

A

VTE

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39
Q

Antiphospholipid Syndrome antibodies

A

Lupus Anticoagulant (LA) and Anti-Cardiolipin (ACL) antibodies

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40
Q

Test to differentiate IDA from Thalassaemia Trait

A

Hb Electrophoresis

  • IDA: normal
  • Thalassaemia: increased HbA2 in beta-thalssaemia, normal in alpha
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41
Q

Megakaryocytes in neonate

A

Neonatal Leukaemia (develops in utero and remits spontaneously)

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42
Q

Howell-Jolly Body

A

Sickle Cell Anaemia

infarction of spleen –> hyposplenism

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43
Q

What animal causes hyposplenism in sickle cell?

A

Dog bites = capnocytophaga canimorsus

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44
Q

Hyperplasia of facial bones

A

Beta-Thalassaemia

increased EPO –> bone expansion

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45
Q

Irregularly contracted cells

A

G6PD deficiency

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46
Q

Schistocytes

A

MAHA (fragmented red cells)

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47
Q

Coagulation disorder with NORMAL bleeding time

A

Haemophilia A

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48
Q

Universal donor

A

Group O, RhD –ve

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49
Q

Universal recipient

A

Group AB, RhD+ve

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50
Q

Maculopapular rash/desquamation after blood transfusion

A

Transfusion-Associated Graft Vs Host Disease

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51
Q

Patients affected by Post-Transfusion Purpura

A

HPA-1a negative patients

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52
Q

Polychromatic macrocytes

A

G6PD deficiency

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53
Q

100 days after bone marrow transplant, develop widespread illness that looks autoimmune.

A

Chronic Graft vs Host Disease

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54
Q

Drug which reverses heparin

A

Protamine

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55
Q

“Toxic granulation and vacuolation”

A

Sepsis

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56
Q

Koilonychia and Angular Cheilitis

A

Iron Deficiency Anaemia

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57
Q

Glossitis (“beefy tongue”)

A

B12 Deficiency

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58
Q

Target and pencil cells

A

Iron Deficiency Anaemia

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59
Q

Thrombotic Thrombocytopaenia Purpura (TTP) caused by what deficiency?

A

von Willebrand Factor Cleaving Protease (ADAMTS13)

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60
Q

Common infections in splenectomy patients

A

Encapsulated (pneumococcus, meningococcus)

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61
Q

Low platelets in post-surgical/septic patient

A

DIC

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62
Q

Osmotic Fragility Test

A

Hereditary Spherocytosis

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63
Q

Glucose-6-Phosphate Dehydrogenase Deficiency have deficiency in what?

A

Glutathione

G6PD helps make NADPH, which makes glutathione, which protects RBCs against oxidative stress…

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64
Q

Echinocytes

A

Pyruvate Kinase Deficiency

red cells have projections

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65
Q

Di-Binding Test

A

Hereditary Spherocytosis

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66
Q

Middle Eastern baby with sudden pallor and jaundice

A

G6PD deficient who ate fava beans

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67
Q

Heinz-Bodies

A

G6PD Deficiency

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68
Q

Stain for Heinz-Bodies

A

Methyl violet stain

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69
Q

Pectus excavatum, lax joints and a high-arched palate.

A

Ehlers-Danlos syndrome

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70
Q

The commonest adult leukaemia

A

Chronic lymphocytic leukaemia

71
Q

Tan-to-grey hyperpigmented patches on his upper trunk, neck and face, nail ridges
Leukoplakia

A

Dyskeratosis congenita

72
Q

Ham’s Test positive

also abdo pain and pancytopaenia

A

Paroxysmal nocturnal haemoglobinuria

73
Q

19 year old Jewish male presenting with multiple pathological fractures and hypersplenism

A

Gaucher’s disease (glucosylceramide lipidosis)

74
Q

Donath-Landsteiner positive

A

Paroxysmal cold haemoglobinuria

75
Q

Bone marrow red cell aplasia and a positive Paul-Bunnell test

A

B19 parvovirus infection

76
Q

Anti-leucocyte antibodies with similar specificity to the patient’s white blood cell antigens

A

TRALI – Transfusion related acute lung injury

77
Q

Deficiency of which immunoglobulin causes anaphylaxis after blood transfusions?

A

IgA Deficiency

78
Q

Haemolytic Uraemic Syndrome is triad of what?

A
  1. MAHA
  2. AKI
  3. Thrombocytopaenia
79
Q

Low Factor VIII and low ristocetin cofactor activity

A

Von Willebrand Disease

80
Q

Tumour cells express tartrate-resistant phosphatase (TRAP)

A

Hairy Cell Leukaemia

  • Cancer of B cells (subset of CLL)
  • Middle-aged men
81
Q

Japanese person with lymphocytosis and hypercalcaemia

Tumour cells have cloverleaf appearance

A

Adult T-cell Leukaemia

  • Caused by Human T-Lymphotrophic Virus 1
  • Common in Japs and Carribeans
82
Q

t(11;14) –> over-expression of BCL-2 and cyclin-D1

A

Mantle Cell Lymphoma

-Aggressive B cell lymphoma in old men

83
Q

Tumour cells contain centrocytes and centroblasts

A

Follicular Lymphoma

  • Centrocytes = small B cells with irregular nuclei
  • Centroblasts = large B cells with many nuclei

Presents with painless “waxing and waning” lymphadenopathy

84
Q

When would you give irradiated blood?

A

Very immunosuppressed — prevents Graft vs Host Disease (donor WBCs attack host)

85
Q

Old man with vision disturbances (looks like looking out of windscreen). Protein electrophoresis shows an IgM paraprotein

A

Waldenstrom’s macroglobulinaemia

86
Q

Sudden jaundice and haemaglobinuria after cold exposure

A

Paroxysmal cold haemoglobinuria

-Donath-Landsteiner antibodies

87
Q

What does warfarin inhibit?

A

Vitamin K epoxide reductase

88
Q

Which haematological cancer is increased in first 3 years in Down Syndrome?

A

AML –> get Auer Rods!

89
Q

BCR-ABL fusion gene

A

CML – arises from Philadelphia Chromosome = t(9;22)

90
Q

t(15;17) –> PML-RARA fusion gene

A

Acute Promyelocytic Leukaemia

91
Q

What medical emergency is Acute Promyelocytic Leukaemia associated with?

A

DIC

92
Q

Desmopression treats this clotting disease

A

Von Willebrand Disease

93
Q

Bite cells

A

G6PD Deficiency

94
Q

Basophilic stippling

A

Beta-Thalassaemia trait (and lead poisoning)

95
Q

Acanthocytes (spiculated blood cells/spur cells)

A

Hyposplenism

96
Q

“Turkish patient”

A

Turkish (G6P)Delight!

97
Q

Mechanism of Factor V Leiden

A

Resistance to protein C

98
Q

Sudden anaemia and low reticulocytes

A

Parvovirus

99
Q

When would you give Fresh Frozen Plasma?

A

Person with coagulopathy is bleeding, and cannot give them the relevant factor

100
Q

IgA deficient need what type of blood product?

A

Washed red blood cells

101
Q

Lack of HPA-1a antigen causes this transfusion reaction

A

Post-transfusion purpura

102
Q

Definition of accelerated phase in CML (in terms of % blasts)

A

10-19% blasts

103
Q

Definition of blast crisis in CML (in terms of % blasts)

A

> 20% blasts

104
Q

Treatment of blast crisis in CML

A

Allogeneic Stem Cell Transplant

105
Q

3 components of Virchow’s Triad

A
  1. Hypercoagulability
  2. Vessel wall injury
  3. Stasis of blood
106
Q

What measures Intrinsic and Common pathways?

A

APTT

107
Q

Which clotting factors are in Intrinsic and Common pathways?

A

Factors 8 and 9 (= Haemophilia!)

108
Q

What measures Extrinsic pathway?

A

PT

109
Q

Which clotting factors are in Extrinsic pathway?

A

Factors 2, 7 and 10 (= INR)

110
Q

Difference between Von Willebrand and Haemophilia (in terms of PT, APTT and Bleeding Time)

A

Von Willebrand has increased bleeding time

Both have increased APTT (involves Factors 8 and 9)

111
Q

Slight anaemia with hyperchromic cells lacking central pallor

A

Hereditary Spherocytosis

112
Q

Warm vs Cold AIHA

A

Warm = IgG, which bind to RBCs at 37degrees

  • Lymphoproliferative disorders
  • Penicillin
  • Autoimmune

Cold = IgM, which binds to RBCs at 4degrees
-Mycoplasma or EBV

113
Q

Virus which causes Hodgkin’s

A

EBV

114
Q

Causes primary effusion lymphoma

A

HHV8 (effusion in a tumour mass)

115
Q

Neonate with thumb abnormalities and macrocytic anaemia (WBC and platelets normal)

A

Diamond-Blackfan Anaemia (affect RBC progenitors)

116
Q

Condition increasing risk of thrombosis when on COCP

A

Factor V Leiden = activated Protein C resistance

117
Q

When would you use cryoprecipitate?

A

Replace fibrinogen

-cryoprecipitate contains clotting factors and fibrinogen

118
Q

What can CLL rapidly transform into?

A

Diffuse Large B cell non-Hodgkin’s lymphoma (=Richter’s transformation)

119
Q

“Rain-drop skull” on X-Ray

A

Multiple Myeloma (multiple osteolytic lesions)

120
Q

Clotting disorders associated with haemarthroses

A

Haemophilia A and B

121
Q

Polycythaemia vera can transform to which leukaemia?

A

AML (>20% blasts on blood film)

122
Q

Primary Myelofibrosis is associated with this genetic mutation

A

JAK2

123
Q

Sickle Solubility Test is used to diagnose this

A

Sickle Cell Trait

124
Q

Gene affected in Burkitt’s

A

c-myc

125
Q

What is HbA?

A

a2b2 = 95% adult Hb

126
Q

What is HbA2?

A

a2d2 = increased in beta thalassaemia as can’t make HbA

127
Q

What is HbF?

A

a2g2 = foetal Hb

128
Q

What is HbH?

A

b4 = in HbH Disease in alpha thalassaemia (3 alpha genes deleted)

129
Q

What is Hb Barts?

A

g4 = alpha-thalassaemia major (4 alpha genes deleted)

130
Q

What is HbS?

A

Hb found in sickle cell anaemia

131
Q

Most common inherited bleeding disorder

A

Von Willebrand Disease

132
Q

Pattern of inheritance in Von Willebrand

A

Autosomal dominant

133
Q

How long should warfarin be used after DVT/PE?

A

3 months if provoked; 6 months if unprovoked

134
Q

Rouleaux formation

A

Myeloma (stacking of RBCs)

135
Q

Lymphoma which produces IgM

A

Waldenström’s macroglobulinemia

136
Q

Proliferation of megakaryocytes –> bone marrow fibrosis

A

Myelofibrosis = tear drop poikilocytes, dry tap

137
Q

Mechanism of febrile transfusion reaction

A

Recipient anti-HLA antibodies react against donor WBCs

138
Q

Common lymphoid progenitor gives which 3 cells?

A

T, B and NK Cell (rest are from common myeloid)

139
Q

Pneumonia bug causing autoimmune haemolytic anaemia

A

Mycoplasma (acute cold haemagluttinin)

140
Q

IDA vs Anaemia of Chronic Disease

A

ACD: increased ferritin, reduced TIBC

141
Q

VTE – how long warfarin and what INR target?

A

Warfarin for 3 months (6 if cancer)

INR 2.5-3.5

142
Q

VTE while on warfarin - how long warfarin and what INR target?

A

Warfarin lifelong

INR 3.5

143
Q

Emergency treatment in Haemophilia A vs B

A 
A = cryoprecipitate (contains VIII)
B = FFP
144
Q

Hepatomegaly and chondrocalcinosis

A

Haemachromatosis

145
Q

Vit B12 deficiency - loss of touch and proprioception, UMN signs, but pain and temperature spared

A

Subacute Combined Degeneration of Cord

146
Q

Most sensitive antibody in pernicious anaemia

A

Anti-parietal cell

147
Q

PML-PARA fusion gene

A

Acute Promyelocytic Leukaemia (t15;17)

148
Q

Microcytic anaemia – reduced iron but increased ferritin

A

Anaemia of Chronic Disease (ferritin = acute phase protein)

149
Q

Anaemia of Chronic Disease - what does liver produce which mediates the reduced iron?

A

Hepcidin (retains iron in macrophages and reduces export from enterocytes)

150
Q

Immunoglobulin which binds to platelets in ITP

A

IgG

151
Q

Apart from low VIII, what else is low in Von Willebrand?

A

Ristocetin

152
Q

Hairy cell leukaemia express

A

Tartrate-resistant acid phosphatase

153
Q

This degrades factor V

A

Protein C

154
Q

Impaired degradation of factor Va and VIIIa

A

Protein S deficiency

155
Q

Nuclei of cancer cells have cloverleaf apperance

A

Adult T-cell leukaemia

156
Q

WBCs with filamentous projections/finger-like projections of cytoplasm

A

Hairy Cell Leukaemia

157
Q

Blood film shows lots of RBCs stacked

A

Rouleaux = Multiple Myeloma

158
Q

Hodgkin type that spreads contiguously

A

Hodgkin

159
Q

Most common Hodgkin type

A

Nodular sclerosing (peaks in young women)

160
Q

Treatment of Hodgkin relapse

A

High-dose salvage chemo –> autologous stem cell transplant

161
Q

Waxing and waning lymphadenopathy but NO B symptoms

A

Follicular non-Hodgkin

162
Q

First-line in myelodysplasia

A

Allogeneic Stem Cell Transplant

163
Q

Which cells targeted in Aplastic Anaemia?

A

CD34 haematopoietic stem cells

164
Q

Treatment of Aplastic Anaemia in
< 50yrs
> 50yrs

A

<50yrs: stem cell transplant

>50yrs: horse anti-thymocyte globulin and ciclosporin

165
Q

Mode of inheritance of most common form of Dyskeratosis Congenita

A

X-linked (mutated DKC1)

166
Q

Haematocrit target in polycythaemia vera

A

<45% (via venesection and hydroxycarbamide)

167
Q

Most common cause of high platelets

A

Essential Thrombocythaemia = platelets > 600

168
Q

Neutrophil precursor found in CML

A

Myelocytes

169
Q

Targeted treatment for Philadelphia +ve leukaemia

A

Imatinib

170
Q

Reverses warfarin in emergency

A

Prothrombin Complex Concentrate

171
Q

Cause of Transfusion-Related Acute Lung Injury (TRALI)

A

Anti-WBC antibodies in donor –> clump with recipient’s WBCs

172
Q

Jewish male presenting with multiple pathological fractures and hypersplenism

A

Gaucher’s disease

173
Q

Which paraprotein is most commonly raised multiple myeloma?

A

IgG

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