Haematology Flashcards
(84 cards)
A chemotherapy patient who received a blood transfusion the previous week develops fever, a spotty skin rash, and diarrhoea. What could be going on?
Transfusion-associated graft-versus-host disease
A child presents with frequent nosebleeds and easy bruising. They are prone to chest infections. On examination, you note cafe-au-lait spots, a triangular-shaped face, and skeletal deformity. What could be the diagnosis?
Fanconi anaemia
Autosomal recessive
A patient has an elevated serum paraprotein level of 35g/L, with bone marrow aspirate showing 32% monoclonal plasma cell infiltrate. They have back pain, constipation, and fatigue. What’s the diagnosis?
multiple myeloma
A patient has Bence-Jones proteins in their urine. Does this mean that they have multiple myeloma?
could also be waldenstroms macroglobinaemia
A patient is diagnosed with iron deficiency anaemia, and started on supplementation. What should they be told?
don’t chew the tablets
come back in 2-3 months for review
poo will turn horrible, that is ok
A patient is found to have leukocytosis on routine bloods, with small, normal-appearing leukocytes. Examination is unremarkable except for painless lymphadenopathy. What’s the management?
chronic lymphocytic leukaemia
- watch and wait approach, until patient becomes symptomatic
- treat relapses with chemo. very young/fit patients could consider allogenic HSCT
A patient presents with abdominal pain and jaundice, and is found to have a low haemoglobin, gallstones, and splenomegaly. blood film shows bite cells, blister cells, Heinz bodies. what is the cause
G6PD deficiency
A patient presents with altered mental status, fatigue, a blotchy rash, fever, and dark urine. Blood tests show anaemia and thrombocytopenia. What is the treatment?
TTP- plasma exchange
A patient presents with an enlarged spleen, easy bruising, and swollen, bleeding gums. FBC shows anaemia and thrombocytopenia, and a blood film shows 20% blasts. What’s the diagnosis?
acute myeloid leukaemia
A patient presents with bone pain, and is found to have hypercalcaemia, clonal plasma cells, and IgG paraproteinuria. What’s the treatment?
multiple myeloma
- old/unfit- chemo
young/fit- stem cell transplantation
A patient presents with dark red spots on their skin and bleeding when they brush their teeth. Their medical history is significant for stomach ulcers and HIV infection. What’s the diagnosis?
immune thrombocytopenic purpura
A patient presents with fatigue, massive splenomegaly, anaemia, and proliferation of platelets, mature lymphocytes, and basophils. FISH reveals an aberration of chromosome 22. What’s the diagnosis?
chronic myeloid leukaemia
A patient presents with fever, jaundice, dark red spots on their skin, fatigue, and bleeding gums, which all came on suddenly. They had a nasty bout of gastroenteritis last month. What’s the diagnosis?
TTP
A patient presents with macrocytic anaemia, and both folate and B12 levels are low. Which do you treat first?
B12
A patient presents with recurrent, difficult-to-control nosebleeds, and is diagnosed with vWF deficiency. What’s the treatment?
desmopressin
A patient receiving a blood transfusion develops a mild temperature increase, but when the transfusion is slowed their temperature returns to normal. What could be going on?
febrile non-haemolytic transfusion reaction
A patient receiving a blood transfusion develops a significant temperature increase and rise in NEWS score an hour after the transfusion has finished. What could be going on?
Either acute haemolytic transfusion reaction (check blood match!) or bacterial contamination of components (more common with platelet transfusions)
A patient receiving a blood transfusion develops acute breathlessless and bilateral creps at the lung base. You check their notes, which are significant for a history of heart failure. What’s the management?
TACO (transfusion related acute circulatory overload)
slow down transfusion if possible
give IV furosemide
closely monitor fluid balance
A patient receiving a blood transfusion develops difficulty breathing and raised JVP several hours after the transfusion has finished. What could be going on?
Transfusion-associated circulatory overload
A patient receiving a blood transfusion develops difficulty breathing, hypoxaemia, hypotension, and fever several hours after the transfusion has finished. You listen to her chest and hear rattling sounds at the bases. What could be going on?
Transfusion-related acute lung injury
A patient taking heparin presents with major haemorrhage. What agent can be used to reverse this?
protamine sulfate
A patient with known sickle cell disease presents to their GP as they are feeling a ‘bit under the weather’. They have a temperature. What do you do?
admit urgently!
All patients with emergent sickle crisis should be admitted unless they are really well (no fever or only <38C for an adult)
A teenager presents to her GP with a short history of fatigue, unexplained petechiae, and hepatomegaly. She is otherwise well. What’s the appropriate management
Send her up to AMU for assessment and haematology referral; acute leukaemia until proven otherwise.
Acute leukaemia is defined as an excess of what type of cells? over what percent? in either peripheral blood or bone marrow
blast cells >20%
