Haematology 5: Haematology Of Systemic Disease

Question 1

What is the most common cause of Iron deficiency anaemia ?

Answer 1

Occult blood loss

Question 2

What do these laboratory findings suggest?

Ferritin: Low
Transferrin saturation: Low
TIBC: High

Answer 2

Iron deficiency anaemia

Question 3

List 3 features of leucoerythroblastic anaemia of blood film ?

Answer 3

Nucleated red blood cells
Tear drop cells (anisopoikilocytosis)
Immature myelod cells

Question 4

What is leucoerythroblastic anaemia ?

Answer 4

Anaemia with immature red and white blood cells

Most commonly caused by bone marrow infiltration

Question 5

List 3 causes of bone marrow infiltration ?

Answer 5

Cancers- Leukaemia/ lymphoma/ myeloma/ solid organ
Myelofibrosis
Severe infection- Miliary TB, Massive fungal infection

Question 6

List 4 inherited causes of haemolytic anaemia ?

Answer 6

Sickle cell disease
Thalasaemia
G6PD
HS

Question 7

Which test can be used to diagnose Auto-immune haemolytic anaemia ?

Answer 7

DAT (Coombs’) test

Question 8

List 2 diseases associated with Auto-immune haemolytic anaemia ?

Answer 8

Lymphoma

SLE

Question 9

Which cancer type is associated with MAHA ?

Answer 9

Adenocarcinoma

Adenocarcinoma release procoagulant cytokines. This leads to DIC. THis causes a lot of Fibrin strands to form in the micro vasculature. This shears red cells causing them to fragment and undergo haemolysis

Question 10

Which disease of the returning traveller does not cause neutrophilia ?

Answer 10

Typhoid

Question 11

What is the difference between reactive neutrophilia and Malignant neutrophilia on blood film ?

Answer 11

Reactive neutrophilia: shows band cells (immature WBC), toxic granulation,

Malignant causes: If Neutrophilia +basophilia + immature myelocytes + Splenomegaly then its likely to be CML

If there is a neutrophilia with Myeloblasts then its likely AML

Question 12

Which haematological malignancies cause Eosinophilia ?

Answer 12

Hodgkin’s lymphoma
T cell lymphoma
NHL

Question 13

Which leukaemia has smear cells ?

Answer 13

CLL

Question 14

features of haemolytic anaemia

Answer 14

anaemia
reticulocytosis
raised unconjugated bilirubin 
raised LDH 
reduced haptoglobins

Question 15

causes of inherited haemolytic anaemia

Answer 15

membrane defects - HS
cytiplasm/enymes - G6PD deficiency
haemoglobin - scd, thalassaemia

Question 16

causes of acquired haemolytic anaemia

Answer 16

immune mediated
non-immune mediated

differentiate by DAT/Coombs’ test

Question 17

list features of AI haemolytic anaemia

Answer 17

reticulocytosis
raised unconjugated bilirubin
raised LDH
positive DAT

Question 18

two diseases associated with non-immune haemolytic anaemia

Answer 18

malaria

MAHA

Question 19

lists causes of neutrophilia

Answer 19

corticosteroids 
underlying neoplasm 
tissue inflammation 
myeloproliferative/leukaemic disorders 
infection

Question 20

what 3 diseases clasically dont cause neutrophilia

Answer 20

brucella
typhoid
many viral infections

Question 21

in which conditions in monocytosis often seen

Answer 21

rare
TB, brucella, typhoid
CMV, VZV
sarcoidosis

Question 22

what causes reactive eosinophilia

Answer 22

parasitic infection
allergic diseases - asthma, rheumatoid arthriyis, pulmonary eosinophilia
underlying neoplasms - Hodgkins, T cell lymphoma, NHL
drug reaction - erythema multiforme

Question 23

list causes of reactive lymphocytosis

Answer 23

EBV, CMV, toxoplasmosis
infectious hepatitis 
rubella 
herpes
AI disorders 
sarcoidosis

Question 24

how can we differentiate between reactive lymphocytosis and lymphoproliferative disorders

Answer 24

FLOW CYTOMETRY
reactive lymphocytosis - even mix of kappa and lambda chains
lymphoproliferative - mainly kappa or lambda