Flashcards in Haematology Deck (88):
Summary of Haematology
Diagnostic tests (4)
Heritable/Acquired Blood disorders
What is the term given for the physiological developmental process that gives rise to blood cells?
Embyrologically when do the haematopietic cells penetrate aorta --> liver
State the two lineages of blood cells
Which WBC arise from the myeloid lineage
Broadly, what are the 3 functions of blood cells?
What are the 4 diagostic tests which are carried out in Haematology?
Bone marrow aspirate
The components of the Coagulation screen are...?
Prothrombin Time (PT)
Activated Partial Thromboplastin Time (APTT)
Thrombin Time (TT)
Anaemia = ?
Decrease in RBC
How does the body adapt to anaemia?
Increase CO/BP/RBC/02 extraction
The 3 classifications of anaemia = ?
Which anaemia has low MCV, low MCH and caused by Iron def, thallassaemias, anaemia of chronic D?
Which anaemia is caused by haemolysis, acute blood loss, renal D and bone marrow failure?
(Normal MCV, normal pigment but less Hb)
Megaloblastic anaemia can be caused by Haematological cancer and what else?
If Fe2+ def + male, what should you screen for?
Haematinic def consist of...?
Iron is stored in liver by what protein?
List common causes of Fe2+ def in kids, young women etc.
Ulcers, Diverticula, Bowel cancer
Veganism, Gastric/SI problems can lead to what type of def?
What is a complication of B12 def?
How does it present?
Subacute Combinded degeneration of the Cord
Peripheral neuropathy, numbness/weakness, nsteady walking, Dementia
The clinical presentation of Folate/B12 def is identical. What is it?
What is the treatment if you dont' know the def yet?
IM B12 & Folate
How would you investigate Fe2+ def?
FBC (low MCV, MCH)
How would you investigate B12/Folate def?
Apart from haematinic def, what are other causes of anaemia?
Anaemia of Chronic D
Examples of haemolytic anaemia...?
Antibodies, Heart valves, Drugs, toxins
To treat anaemia of chronic disease, you would treat the underlying cause & give EPO. What sorts of conditions can cause it?
Drugs, alcohol, toxins
Autoimmune ITP, TTP
..can all cause what?
Is TTP or ITP an autoimmune platelet disorder that often presents in kids, post-viral with bruising/bleeding/petechiae?
Treatment of ITP?
(Steroids, IV Ig, Thrombopoeitin)
What does TTP stand for?
What is it?
Thrombotic Thrombocytopenia Purpura
Micro-clots everywhere due to ab bv
RARE BUT EMERGENCY
Classic presentation of TTP?
What products can we transfuse?
Plasma - FFP, Cryoprecipitate, Factors
"GROUP and SCREEN" is referring to what?
Pre-transfusion blood tests
State the steps of "GROUP and SCREEN"
1.Determine ABO & Rh group
2. Screen plasma for Ab against other blood antigens
List the adverse reaction that can occur after transfusion.
Acute transfusion reactions 24hrs
Acute haemolytic reaction - 15 minutes
How does someone present whose had a delayed tranfusion reaction?
Fever, rigors, DIC, dark urine, infusion pain, shock, chest pain are all presentations of what?
Acute haemolytic reaction
FATAL IN ~30%
name the test performed in suspected Delayed haemolytic reaction.
Coomb's test (Anti-human Globin)
In coagulation/clotting disorders is bleeding prolonged & often reoccurs?
Describe what bleeding is like in Platelet & vessel wall defects..
Immediate & non-recurrent
Aspirin can cause dysfunction in which blood cell?
The most common heritable bleeding disorder which often acompanies FVIII def is...?
Describe the 3 types of vWD
Type 1: mild, normal structure, decreased [vWF]
Type 2: mild, normal [vWF], abornmal structure
Type 3: absent vWF, FVIII def, RECESSIVE
Treatments for vWD?
Which are the most common heritable factor def?
Factor XII def
Factor VIII vWD def
What mode of inheritance does Haemophilia display?
Describe the types of bleeding experienced in Haemophilia A/B.
Soft tissue - esp surrounding airwas
The treatment for Haemophilia is similar to the treatment for...?
Transfusion transmitted infections and Inhibition are complications of treating vWD and Haemophilia. T/F?
Bleeding disorders can be acquired from..?
Vit K def
Massive transfusion syndrome
Which factors are Vit K dependant in order to become active?
Factor II, VII, IX, X
What is the consequence of Vit K def in neonates?
Haemorrhagic Disease of the newborn
Causes of Vit K def in adults
Prolonged nutritional def
Obstructive jaundice (fat soluble Vit)
Broad spectrum antibioics (gut flora make vit K)
Define Massive transfusion syndrome.
Transfusion of RBC equal to patient’s total volume in
DIC = microvascular thrombosis when coagulation pathway activated + then platelet depletion --> bleeding.
Who does it tend to occur in?
End-stage Liver D
Acute haemolytic syndrome
Investigations of DIC?
FBC/Film - thrombocytopenia
All Coagulation screen - prolonged
D-Dimer - elevated
How would you treat DIC?
Treat underlying cause
Warfarin is managed using INR as guidance. What drugs interact with it?
Which haemaglobinopathy has acute complications of vasculo-occlusive crises?
What types of Sickle Cell are there?
Sickle cell trait
Sickle cell Disease
Which haemoglobinopathy is characterised by severe anaemia, short stature, enlarged spleen/liver, maxilliary hypertrophy/Hair on head x-ray?
What is the leading cause of mortality in Sickle Cell disease
Iron-rich environment is favourable for bacteria therefore tranfusions in haemoglobinopathies are a risk factor for...?
How would you diagnose haemoglobinopathy?
What haematological state are pregnant women in?
Increased plasma volume --> mild anaemia
Thrombocytopenia in late
Which Ig crosses the placenta?
Where do babies get the rest of the Ig from?
Platelets are low by 18 weeks preg in the foetus. T/F?
Platelets reached adult values
Foetus is hyperresponsive to what factor?
prepare for birth
When do congenital bleeding disorders tend to be diagnosed?
List 4 main ways children can be anaemia from congenital causes.
Bone marrow failure
Blood loss (twin-twin)
RBC destruction (ABO/Rh, sphero, G6PD)
List 3 congenital causes of bleeding/bruising in childhood.
Platelet problem: ITP, drugs
Clotting factor problem
Connective Tissue D
Trauma, Tumour, infection, ITP, TTP, bone marrow failure and drugs can lead to what in childhood
Name the blood cancers
Which blood cancer is diagnosed based on CRAB features, MDEs, > 10% plasma cells neoplastic?
What are the CRAB features
C - hypercalcaemia
R - renal insufficiency
A - anaemia
B- bone pain/lesion
MDEs = Myeloma-defining events, which are..
> 60% plasma cells neoplastic
SFLC ratio > 100
1 bone lesion on MRI
What is myeloma always preceeded by?
Myeloma + AKI = ?
How is myeloma diagnosed?
Follicular Lymphoma often has chromosomal changes of..?
Treatment for warfarin overdose?
Prothrombic Complex concentrate
Which cancer can be precipitated by EBV?
Diagnostic mutation in myeloproliferative disorders?
CML has the t(9,22) abnormality. How does it present?
Abdo discomfort (splenomegaly)
Neutropenic sepsis is a complication of intensive chemo in which cancers?
Presentation of AML, ALL?
Which condition presents as pancytopenia, splenomegaly, B symptoms?