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Toni's Pathology > Haematology > Flashcards

Haematology Flashcards

(68 cards)

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1
Q

IDA

A

Microcytic
Incr TIBC + transferrin
Decr ferritin
Anisocytosis/raised RDW/ poikilocytosis

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2
Q

Vit B 12 deficiency

A

Macrocytic megaloblastic anaemia

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3
Q

Aplastic anaemia

A

Low: Hb, reticulocytes, neutrophils, platelets, BM cellularity
High MCV due to HbF release

CD8 destruction of BM -> fatty changes
80% idiopathic
10% dyskeratosis Congenita + fanconi anaemia
10% secondary: SLE, drugs: carbamazepine, chloramphenicol, anticonvulsants, radiation

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4
Q

Anaemia of chronic disease

A

Microcytic hypochromic anaemia + rouleax
Decr TIBC + serum iron
Incr ferritin

IL 6 mediated -> liver hepcidin production

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5
Q

Beta thalassemia

A 
Microcytic anaemia
Iron studies normal
Target cells
Minor= 1 beta globin chain
Major= 2 beta globin chains 
Severe anaemia, req reg transfusions, skull bossing hepatosplenomegaly
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6
Q

Chronic alcohol consumption

A

Non megaloblastic macrocytic anaemia

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7
Q

Chronic renal failure

A

Normocytic normochromic anaemia

Reduced EPO secretion

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8
Q

Lead poisoning

A

Microcytic anaemia

Basophilic stippling
Pappenheimer bodies

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9
Q

Causes of MAHA

A 
TTP
HUS 
DIC
SLE
Schistocytes aka helmet cells, incr BR, jaundice
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10
Q

Paroxysmal nocturnal haematuria

A

Haemolysis
Haemoglobinuria
Ham’s test +ve

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11
Q

Myelofibrosis

A 
Tear drop cells / dacrocytes
Circulating megakaryocytes
BM aspirate dry, bloody tap
Pancytopenia 
Hepatosplenomegaly - extra medullary haematopoiesis
Abnormal MKcytes release PDGF + TGF beta
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12
Q

Megaloblastic anaemia

A

Cabot rings

Hyper segmented neutrophils

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13
Q

Haemophilia A

A

F VIII deficiency

Low APTT

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14
Q

ITP/ AITP

A

2 wks after viral illness in children
Self limiting
Type 2 hypersensitivity reaction vs GpIIb/IIIa

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15
Q

ITTP

A 
MAHA
Fever
Renal failure
Fluctuating CNS signs
Haematuria
Low platelets
ADAMTS13 mutation -> vWF multimers -> platelet thrombi 
Req plasma exchange
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16
Q

Glanzmann’s

A

GpIIb/IIIa mutation

Causes coagulation

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17
Q

Haemophilia B

A

Factor IX deficiency

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18
Q

Osler Weber Rendu

Aka hereditary haemorrhagic telangiectasia

A

AD
Telangiectasia on skin + mucous membranes
= epistaxis + GI bleeds

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19
Q

Bernard soulier syndrome

A

GpIb mutation

Receptor for VWF in clot formation

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20
Q

Prothrombin G20210A

A

Inherited thrombophilia
Guanine -> adenine
= amplification of PT production
Predisposition to DVT + PE

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21
Q

Factor V Leiden

A 
AD inherited thrombophilia
Arginine -> glutamine
Impaired degradation of FV by protein C
Incr risk DVT + miscarriage
Test function of APC
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22
Q

Antiphospholipid syndrome

A

AI thrombophilia
Anti cardiolipin + lupus anticoagulant
Bind to phospholipids on cell surface -> trigger Coag cascade
Incr risk DVT + miscarriage

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23
Q

Buerger’s

Aka thromboangitis obliterans

A

Small + med vasculitis of vessels of hands + feet
Assoc with smoking
Claudication
Gas gangrene + amputation
Corkscrew appearance of arteries on angiogram

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24
Q

Protein C or S deficiency

A

Inherited thrombophilia / rarely : warfarin / liver disease
Impaired degradation of FVa + FVIIIa
Incr risk DVT

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25
Anti thrombin deficiency
Inherited thrombophilia | Usually inhibits FII (thrombin) + FXa
26
Transfusion complications: | Fluid overload
Dyspnoea Incr JVP Pink frothy sputum Due to too fast transfusion rate >2ml/kg/hr Or in those with pre-existing cardiac or renal failure
27
Transfusion complications: | GVHD
Donor lymphocytes attack recipient cells Especially skin + GIT Diarrhoea, macpap rash, skin necrosis Irradiate donor blood to reduce risk
28
Transfusion complications: | Anaphylaxis
Incr risk in those with IgA deficiency | Due to IgA in donor blood
29
Transfusion complications: | TRALI
Acute non cardiogenic pulmonary oedema within 6 hrs Dry cough, dyspnoea, fever Anti WBC Ab in donor blood attack host leukocytes Donor has had sensitising event e.g. Transfusion/transplant
30
Transfusion complications: | Immed haemolytic transfusion reaction
Within 1-2 hrs post transfusion ABO incompatibility Abdo + loin pain, vomiting, facial flushing, haemoglobinuria Host IgG + IgM -> donor RBCs = removed by retic endothel syst
31
Transfusion complications: | Febrile non-haemolytic reaction
After pregnancy Antileukocytic Abs form Low fever rigors
32
Transfusion complications: | Fe overload
In cases of recurrent transfusion: thalassemia SCD Bronzed skin Short stature Heart failure
33
Transfusion complications: | Bacterial infection
High fever, rigors, hypotension | Hep B, hep C, HIV
34
Transfusion complications: | Delayed haemolytic transfusion reaction
>24 hrs post transfusion | Milder than immed haemolytic reactions
35
Hairy cell leukaemia
``` CLL subtype Middle aged men Hair like projections on tumour cells CD25 (IL2-R) + CD 11c Tartrate-resistant acid phosphatase: TRAP Splenomeg, hepatomeg, pancytopenia ```
36
CML
``` Elderly Elevated: neutrophils, basophils, eosinophils BM: hyper cellular T(9;22) BCR-Abl Imatinib ```
37
AML
``` BM: >20% myeloblasts blasts Ayer rods t(8;21) FLT3 gene CD13, CD33, CD34 Seen in Downs ```
38
CLL
Smudge CeLLs elderly men >4000 cells per microlitre Small lymphocytes in lymph nodes with irregular nuclei Mixed with larger prolymphocytes -> aggregate to proliferation centres Hypogammaglobulinaemia Reiter's transformation -> DLBCL
39
ALL
Paediatric | BM: >20% lymphoblasts
40
APML
AML M3 subtype Faggot cells: loads of Auer rods PML-RARA ATRA asap to prevent DIC
41
Adult T cell leukaemia/lymphoma
Assoc with HTLV1 Endemic in Japan + Carribean Clover leaf nuclei in ATL cells LNpathy, hepatsplenomeg, skin lesions, hypoCa
42
Large granular lymphocytic leukaemia
Blood: large lymphocytes BM: azurophilic granules
43
T cell prolymphocytic leukaemia
Aggressive T cell leukaemia | Inv Chr 14 (q11;q32)
44
Burkitt's lymphoma
``` Latent EBV, most prevalent in Africa children + teenagers C-Myc Chr 8 Starry sky Endemic: mandibles mass Non endemic: abdominal mass ```
45
Hodgkin's lymphoma
EBV -> NF-kappaB activation Reed Sternberg cells (binuc/multinuc surrounded by eosinophils) Painless asymmetrical LNpathy, except with ETOH Fluctuates in size Pel-Ebstein fever B sx Extra nodal involvement rare
46
Mantle cell lymphoma
Elderly men t(11;14) Bcl1 + Ig heavy chain Overextension cyclin D1
47
Follicular lymphoma
``` Middle aged t(14;18) Over expression Bcl2 Centrocytes, centroblasts Non aggressive but difficult to cure ```
48
Diffuse Large B Cell Lymphoma
``` Elderly Large lymphocytes with diffuse pattern of growth Immunodef - assoc with EBV Body cavity based - assoc with HHV8 Follicular lymphoma can transform CLL can transform - Reiters ```
49
Mycosis fungoides
Cutaneous T cell lymphoma Elderly men Rash like lesions Appear similar to eczema/psoriasis
50
Angio centric lymphoma
Cutaneous mass in nasal area Tumour cells express NK cell markers Oft infected with EBV
51
Essential thrombocythaemia
High platelet count >600 Bleeding + thrombosis BM: hyper cellular giant platelets, MKcyte clustering, hyperplasia Rx: hydroxyurea, anagrelide
52
Multiple myeloma
BM: >10% plasma cells, multi nuc, prom nucleoli Rouleaux IgG, IgA, para proteins Paraprotein bands > 30g/L on electrophoresis Incr ESR + Ca, punched out lytic lesions on XR (n ALP) Bench Jones proteins in urine
53
Polycythaemia Rubra Vera
JAK2 gene, exon 2, V167F Incr Hb low EPO Gout = incr cell turnover Headaches, dizziness, stroke = hyperviscosity Plethoric, pruritic after baths, peptic ulcer = hyper mast cell degran
54
Hereditary spherocytosis
``` AD haemolytic anaemia Dysfunct: spectrin/ankyrin/ band 4.2 +ve osmotic fragility -ve Coombs Jaundice, splenomeg, pigment gallstones +ve fhx ```
55
Hyposplenism
``` Howell Jolly bodies Target cells Uncleared RBCs Lymphocytosis Macrocytosis Acanthocytes: speculated RBCs ```
56
Precautions to take in Hyposplenism
Penicillin V prophylaxis Pneumococcal conjugate vaccine Hib vaccine Meningococcal vaccine
57
Diseases in which splenectomy may be required
``` Thalassemia Pyruvate kinase deficiency AIHA ITP Ellipto + spherocytosis ```
58
Cold AIHA
``` IgM mediated 28-31 Celsius Causes: CLL Lymphoma Mycoplasma EBV Idiopathic ```
59
Paroxysmal cold haemoglobinuria
AI haemolytic anaemia Children following infection Donate Landsteiner antibodies IgG antiglobulins at low temperatures
60
Smouldering myeloma
Paraprotein >30g/L Clonal plasma cells >10% No myeloma related organ/ tissue impairment
61
MGUS
Serum paraprotein
62
Combined Polycythaemia
Aka smokers Polycythaemia Carbon monoxide -> incr EPO = incr red cell mass + smoker's reduced plasma volume
63
Marginal zone lymphoma
Chronic antigen stimulation -> malig transformation B cell NHL Extranodal: MALT= stomach, lung, thyroid, breast, synovium, lac, saliv Nodal: Splenic:
64
Nodular lymphocytic HL
``` Non classical Lymphocytic + histiocytic Reed Sternberg variant 'popcorn cells' Children or 30-40yrs More common in Afro Carribean Peripheral LNpathy without B sx ```
65
Nodular sclerosis classical HL
Nodular growth pattern fibrous bands separating nodules
66
Mixed cellularity classical HL
Heterogenous group | Diffuse/ vaguely nodular pattern without band forming sclerosis
67
Lymphocytic rich HL
Nodular growth pattern | Background infiltrate: mainly lymphocytes
68
Lymphocyte depleted HL
Diffuse growth pattern Hypocellular Lack of inflammatory cells

Toni's Pathology (6 decks)

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