Haematology Flashcards

Question

What is Subacute Combined Degeneration of the Cord

Answer 1

- Usually only caused by pernicious anaemia Combined symmetrical dorsal column loss and corticospinal tract loss. → distal sensory loss: esp. joint position and vibration → ataxia ̄c wide-gait and +ve Romberg’s test ``` Mixed UMN and LMN signs  Spastic paraparesis  Brisk knee jerks  Absent ankle jerks  Upgoing plantars - Pain and temperature remain intact ```

Answer 2

 Splenomegaly: may → sequestration crisis  Infarction: stroke, spleen, AVN, leg ulcers, BM  Crises: pulmonary, mesenteric, pain  Kidney disease  Liver, Lung disease  Erection  Dactylitis

Answer 3

 Sequestration crisis  Splenic pooling → shock + severe anaemia  Splenic infarction: atrophy and hyposplenism  ↑ infection: osteomyelitis  Aplastic crisis: parvovirus B19 infection  Gallstones

Answer 4

Intrinsic pathway - F 12,11,9,8 (+ common 10,5,2,1) ``` Increased  Lupus anti-coagulant  Haemophilia A or B  vWD (carries factor 8)  Unfractionated heparin  DIC  Hepatic failure ```

Answer 5

Extrinsic: 7 (+ common 10,5,2,1) Increased  Warfarin / Vit K deficiency  Hepatic failure  DIC

Answer 6

Causes - vascular: ehlers danlos; cit C def; meningococcus; steroids; HSP - Thrombocytopenia ↓ production  BM failure: aplastic, infiltration, drugs (EtOH, cyto)  Megaloblastic anaemia ↑ destruction  Immune: ITP , SLE, CLL, heparin, viruses  Non-immune: DIC, TTP , HUS, PNH, anti-phospholipid Splenic pooling  Portal hypertension  SCD Sx  Bleeding into skin: petechiae, purpura, echymoses  Bleeding mucus mems: epistaxis, menorrhagia, gums  Immediate, prolonged bleeding from cuts

Answer 7

Causes - Severe liver disease - anti-coagulants - Vit K def - Haemophilia A/B - vWD Sx  Deep bleeding: muscles, joints, tissues  Delayed but severe bleeding after injury

Answer 8

``` CLOTs: venous and arterial  Coagulation defect: ↑APTT  Livido reticularis  Obstetric complications: recurrent 1st trimester abortion  Thrombocyotpenia ```

Answer 9

Congenital  Fanconi’s anaemia: aplastic anaemia ``` Acquired  Idiopathic aplastic anaemia  BM infiltration  Haematological -->Leukaemia; Lymphoma; Myelofibrosis; Myelodysplasia; Megaloblastic anaemia  Infection: HIV  Radiation  Drugs - cyclophos, azathioprine, methotrexate; chloramphenicol, sulphonamide; thiazides; carbimazole; clozapine; phenytoin ```

Answer 10

Heterogeneous group of disorders → BM failure Clone of stem cells--> abnormal development → functional defects → quantitative defects May be primary or secondary (Chemo/RT) ``` Characteristics  Cytopenias  Hypercellular BM  Defective cells: e.g. ringed sideroblasts  30% → AML ``` Mx - Supportive: transfusions, EPO, G-CSF - Immunosuppression - Allogeneic BMT: may be curative

Answer 11

↑RBC; Hb; Hct; WCC; plats ``` Hyperviscosity  Headaches  Visual disturbances  Tinnitus  Thrombosis - Arterial (strokes, TIA, peripheral emboli) or Venous (DVT, PE) ``` Erythromelalgia - Sudden, severe burning in hands and feet + redness of the skin HSM; Gout; Histamine Release - pruritus 99% JAK2+ve Mx - Aspirin 75mg OD  Venesection if young

Answer 12

``` True Polycythaemia: ↑ total volume of red cells  Primary: PV  Secondary - Hypoxia: altitude, COPD, smoking - EPO: renal cysts/tumours ``` Pseudopolycythaemia: ↓ plasma volume  Acute - Dehydration; Shock; Burns  Chronic - Diuretics; Smoking

Answer 13

Group of disorders characterised by extracellular deposits of a protein in an abnormal fibrillar form that is resistant to degradation. Sx  Renal: proteinuria and nephrotic syndrome  Heart: restrictive cardiomyopathy, arrhythmias, echo (“Sparkling”)  Nerves: peripheral and autonomic neuropathy, CTS  GIT: macroglossia, malabsorption, perforation, haemorrhage, hepatomegaly, obstruction.  Vascular: periorbital purpura (characteristic)

Answer 14

Widespread activation of coagulation from release of pro- coagulants into the circulation. CF and plats are consumed → bleeding Fibrin strands → haemolysis ``` Causes  Malignancy: e.g. APML  Sepsis  Trauma  Obstetric events: e.g. PET ``` Signs  Bruising  Bleeding  Renal failure Ix ↓plats, ↓Hb, ↑APTT, ↑PT, ↑FDPs, ↓fibrinogen (↑TT) Rx - treat cause; FFP/ cyroprecipitate

Answer 15

 Phagocytosis of old RBCs, WBCs and opsonised bugs  Antibody production  Haematopoiesis  Sequestration of formed blood elements

Answer 16

Massive --> CML; Myelofibrosis; Malaria ``` All Haematological  Haemolysis: HS  PV  Leukaemia, lymphoma Infective  EBV, CMV, hepatitis, HIV,  TB, infective endocarditis Portal HTN: cirrhosis, Budd-Chiari Connective tissue: RA, SLE, Sjogrens Other -->Sarcoid; Amyloidosis; 1O Ab deficiency (e.g. CVID) ```

Answer 17

Malignancy RHF Fatty Liver Hepatitis

Answer 18

``` CLD and portal HTN Leukaemia HBV/CMV/HCV Malaria Sarcoidosis ```

Answer 19

```  Trauma  Rupture (e.g. EBV infection)  AIHA  ITP  HS  Hypersplenism ```

Answer 20

 Redistributive thrombocytosis → early VTE  Gastric dilatation (ileus)  Left lower lobe atelectasis: v. common  ↑ susceptibility to infections (daily Abx)  Encapsulates: haemophilus, pneumo, meningo (immunise)

Answer 21

```  Myeloma  SLE  GCA  AAA  Ca prostate ```

Answer 22

``` Neutrophilia  Bacterial infection  Stress: trauma, surgery, burns, haemorrhage  Steroids  Inflammation: MI, PAN  Myeloproliferative disorders: e.g. CML ``` ``` Neutropenia  Viral infection  Drugs: chemo, cytotoxics, carbimazole, carbimazepine, colchine, sulphonamides  Severe sepsis  Hypersplenism: e.g. Felty’s ```

Answer 23

Lymphocytosis  Viral infections: EBV, CMV  Chronic infections: TB, Brucella, Hepatitis, Toxo  Leukaemia, lymphoma: esp. CLL Lymphopenia  Drugs: steroids, chemo  HIV

Answer 24

``` Howell-Jolly bodies- Hyposplenism Heinz bodies- G6PD deficiency Pencil cells- IDA Reticulocytes- Haemolysis / Haemorrhage Spherocytes - AIHA; Hereditary spherocytosis Schistocytes- MAHA; Prosthetic valve Tear-drop cells - BM infiltration ```

Haematology Flashcards

(48 cards)