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Phase 2A Med Concise > Haematology > Flashcards

Haematology Flashcards

(72 cards)

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1
Q

What is anaemia?

A

A decrease in haemoglobin in the blood below the reference range

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2
Q

Anaemia - 3 Types

A

Microcytic - MCV <80
Normocytic - MCV 80-100
Macrocytic - MCV >100

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3
Q

Microcytic anaemia - Causes

A

Iron deficiency
Haemoglobinopathies (Thalassaemia)
CKD

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4
Q

Iron deficiency - Causes

A

Bleeding (Menorrhagia - heavy menstrual bleeding)
Poor diet/malabsorption
Breastfeeding

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5
Q

Iron deficiency - Investigation

A

Serum ferritin

Endoscopy - GI bleeding

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6
Q

What is reticulocyte count?

A

Rate at which RBCs are being made in bone marrow

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7
Q

Causes of raised and low reticulocyte count

A

Raised - blood loss, haemolytic anaemia

Low count - production problem (iron deficiency anaemia)

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8
Q

Iron deficiency - Symptoms

A

Atrophic glossitis
Brittle hair/nails
Angular stomatitis

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9
Q

Iron deficiency - Treatment

A

Ferrous sulphate (Iron tablets)

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10
Q

Ferrous sulphate - Side effects

A 
Constipation
Diarrhoea
Nausea
GI irritation 
Epigastric pain
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11
Q

Normocytic anaemia - Causes

A

Acute blood loss

CKD

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12
Q

Macrocytic anaemia - Causes

A

B12/folate deficiency
Alcoholism/liver disease
Hypothyroidism

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13
Q

3 sources of folate

A

Green vegetables
Fruit
Offal (animal organ meat)

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14
Q

Folate deficiency - Causes

A

Malabsorption
Poor diet
Pregnancy (increased demand)

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15
Q

Pernicious anaemia - Pathophysiology

A

Vitamin B12 malabsorption, B12 needed for RBC production

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16
Q

Pernicious anaemia - Treatment

A

Vit B12 injections/tabs

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17
Q

B12 deficiency - Causes

A

Atrophic gastritis
Gastrectomy
Crohn’s disease
Coeliac disease

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18
Q

Anaemia - Signs and symptoms

A

Signs - Pale skin, tachycardia

Symptoms - Fatigue, faintness, breathlessness, reduced exercise tolerance

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19
Q

Why might patients on anti-coag drugs (warfarin) be over anti-coagulated?

A

Bad patient compliance
Artificial valves
New/interacting drugs

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20
Q

Over anti-coagulation - Symptoms

A 
Bruising
Bleeding
Haemoptysis (coughing up blood from lungs/bronchi)
Haematemesis (vomiting of blood)
Epistaxis - nose bleed
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21
Q

What is disseminated intravascular coagulation (DIC) ?`

A

Thrombosis followed by bleeding

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22
Q

Disseminated intravascular coagulation (DIC) - Causes

A 
Malignancy
Septicaemia
Pregnancy 
Trauma
Infection
Liver disease
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23
Q

Disseminated intravascular coagulation (DIC) - Treatment

A

Blood transfusion

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24
Q

Thrombocytopenia - Causes

A

Reduced platelet production in bone marrow
Excessive peripheral destruction of platelets
Enlarged spleen

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25
Immune thrombocytopenic purpura (ITP) - Pathophysiology
Autoimmune destruction of platelets
26
Immune thrombocytopenic purpura (ITP) - Symptoms
Easy bruising Epistaxis (nose bleeds) Menorrhagia (menstrual bleeding) Purpura (skin haemorrhages)
27
Immune thrombocytopenic purpura (ITP) Investigations
Blood tests - Reduced platelets, detection of platelet autoantibodies
28
Immune thrombocytopenic purpura (ITP) - Treatment
Prednisolone (corticosteroid) | Splenectomy
29
Deep vein thrombosis (DVT) - Virchow's triad
Stasis Vessel wall injury Hypercoagulability
30
DVT/thromboembolism - Causes
``` Age Obesity Varicose veins Long haul traveling Immobility/bed rest Plasminogen deficiency Thrombophilia Pregnancy ```
31
DVT/thromboembolism - Symptoms
Calf pain/swelling/warmth Ankle oedema Pitting oedema
32
DVT/thromboembolism - Investigations
FBC - platelets | Doppler - Wells scote
33
DVT/thromboembolism - Treatment
Heparin Warfarin NOACs
34
DVT/thromboembolism - Prevention
Stockings | Leg elevation
35
What is polycythaemia?
Increase in Hb, PCV (packed cell volume) and RBCs
36
Polycythaemia - Primary causes
Polycythaemia vera - genetic mutation in JAK2 gene, increased RBC production due to bone marrow cells more sensitive to Epo (erythropoietin) Primary familial/congenital polycythaemia - genetic mutation in EPOR gene, increased RBC production in response to Epo
37
Polycythaemia - Secondary causes
More RBCs due to more circulating Epo due to (Chronic hypoxia, high altitude - poor O2 delivery, tumours releasing excess Epo)
38
Polycythaemia - Symptoms
Easy bleeding/bruising Fatigue Dizziness Headaches
39
Polycythaemia - Investigations
FBC Bone marrow biopsy Genetic testing for JAK2 gene
40
Polycythaemia - Treatment
Blood letting | Aspirin (reduces clots)
41
Chronic myeloid leukaemia - Pathophysiology
Proliferation of myeloid cells
42
Chronic myeloid leukaemia - Signs and symptoms
Signs - Splenomegaly, hepatomegaly, anaemia, bruising | Symptoms - Weight loss, tiredness, fever, sweats, bleeding, abdo discomfort
43
Chronic myeloid leukaemia - Investigations
FBC - Raised WCC (all myeloid cells raised - neutrophils, macrophages, basophils) Cytogenetics (PCR/FISH/karyotype) - Philadelphia chromosome
44
Chronic myeloid leukaemia - Treatment
Imatinib/dasatinib (Tyrosine kinase inhibitor) Hydroxycarbimide (chemo) Stem cell transplant (curative outcome)
45
Chronic lymphocytic leukaemia - Pathophysiology
Accumulation of mature B cells that have escaped apoptosis
46
Chronic lymphocytic leukaemia - Signs and symptoms
Signs - Enlarged rubbery non-tender nodes, splenomegaly, hepatomegaly Symptoms - Anaemia, weight loss, sweats, anorexia
47
Chronic lymphocytic leukaemia - Investigations
``` FBC - Raised lymphocytes RAI staging (1-5 scale) ```
48
Chronic lymphocytic leukaemia - Complications
Autoimmune haemolysis (decreased RBCs) Infection Marrow failure
49
Chronic lymphocytic leukaemia - Treatment
Stem cell transplant Rituximab (Chemo) Radiotherapy
50
Acute lymphocytic/myeloid leukaemia - Pathophysiology
Lymphocytic - Malignancy of T/B cell lines | Myeloid - Malignancy of myeloid cell lines
51
Acute lymphocytic/myeloid leukaemia - Epidemiology
Lymphocytic - Childhood | Myeloid - Adults
52
Acute lymphocytic/myeloid leukaemia - Signs and symptoms
Lymphocytic - Bone pain, marrow failure, hepatosplenomegaly, lymphadenopathy, cranial nerve palses, meningism Myeloid - Marrow failure, hepatosplenomegaly, gum hypertrophy
53
Acute lymphocytic/myeloid leukaemia - Investigation
Lymphocytic - FBC (Low RBC, low platelets), clotting screen (DIC occurs), lumbar puncture, cytogenetics Myeloid - FBC (Low RBC, low platelets), clotting screen (DIC occurs)
54
Acute lymphocytic /myeloid leukaemia - Treatment
Supportive - bloods, platelets, fluids Chemo Bone marrow transplant
55
Marrow failure - Deficiencies
Hb WBC Platelets
56
Marrow failure - Signs and symptoms
Anaemia Tiredness Recurrent infections Thrombocytopenia - bruising, nose/gums bleeding
57
Difference between lymphoma and leukaemia
Leukaemia - Malignancy of lymphocyte precursors arising in bone marrow Lymphoma - Malignancy of mature lymphocytes arising in lymphatics
58
Lymphoma - 2 Types
Hodgkin's lymphoma - Reed-sternberg cells | Non-hodgkin's lymphoma - No reed-sternberg cells
59
Hodgkin's lymphoma - Signs and symptoms
Signs - Enlarged lymph nodes, hepatosplenomegaly Symptoms - Painless, non-tender rubbery lymph node enlargement (cervical, axillary, inguinal), fever, weight loss, night sweats, alcohol-induced lymph node pain, lethargy (lack of energy/enthusiasm)
60
Hodgkin's lymphoma - Investigation
Biopsy Histology (Reed-sternberg cells) Ann-arbor system (1-4 scale)
61
Hodgkin's lymphoma - Treatment
Chemo | Radio
62
Non-hodgkin's lymphoma - Pathophysiology
Lymphoma without reed-sternberg cells | Includes gastric MALT (Mucosa associated lymphoid tissue)
63
Non-hodgkin's lymphoma - Risk factors
H.pylori HIV Toxins
64
Non-hodgkin's lymphoma - Symptoms
Same as hodgkin's | Also GI symptoms - Abdo pain, diarrhoea, vomiting
65
Non-hodgkin's lymphoma - Treatment
Chemo - Rituximab | Prednisolone (steroid)
66
Myeloma - Pathophysiology
Malignant proliferation of plasma B lymphocytes accumulating in bone marrow, leading to overproduction of Ig causing renal dysfunction
67
Myeloma - Signs and symptoms (CRAB)
Hypercalcaemia Renal impairment (Decreased urine output, oedema) Infection Anaemia Thrombocytopenia (bleeding) Osteolytic bone lesions (Pepperpot skull - fractures) Backache
68
Myeloma - Investigations
Bloods - Raised urea and creatinine | X-ray of skull (Pepperpot skull)
69
Myeloma - Complications
Hypercalcaemia Spinal cord compression Hyperviscosity Acute kidney injury
70
Myeloma - Treatment
Analgesia and bisphosphonates (bone pain) Transfusion (anaemia) Chemo
71
Warfarin overdose - Treatment
Vit K | Beriplex
72
Anaemia - 3 Types and their Causes
Microcytic - Iron deficiency Normocytic - Blood loss Macrocytic - B12/Folate deficiency

Phase 2A Med Concise (18 decks)

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