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Y3 Revision Points > Haematology > Flashcards

Haematology Flashcards

1
Q

What causes sickle cell anaemia?

A

Point mutation in beta globin chain

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2
Q

How does multiple myeloma present?

A 
hyperCalcaemia
Renal
Anaemia
Bone pain - lytic lesions
Hyperviscosity syndrome - spontaneous bleeding, neurological symptoms, visual disturbance
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3
Q

What proportion of BM must be plasma cells for MM diagnosis?

A

> 10%

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4
Q

What causes hereditary spherocytosis? How is it diagnosed? When do flares occur?

A

Mutation in structural red cell membrane protein
Spherocytes on blood film, increased osmotic fragility
Flares precipitated by acute illness

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5
Q

In lymph nodes what causes a response from

  • B cells
  • Phagocytes
  • T cells
A

B cells - infection or autoimmune
Phagocytes - metastases
T cells - viral, drugs eg phenytoin

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6
Q

What is the triad of hypersplenism

A

Splenomegaly
Decrease in 2 or more blood compartments
Correction of cytopenia by splenic removal

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7
Q

What infections does splenectomy increase the risk of?

A

S pneumonia, H influenza, Neisseria meningitidis

Malaria

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8
Q

What is myelodysplastic syndrome? What can it progress to?

A

Acquired DNA mutation in progenitor cells –> stem cell malignancy resulting in ineffective haematopoiesis
Can progress to AML

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9
Q

Which mutations are found in PRV?

A

JAK2

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10
Q

Which mutations are found in essential thrombocytosis? How is it managed?

A

JAK2 (50%), CALR (10%)

1st line hydroxyurea

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11
Q

What is the precursor of a neutrophil?

A

Myelocyte

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12
Q

What is the normal BM myeloid:erythroid ratio? When can this change?

A

1.5:1

Reverses in haemolytic anaemia - need more RBCs

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13
Q

How is acute intermittent porphyria caused? What can it be precipitated by? How does it present?

A

Porphobilinogen deaminase enzyme deficiency
Alcohol
Intermittent abdo pain, nausea, vomiting

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14
Q

What is the Kleihauer test?

A

Detects HbF in maternal blood in feto-maternal haemorrhage

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15
Q

What are effects of alcohol on the blood?

A

Macrocytosis
Thrombocytopenia
Low clotting factors

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16
Q

What can B12 deficiency cause?

A

Subacute degeneration of the spinal cord

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17
Q

How long does reticulocytosis take to occur after haemorrhage?

A

1-2 days

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18
Q

What is the management of autoimmune haemolytic anaemia?

A

Steroids and folic acid

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19
Q

What is the management of neutropenic sepsis?

A

Piperacillin/tazobactam

Add Gent if NEWS>/5

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20
Q

How to Protein C and S work?

A

Bind to Va and VIIa to switch off clotting

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21
Q

What does prostacyclin do?

A

Inhibits platelet activation

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22
Q

What does plasmin do?

A

Breaks down fibrin

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23
Q

What can cause worsening of G6PD

A

Co-trimoxazole

24
Q

What are warm and cold haemolytic anaemia?

A

Warm - IgG

Cold - IgM

25
Q

List causes of a leukoerythroblastic film

A

Marrow infiltration - lymphoma, non-haem malignancies, fibrosis
Marrow stress - severe sepsis, severe bleeding, shock

26
Q

List causes of pancytopenia

A

Increased destruction - immune, sepsis
Sequestration - hypersplenism
Decreased production - infiltration, B12 deficiency, aplastic anaemia, drugs, viruses, radiation

27
Q

Which drugs can interfere with warfarin through Cyp450?

A

Cyp450 inhibitors - increase INR - cimetidine, omeprazole, metronidazole, trimethoprim/co-trimoxazole, amiodarone
Cyp450 inducers - reduce INR - barbiturates, phenytoin, carbamazepine

28
Q

What do warfarin and heparin prolong?

A

Warfarin - PT

Heparin - APTT

29
Q

What is clopidogrel? How does it work?

A

Antiplatelet - ADP antagonist

30
Q

What is aspirin? How does it work?

A

Antiplatelet - COX1 inhibitor to prevent TX synthesis

31
Q

How does tranexamic acid work?

A

Inhibits plasmin (so inhibits fibrin breakdown)

32
Q

What is rituximab?

A

Monoclonal antibody against CD20

33
Q 
List side effects of chemotherapy agents:
Anthracyclines
Vinka alkaloids
Cisplatin
Alkylating agents
A

Anthracyclines - cardiomyopathy
Vinka alkaloids - neuropathy
Cisplatin - nephrotoxicity, ototoxicity
Alkylating agents - infertility, secondary malignancy

34
Q

List blood film appearance of iron deficiency anaemia, thalassaemia, anaemia of chronic disease

A

Macro-ovalocytes
Rod cells
Hypochromic microcytic cells

35
Q

What are target cells seen in?

A

Thalassaemia

36
Q

List blood film appearance in splenic hypofunction

A

Howell Jolly bodies

37
Q

List blood film appearance in B12 deficiency

A

Macro-ovalocytes
Macrocytic red cells
Hypersegmented neutrophils
Pancytopenia

38
Q

List blood film appearance in G6PD

A

Bite cells
Blister cells
Polychromatic reticulocytes
Heinz bodies

39
Q

List blood film appearance in autoimmune haemolysis

A

Spherocytes

Heinz bodies

40
Q

List blood film appearance in hereditary spherocytosis

A

Spherocytes

41
Q

List blood film appearance in MPD

A

Basophilia
Eosinophilia
Myelocytes

42
Q

List blood film appearance in PRV

A

Crowding of red cells

43
Q

List blood film appearance in essential thrombocythaemia

A

Giant platelets

Increased number of platelets

44
Q

List blood film appearance in myelofibrosis

A

Leukoerythroblastic film
Tear-drop red cells
Hyposegmented neutrophils

45
Q

List blood film appearance in AML

A

Blasts with Auer rods

46
Q

List blood film appearance in ALL

A

Blasts (need to do immunophenotyping to differentiate from AML)

47
Q

List blood film appearance in CLL

A

Smear cells

48
Q

List blood film appearance in Burkitt’s lyphoma

A

Blasts with basophilic vacuolated cytoplasm

starry sky on BM biopsy

49
Q

List pathological features of Hodgkin’s lymphoma

A

Reed-Sternberg cells

Nodular sclerosis

50
Q

List blood film appearance in multiple myeloma

A

Rouleaux formation

Plasma cells

51
Q

List blood film appearance in DIC

A

Helmet cells/fragment cells
Toxic granulation
Schistocytes

52
Q

List blood film appearance in HUS

A

Crenated cells

Fragmen cells

53
Q

List causes of atypical lymphocytes

A

EBV
HIV
Hep B

54
Q

Blood results in myeloma

A

May have lot platelets and RBC
Increased plasma cells
Increased ESR

55
Q

Name a CD30+ lymphoma

A

Hodgkin’s

56
Q

What is the translocation in Burkitt’s lymphoma?

A

t(8;14)

57
Q

What is an IgM paraprotein present in?

A

Waldenstrom’s macroglobulinaemia

Y3 Revision Points (6 decks)

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