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Haematology Flashcards

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1
Q

Causes of microcytic anaemia

A 
Thalassaemia
Anaemia of Chronic Disease
Iron deficiency Anaemia
Lead poisoning
Sideroblastic anaemia
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2
Q

Sx of iron deficiency anaemia

A 
Glossitis
Kolionychia
PR bleed
Epistaxis
Angular cheilosis
Menorrhagia
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3
Q

Blood tests for anaemia

A 
FBC - Hb and MCV
Haematinics - Fe, ferritin, total iron binding capacity
U+E - upper GI bleed
CRP
ESR - chronic disease
Blood film
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4
Q

What should you aim for when giving iron tablets?

A

Should raise Hb by 10g/L per week - continue for 3 months

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5
Q

Causes of macrocytic anaemia

A

B12 deficiency
Alcoholism
Liver disease
Drugs - anti-folate

Hypothyroidism
Aplastic anaemia
Increased reticulocytes
Reduced folate - malabsorption, poor diet etc
96 - MCV >96
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6
Q

Why is B12 deficiency bad?

A

Causes neuronal demyelination

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7
Q

What blood tests would you do for macrocytic anaemia?

A 
FBC
Haematinics - folate and B12
LFTs - increased gamma-GT in alcohol
TFTs - hypothyroidism
Blood film

If no cause found - bone marrow biopsy

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8
Q

Mx macrocytic anaemia

A
  • Foic acid 5mg/24hrs for 4 months
  • Hydroxocobalamin 1mg - (B12)
  • Treat other causes
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9
Q

What is sideroblastic anaemia?

A

Altered mitochondrial function and defects in haem synthesis = haemochromatosis

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10
Q

What are the blood signs for haemolysis?

A

Increased LDH
Increased serum conjugated bilirubin
Reduced haptoglobin

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11
Q

Which condition are Heinz Bodies seen in?

A

G6PD

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12
Q

How do you manage sickle-cell crisis?

A

Lots of analgesia and fluid
Warming
Oxygen
Consider broad spec Abx

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13
Q

Mx haemolytic transfusion reaction

A 
Help
Oxygen/fluids
Hydrocortisone 200mg
Chlorphenamine 10mg
Catheterise and monitor BP and UO
ECG, U+Es - raised K+, clotting factors
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14
Q

What test can you do for haemolytic anaemia?

A

Direct Coombs

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15
Q

What blood markers change in DIC?

A

Reduced platelets and fibrinogen and Hb

Increased APTT, PT and FDPs

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16
Q

What long-term Mx is there for sickle cell?

A

Pen V
Hydroxycarbamide
Bone-marrow transplant

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17
Q

What signs are there for Sickle Cell?

A 
Hairy/fuzzy skull
Target cells
Howel-Jolly bodies
Enlarged cheeks
Dactylitis
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18
Q

What causes Sickle Cell?

A

Glutamic acid –> Valine causing aggregation of B-Hb and distortionof RBC

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19
Q

Main Sx of myeloma

A

Calcium increase
Renal disease
Anaemia
Bone lesions

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20
Q

What is the main tests for Myeloma?

A

Blood film - Rouleaux
Bence-Jones protein <48hrs if pt >60 - in urine
Skeletal survey
MGUS - monoclonal gammopathy of undetermined significance

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21
Q

Which anti-bodies are predominant in myeloma?

A

IgG

IgM

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22
Q

What CTx regimen is used for myeloma?

A

Bortezomib
Thalidomide
Dexamethasone

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23
Q

What X-Ray signs show myeloma?

A

Pepper pot skull

Vertebral collapse

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24
Q

What is the 1st line imaging for myeloma?

A

Whole body MRI

CT

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25
Which pain medication should you avoid in myeloma?
NSAIDs
26
Alcohol-induced lymph node pain is associated with what?
Hodgkin's lymphoma
27
What do you find on blood film in Hodgkin's lymphoma
Reed-Sternberg cells
28
What staging is used for Hodgkin's?
Ann Arbor
29
What's the main Ix for Hodgkin's lymphoma?
Lymph node excision biopsy
30
What's the main CTx for HL?
Adriamycin Bleomycin Vinblastine Dacarbazine AVBD
31
Which stage of Ann-Abor do lymph nodes cross the diaphragm?
III (1 below) | IV (more than one)
32
Which virus is commonly associated with Non-Hodgkin's Lymphoma?
Human T-lymphotrophic virus
33
What genetic mutation is associated with Burkitt's lymphoma?
c-myc translocation
34
What CTx is used for NHL?
R-CHOP
35
What treatment is used for CD20 positive B-cell non-Hodgkin Lymphomas?
Rituximab
36
Which condition is associated with the t(9,22) Philadelphia translocation?
CML - BCR-ABL1 fusion
37
Which Sx are more common in ALL than AML?
Bone pain and hepatosplenomegaly
38
Which acute leukaemia is associated with over 60s?
AML
39
What blood count would show ALL?
Increased lymphoblasts and WCC
40
Which test distinguishes ALL from AML?
Terminal deoxynucleotidyl transferase - TdT
41
Which Sx are more common in AML than ALL?
Bleeding gums | Leukaemia cutis
42
What would a blood smear of AML show?
Increased leukocytes | Anaemia
43
What would a bone marrow smear in AML show?
Increased myeloblasts - containing Auer rods
44
Mx for AML
CTx | All-trans retinoic acid treatment - ATRA - causes cells to develop
45
What is the most common leukaemia in adults?
CLL
46
Main diagnoistic for CLL
Lymph node biopsy Increasingly small, round lymphocytic infiltration Proliferation centers
47
Which condition does a blast crisis occur?
CML
48
Blood Smear CML
Increased granulocytes
49
What are the stages of CML?
Chronic phase - vague symptoms Accelerated phase - spleno/hepatomegaly, lymphadenopathy Blast crisis - terminal phase, rapid progression
50
What can be used to treat CML?
Tyrosine kinase inhibitors
51
What are the causes of thrombophilia?
Factor V Leiden | Reduced protein C+S
52
Christmas Disease
Haemophilia B - FIX
53
Which clotting factors is deficient in Haemophilia A?
FVIII - vWillebrand disease
54
Which clotting factor is the main extrinsic pathway?
7
55
Which clotting factors are intrinsic pathways?
12, 11, 9, 8,
56
Common pathway clotting factors
10, 5, 2, 1 (1521)
57
What does prothrombin time test?
Extrinsic and common
58
What does partial thrombin time test?
Intrinsic and common
59
Haemophilia - how is PT and PTT affected?
``` PT = normal PTT = long ```
60
Mx Haemophilia A -
Desmopressin | Cryoprecipitate
61
Bloods for Haemochromatosis
Ferritin - raised | TIBC - low
62
Signs for haemochromatosis
Bronze skin Hepatomegaly Diabetes mellitis
63
Mx anal fissue
GTN Stool softener Botulinum toxin

Finals Questions (8 decks)

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