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Haematology Flashcards

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1
Q

What cells can be seen in a Hodgkins Lymphoma biopsy?

A

Reed Sterberg cells

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2
Q

What chemotherapy regime is used for Hodgkin’s Lymphoma?

A 
ABVD
(A)driamycin (also known as doxorubicin)
(B)leomycin
(V)inblastine
(D)acarbazine
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3
Q

What classification system is used for Hodgkin’s Lymphoma?

A

Ann Arbor

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4
Q

What organism is associated with gastric MALT?

A

H. Pylori

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5
Q

Where is lymphadenopathy common in Burkitt’s lymphoma?

A

Jaw - in African children

Ileo-cecal junction in caucasians.

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6
Q

What is the appearance of Burkitt’s on histology?

A

‘Starry sky’

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7
Q

What is the chemotherapy regimen for non-Hodgkins?

A

R-CHOP

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8
Q

What genetic syndromes is ALL associated with? (2)

A

Down’s Syndrome, Klinefelters

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9
Q

What are signs of marrow failure?

A

Anaemia, infection, bleeding

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10
Q

What are four poor prognostic factors in ALL?

A

Older age, male sex, Philadelphia chromosome, CNS involvement

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11
Q

How can AML be differentiated from ALL on microscopy?

A

AML has Auer rods

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12
Q

What is the Philadelphia chromosome mutation?

A

Translocation between chromosome 9 and 22 (BRC-ABL) leading to an over-activation of tyrosine kinase.

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13
Q

What are the three phases of CML?

A

Chronic
Accelerated phase
Blast transformation (becomes AML)

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14
Q

What can be seen on blood film in CLL?

A

Smudge/smear cells

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15
Q

What are the two main causes of death in CLL?

A

Infection

Richter’s syndrome

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16
Q

What viral condition is common in CLL?

A

Shingles (Varicella Zoster)

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17
Q

How are acute and chronic leukaemia differentiated on blood smear?

A

> 20% blast cells classifies it as an acute leukaemia

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18
Q

What is found in the urine of patients with myeloma?

A

Bence Jones proteins - Ig light chains

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19
Q

What is identified in serum electrophoresis of myeloma?

A

Monoclonal protein cells

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20
Q

Name three drugs used in multiple myeloma induction therapy?

A

Bortezomib, dexamethasone, thalidomide

Lenalidomide

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21
Q

What can be used to suppress EPO in secondary polycythemia?

A

Hydroxycarbamine

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22
Q

What gene mutation is associated with poor prognosis in AML?

A

FLT3

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23
Q

What neoplasms could elevated monocyte levels represent?

A

Hodgkin’s lymphoma

Monocytic leukaemia

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24
Q

What is the management of minor bleeding in Haemophilia?

A

Desmopression and tranexamic acid

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25
What is the inheritance pattern of Haemochromatosis?
Autosomal recessive
26
What are the symptoms of acute haemolytic transfusion reaction?
``` Fever +/- rigors (chills) Abdominal, back, flank, or chest pain SOB Hypotension Hemoglobinuria Sever - Shock and disseminated intravascular coagulation ```
27
What antibodies are present in pernicious anaemia?
Anti-intrinsic factor antibodies
28
How should a patient presenting with extremely high granulocyte/leukocyte count be treated?
Leukapheresis
29
What is the management of massive haemorrhage in a patient being treated with warfarin?
Withhold warfarin IV vitamin K Prothrombin complex
30
Which pathway of the clotting cascade does Haemophilia affect?
The intrinsic pathway
31
What is the inheritance pattern of von Willebrand disease?
Autosomal dominant
32
What is Plummer-Vinson syndrome?
A triad of microcytic anaemia, glossitis and oesophageal webs (difficulty swallowing)
33
What type of myeloma has normal serum calcium, potassium and creatinine but bone marrow plasma cells >10% ?
Smouldering myeloma (transition between MGUS and multiple myeloma)
34
What are the morphological signs of Fanconi's anaemia?
``` Small wide thumbs Small kidneys High levels of fetal haemoglobin Hypopigmentation freckles Low set ears ```
35
What is the INR target for patients with recurrent thrombotic events?
3.5
36
What is the management for AML?
Chemotherapy: Cytarabine and daunorubicin
37
What is Richter's syndrome? (1)
Transformation of B cell chronic lymphocytic leukemia (CLL) into a fast-growing diffuse large B cell lymphoma
38
What disease does lymphadenopathy become painful on consuming alcohol? (1)
Hodgkin's lymphoma
39
What class of drug can be used to treat CML? Give an example? (2)
Tyrosine kinase inhibitors | Imatinib
40
What infection predisposes to haemolytic uraemic syndrome and what does it release to cause the syndrome? (2)
E. Coli | Shiga toxin
41
What are the triad of signs for haemolytic uraemic syndrome (3)
Haemolytic anaemia Thrombocytopenia - purpuric rash AKI - Oliguria
42
What conditions can schistocytes be seen on blood film? (4)
Disseminated intravascular coagulation Thrombotic thrombocytopenic purpura Haemolytic uraemic syndrome Valve disease
43
Who needs to be informed about a case of haemolytic uraemic syndrome? (1)
Proper officer - local health protection team (Public Health England)
44
What are the symptoms of TTP?
``` Anaemia Thrombocytopenia CNS involvement Fever Renal impairment ```
45
What is the underlying mechanism of TTP? (2)
Antibodies inhibiting the enzyme ADAMTS13. This results in decreased break down of von Willebrand factor (vWF) into smaller units
46
What are blood and clotting tests derangement in TTP?
Prolonged APTT High lactate dehydrogenase Low Hb Low platelets
47
How is TTP managed? (3)
IV plasma exchange - gold standard Rituximab Prednisolone
48
Name causes of Immune Thrombocytopenia Purpura
URTI HIV H. Pylori Autoimmune conditions - SLE, Antiphospholipid syndrome
49
What are the investigations done in ITP and what are the results? (8)
Bone marrow biopsy - Normal Blood film - Normal Platelets - Low Serology - Anti platelet antibodies
50
What pregnancy complications can lead to DIC? (4)
Pre-eclampsia Amniotic fluid embolus HELLP Placental abruption
51
What test results are done in suspected DIC and what are the expected results?
Clotting screen - Prolonged PT and aPTT, low fibrinogen FBC - Thrombocytopenia D-dimer - elevated Blood film - Schistocytes
52
What is the management for DIC? (5)
``` Treat underlying cause RBC Platelets FFP Cryoprecipitate ```
53
What does cryoprecipitate consist of? (4)
Fibrinogen Factor VIII von Willebrand factor Factor XIII
54
When is unfractionated heparin used? (1)
Massive pulmonary embolism
55
What is seen on clotting screen in Haemophilia A and B?
Prolonged APTT | Factor deficiency
56
What can be used to treat mild Haemophilia A? (1)
Desmopressin
57
What are the functions of von Willenbrand factor? (3)
Transport and protection of factor VIII Recruits platelets to exposed subendothelium Platelet adhesion
58
What is the mechanism of action of desmopressin? (1)
Stimulates release of vonWillebrand factor from endothelial cells
59
What are symptoms of polycythemia vera?
Itchy after hot bath Facial plethora Clots Spent phase - bleeding, anaemia symptoms
60
What mutation is seen in polycythemia vera?
JAK2

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