Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Kat's Pathology > Haematology of Systemic Disease > Flashcards

Haematology of Systemic Disease Flashcards

(70 cards)

Start Studying
1
Q

A patient with lymphoma is referred by the GP with new onset jaundice, anaemia and raised LDH.

A

Lymphoma stage 4 with bone marrow +liver involved
Lymphoma with nodes compressing the bile duct plus anaemia of inflammation
Lymphoma with Acquired auto immune haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can be the first presentation in cancer

A

Anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the forms of anaemia associated with cancer

A

Iron deficiency
Anaemia of inflammation (chronic disease)
Leucoerythroblastic anaemia
Haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What cancers can cause secondary polycythaemia

A

Renal cell cancer

Liver cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the lab findings in iron deficiency anaemia

A

Reduced ferritin
Reduced transferrin saturation
Raised TIBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Reduced ferritin
Reduced transferrin saturation
Raised TIBC

A

Iron deficiency anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the major cause of iron deficiency anaemia until proven otherwise

A

Bleeding until proved otherwise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What cancers can cause occult blood loss

A

GI cancer: gastric, colonic/rectal

Urinary tract cancer: renal cell carcinoma (physicians tumour), bladder cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What may cause acquired haemolytic anaemia in cancer

A

Immune mediated

Non-immune mediated - fragmentation (micro-angiopathic haemolytic anaemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is leucoerythroblastic anaemia

A

Red cell and white cell precursor anaemia

Variable degree of anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the morphological features on blood film of leucoerythroblastic anaemia

A

Teardrop RBCs (and aniso and poikilocytosis)
Nucleated RBCs
Immature myeloid cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can cause a leucoerythroblastic film

A

Bone marrow infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some causes of bone marrow infiltration (producing leucoerythroblastic film)

A

Cancer: haemopoietic (leukaemia, lymphoma, myeloma), non-haemopoietic (breast, bronchus, prostate)
Severe infection: MTB, severe fungal infection
Myelofibrosis: massive splenomegaly, dry tap on BM aspirate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What process underpins haemolytic anaemias

A

Shortened red cell survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some key markers looked for to distinguish causes of haemolytic anaemias

A

Anaemia (may be compensated)
Reticulocytosis
Raised bilirubin (unconjugated)
Reduced haptoglobins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Subsets of haemolytic anaemia

A

Inherited: defects of the red cell
Acquired: defects of the environment in which the red cells find themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Components of a RBC

A

Membrane
Haemoglobin
Enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Defects of RBC membrane leading to haemolytic anaemia

A

Spherocytosis

Ellipotcytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Defects of RBC haemoglobin leading to haemolytic anaemia

A

Structural - sickle cell disease

Quantitative - thalassaemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Defects of RBC enzymes leading to haemolytic anaemia

A

G6PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Types of acquired haemolytic anaemia

A

Immune

Non-immune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you distinguish an immune from a non-immune haemolytic anaemia

A

Direct antiglobulin test (Coombs test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Spherocytes

DAT +ve

A

Auto-immune haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the associated systemic disorders with auto-immune haemolytic anaemias

A

Cancer of the immune system: lymphoma
Disease of the immune system: SLE
Infection (disturbing the immune system)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Causes on non-immune acquired haemolytic anaemias
Infection (malaria) | Micro-angiopathic haemolytic anaemia (MAHA)
26
What are the manifestations of MAHA
Red cell fragments Low platelets DIC/bleeding Underlying adenocarcinoma
27
Micro-angiopathy in malignancy - e.g. adenocarcinomas with low grade DIC
Platelet consumption Fibrin deposition and degradation Red cell fragmentation (microangiopathy) Bleeding
28
True polycythaemia
raised red cell mass
29
What can cause true polycythaemia
Cancer
30
Types of true polycythaemia in cancer
``` Secondary (raised EPO) Polycythaemia vera (PV) ```
31
Causes of secondary true polycythaemia
Inappropriate: hepatocellular cancer, bronchial cancer, renal cancer Appropriate: high altitude, hypoxic lung disease, cyanotic heart disease
32
Normal mature WBCs
Phagocytes: granulocytes - neutrophils, eosinophils, basophils; monocytes. Immunocytes: T cells, B cells, natural killer cells
33
Where are immature WBCs normally found
In the bone marrow
34
What needs to be considered when looking at a high WBC count
Consider the FBC print out Review the blood film How high is the total WBC Which lineage is elevated Are the cells normal or abnormal in appearance Are the cells mature or immature
35
Causes of neutrophilia
``` Corticosteroids Underlying neoplasia Tissue inflammation (e.g. colitis, pancretitis) Myeloproliferative/leukaemic disorders Infection ```
36
What infections do not produce neutrophilia
Brucella Typhoid Many viral infections
37
What type of infections produce neutrophilia
Both localised and systemic infections | Acute bacterial, fungal, certain viral infections
38
Reactive neutrophilia features
Presence of bands Toxic granulation Signs of infection/inflammation
39
Malignant neutrophilia features
Neutrophilia, basophilia plus immature cells myelocytes, and splenomegaly (CML) Neutropenia plus myeloblasts (AML)
40
Causes of reactive eosinophilia
Parasitic infestation Allergic diseases e.g. asthma, rheumatoid, polyarteritis, pulmonary eosinophilia Underlying neoplasma, especially Hodgkin's, T cell NHL (reactive eosinophilia) Drugs (reactive erythema multiforme)
41
Chronic eosinophilic leukaemia features
Eosinophils part of the 'clone' | FIP1L1-PDGFRa fusion gene
42
Causes of moncytosis
Rare, but seen in certain chronic infections and primary haematological disorders TB, brucella, typhoid Viral: CMV, varicella zoster Sarcoidosis Chronic myelomonocytic leukaemia (MDS)
43
Infective causes of neutrophilia
Bacterial
44
Infective causes of eosinophilia
Parasites
45
Infective causes of basophilia
Pox virus
46
Infective causes of monocytosis
Chronic (TB, brucella)
47
Inflammatory causes of neutrophilia
Auto-immune | Tissue necrosis
48
Inflammatory causes of eosinophilia
Allergic (asthma, atopy, drug reactions)
49
Neoplastic causes of neutrophilia
All types
50
Neoplastic causes of eosinophilia
Hodgkin's | Non-Hodgkin's
51
Myeloproliferative causes of neutrophilia
CML
52
Myeloproliferative causes of basophilia
CML
53
Myeloproliferative causes of monocytosis
CML
54
Types of lymphocytosis
Primary | Secondary
55
Causes of primary lymphocytosis
Monoclonal lymphoid proliferation (e.g. CLL, NHL)
56
Causes of secondary lymphocytosis
Polyclonal response to infection | Chronic inflammation
57
How to interpret a lymphocytosis
Clinical: symptoms suggestive of infection or lymphoma FBC: degree of lymphocytosis Light microscopy/morphology: mature cells or primitive lymphoblasts Flow cytometry: lineage: B or T cells, stage of differentation Molecular genetics: rearranged: T cell receptor or immunoglobulin gene
58
Causes of reactive lymphocytosis (secondary)
Infection: EBV, CMV, toxoplasma, infectious hepatitis, rubella, herpes, infections Autoimmune disorders Sarcoidosis
59
How do you evaluate a patient with lymphocytosis
History Clinical examination Imaging
60
Mature lymphocytes in peripheral blood
Reactive/atypical lymphocytes (IM) | Small lymphocytes and smear cells (CLL/NHL)
61
Immature lymphoid cells in peripheral blood
Lymphoblasts (acute lymphoblastic leukaemia)
62
What does immunopheotyping do
Looks at the antigens expressed on the cells
63
Antigen on lymphoid stem cell
TdT | HLA-DR
64
Antigens on pro B cells
``` HLA-DR CD19 CD10 CD79 cyCD22 ```
65
Antigens on pre B cell
``` HLA-DR cyIg CD19 CD79 CD22 ```
66
Antigens on intermediate B cell
``` HLA-DR CD19 CD5 CD79 CD22 ```
67
Antigens on mature B cell
``` HLA-DR sIg CD19 FMC7 CD79 CD22 ```
68
Antigens on plasma cell
cyIg CD138 CD38
69
Polyclonal antibodies
Kappa and lambda
70
Monoclonal antibodies
Kappa only or lambda only

Kat's Pathology (105 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions