Haematology results

Question 1

What is the definition of anaemia?

Answer 1

Less than 13g/dL in men
Less than 12g/dL in women
Less than 11g/dL in pregnant women

Question 2

What are the causes of microcytic anaemia?

Answer 2

Iron deficiency
Thalassaemia
Chronic disease
Sideroblastic anaemia

Question 3

What are the causes of a normocytic anaemia?

Answer 3

Chronic disease
Haemolytic anaemia
Acute blood loss
Marrow infiltration

Question 4

What are the causes of a microcytic anaemia?

Answer 4

Vitamin B12 deficiency
Folate deficiency
Excess alcohol consumption
Reticulocytosis
Hypothyroidism
Multiple Myeloma
Myeloproliferative disorders
Aplastic anaemia

Question 5

What are the haematinics?

Answer 5

Iron
B12
Folate

Question 6

What results do you get in iron studies?

Answer 6

Serum iron
Serum total iron-binding capacity
Serum ferritin
Transferrin saturation
Serum soluble transferrin receptors

Question 7

What would iron studies show in an iron deficiency state?

Answer 7

Reduced serum iron
Increased TIBC
Reduced serum ferritin
Reduced transferrin saturation
Increased serum sTfRs

Question 8

What causes a rise in serum ferritin and why?

Answer 8

Active inflammation, because it is an acute phase reactant

Question 9

In what cases would you see iron overload?

Answer 9

Haemochromatosis

Haematological conditions that require frequent blood transfusions

Question 10

In anaemia of chronic disease, what do iron studies commonly show?

Answer 10

Normal/slightly reduced serum iron
Reduced TIBC
Normal sTfR

Question 11

What is the most common reason for vitamin B12 deficiency?

Answer 11

Poor absorption due to absence of intrinsic factor or disease of the ileum

Question 12

What is the most common disease causing vitamin B12 deficiency?

Answer 12

Pernicious anaemia - autoantibodies against parietal cells causing defective intrinsic factor production

Question 13

What other blood test will be increased in haemolytic anaemia?

Answer 13

Plasma bilirubin

Question 14

What is the main laboratory test for autoimmune haemolytic anaemia?

Answer 14

Direct antiglobulin test (also called Coomb’s test)

Question 15

What are some inherited causes of haemolytic anaemia?

Answer 15

Spherocytosis
Elliptocytosis
Thalassaemia
Sickle cell anaemia

Question 16

What is the definition of polycythaemia?

Answer 16

Packed cell volume greater than 0.51 in males or 0.48 in females

Question 17

What is used to distinguish between true and apparent polycythaemia?

Answer 17

Red cell mass (in true polycythaemia it would be raised)

Question 18

What is apparent polycythaemia due to?

Answer 18

Reduction in plasma volume (rather than increase in red cell mass)

Question 19

What can true secondary causes of polycythaemia be subdivided into?

Answer 19

Caused by hypoxia

Caused by excess erythropoietin

Question 20

What are common causes of neutrophilia?

Answer 20

Bacterial infections
Inflammation
Necrosis
Corticosteroid treatment
Malignancy

Question 21

What are common causes of neutropenia?

Answer 21

Post-chemo
Post-radiotherapy
Adverse drug reaction
Viral infection

Question 22

What are common causes of lymphocytosis (lymphocytes >3.5)?

Answer 22

Viral infection
Chronic infections (TB)
CLL
Lymphoma

Question 23

What are common causes of eosinophilia?

Answer 23

Allergic disorders
Parasite infection
Skin diseases (eczema)
Malignancy (eg, Hodgkin’s disease)

Question 24

What can the common causes of thrombocytosis be subdivided into?

Answer 24

Primary haematological disease

Reactive thrombocytosis secondary to something else

Question 25

What primary haematological diseases can cause thrombocytosis?

Answer 25

Essential thrombocythaemia (and other myeloproliferative disorders) CML Myelodysplasia

Question 26

What can cause a reactive thrombocytosis?

Answer 26

``` Infection Inflammation Malignancy Bleeding Pregnancy Post-splenectomy ```

Question 27

Reduced platelet production is due to bone marrow failure. What can cause this?

Answer 27

``` Infections (particularly viral) Drug-induced Leukaemia Aplastic anaemia Myelofibrosis Bone marrow replacement with tumour (eg myeloma or mets) ```

Question 28

What can cause increased platelet destruction?

Answer 28

Autoimmune idiopathic thrombocytopaenia purpura Drug-induced (heparin-induced thrombocytopaenia) Hypersplenism Thrombotic thrombocytopaenia purpura DIC

Question 29

What is pancytopaenia?

Answer 29

Low levels of RBCs, WBCs and platelets

Question 30

What can cause pancytopaenia?

Answer 30

``` Aplastic anaemia Bone marrow infiltration (eg tumour) Hypersplenism Megaloblastic anaemia Sepsis SLE ```

Question 31

What are common causes of a raised ESR?

Answer 31

``` Infectious disease Neoplastic disease (particularly MM) Connective tissue disease (eg Giant cell arteritis and PMR) Anaemia Renal disease ```

Question 32

When would you see Howell-Jolly bodies?

Answer 32

In erythrocytes, post-splenectomy or in hyposplenism

Question 33

In what condition would you see smear cells?

Answer 33

CLL

Question 34

What are the common tests of coagulation?

Answer 34

Prothrombin time INR Activated partial thromboplastin time (APTT) Bleeding time

Question 35

What clotting factors is PT dependent on?

Answer 35

1, 2, 5, 7 and 10

Question 36

What coagulation pathways does APTT test?

Answer 36

Intrinsic and common pathways

Question 37

Which clotting factor does APTT NOT depend on?

Answer 37

Factor VII

Question 38

APTT is used most commonly with patients receiving what drug?

Answer 38

Heparin

Question 39

What laboratory findings are typically found in DIC?

Answer 39

Raised PT and APTT Reduced fibrinogen Raised D-dimer

Question 40

What laboratory findings are found in haemophilia?

Answer 40

Normal PT Raised APTT Normal fibrinogen

Question 41

What laboratory findings are found in warfarin treatment?

Answer 41

Raised PT Normal (or slightly raised) APTT Normal fibrinogen