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Year 6 > Haemotology > Flashcards

Haemotology Flashcards

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1
Q

Causes of macrocytic anaemia

A

B12
Folate- methotrexate, phenytoin, ?nitro
Alcoholism
MM
Hypothyroid

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2
Q

Haemolytic anaemic serology features

A

Increased bilirubin
Increase urinary urobillinogen
Increased LDH
Reticulocytosis
Low haptoglobin

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3
Q

Types of haemolytic anaemia

A

Acquired
Immune- warm/cold- DAT positive
Mechanism- MAHA- DIC, HUS, TTP
Heart valve
Malaria

Hereditary
G6PD, Pyruvate
Hereditary spherocytosis
SCD, thalassaemia

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4
Q

Types of immune mediated haemolytic anaemia and features

A

DAT +
Warm- IgG- extravascular haemolysis- lymphoma, SLE

Cold- IgM, intravascular

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5
Q

Features of HUS

A

E coli- O157
Diarrhoea
MAHA
Thrombocytopenia
Renal failure

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6
Q

Features of TTP

A

Attacking ADAMTS 13- which usually breakdown vWF- causes plt aggregations
 Adult females
Pentad
 Fever
 CNS signs: confusion, seizures
 MAHA
 Thrombocytopenia
 Renal failure

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7
Q

Triggers for G6PD

A

Broad beans
Infections
Antimalarials
Sulphonamides, cipro, nitrofuratoin
Sulphylureas

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8
Q

Inheritance of G6PD, SCD,

A

G6PD- X linked- MALES

SCD- recessive

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9
Q

Pernicious anaemia features

A

AB against IF or parietal cells
Atrophic gastritis
B12 deficiency
Peripheral neuropathy
Anaemia
Lemon tinged skin

Associated with AI diseases

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10
Q

Causes of B12 deficiency

A

Vegan - low intake
Pernicious anaemia- low IF
Crohns - affects terminal ileum
Bacterial overgrowth

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11
Q

Presentation of sickle cell

A

Splenomegaly
Infarction
Crises
Kidney
Liver/Lung
Erection
Dactylics

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12
Q

Complication and Tx of SCD

A

Sequestarion crisis- shock and severe anemia- splenectomy

Acute chest crisis- pain, O2, Abs
Aplastic crisis

Painful crisis- analgesia, hydration, O2

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13
Q

Causes of DIC

A

Sepsis, malignancy, trauma

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14
Q

Tumour lysis syndrome Dx

A

Recent chemo
Increased K, P, low Ca
Raised creatinine

Seizure, arrhythmia

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15
Q

Indication of RBC transfusion

A

ACS- maintain >80
No ACS- >70

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16
Q

Indication of plt transfusion

A

Pre-procedure- >50 , 100 if eye
No bleeding- <10
Bleeding <30

CI if BM failure, TTP, Heparin induced T

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17
Q

Heparin induced thrombocytopenia features

A

AB induce plt activation

Low plt but prothrombotic

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18
Q

Who gets what in FFP transfusion

A

If A- A, AB
If B- B, AB
If AB- only AB
If O- All

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19
Q

Immediate Transfusion reactions

A

Haemolytic- ABO incompatible, fever, agitation,DIC shock- renal failure - stop

Bacterial- temp, shock- more common in platelet

Febrile non haemolytic- just high fever- slow and paracetamol

Allergic- urticaria, anaphylaxis

TACO- high HR, BP, low SpO2- fluid overload

TRALI- anti WBC abs- ARDS- cough, SOB, bilateral infiltrates- stop

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20
Q

Causes of thrombophilia

A

Increased clotting

Factor V leiden- increased likelihood to clot
Prothrombin mutation- increased chance
Protein C and S deficiency- C and S used to prevent clotting
Antithrombin III deficiency

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21
Q

Cause of increased bleeding

A

Thrombocytopaenia- TTP, DIC, HUS
VWD
Haemophilia A and B

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22
Q

Features of VWD

A

Increased bleeding
Mildly elevated APTT- due to reduced factor 8

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23
Q

Cause of Howell Jolly bodies

A

Hyposplensim - SCD, coeliac

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24
Q

Cause of hypersegmented neutrophils

A

B12/folate deficiency

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25
Treatment of folate and B12 deficiency together
I 1 mg of IM hydroxocobalamin 3 times each week for 2 weeks, then once every 3 months, then oral folate when b12 normal
26
Prophylaxis of TLS
Allopurinol
27
Difference between aplastic and sequestration in SCD in bloods
Both anaemic Low reticulocytes in aplastic High in sequestration
28
Ann Arbor staging
I: single lymph node II: 2 or more lymph nodes/regions on same side of the diaphragm III: nodes on both sides of the diaphragm IV: spread beyond lymph nodes
29
Causes of polycythaemia
Secondary- hypoxia- COPD, high altitiude Primary- PRV, EPO producing tumour
30
Signs of ALL
Anaemic, petechiae, infections
31
High metHb meaning and Tx
Dysfunctional Hb- +3 state caused by nitrate Treat with methylene blue if acquired
32
Imaging for suspected MM
Whole body MRI
33
Polycythaemia Tx
Venesection Aspirin
34
ALL vs AML vs CLL vs CML
Acute- blasts chronic- bands- different stages of maturation Low lymph- myeloid WBC >100- Chronic AML- Auer rods ALL- anaemia, neutropenia, lymphadenopathy CLL- lymph, CML- Phil +ve , all stages seen, splenomegaly
35
CML treatment
Imatinib
36
Poor prognosis of lymphoma
B symptoms
37
Factor V leiden pathology
Resistance to protein C
38
Blood clot results for haemophilia
APTT- incresase PT- normal Bleeding time- normal
39
Blood clot results for von Willebran disease
APTT- increase- F8 PT- normal BT- increased
40
Vit K deficiency blood clot results
APTT- increased PT- increased BT- normal
41
APTT in antiphospholipid sx
Increased
42
Myelofibrosis features
Massive splenomegaly Anaemia High plt and WBC early- but can be pancytopenia Tear drop- poikilocytosis
43
Myeloma Ca, P and ALP levels
Ca high P high Normal ALP Infections
44
Mx of ITP
Oral prednisolone
45
Complication of hereditary spherocytosis
Aplastic crisis Parvovirus
46
Aplastic crisis sx
Jaundice, fatigue, splenomegaly Erythema infectiosum
47
Ix for G6PD deficiency
Enzyme assay at time and 3 months
48
Glucocorticoids effect on neutrophils
Neutrophillia
49
What is the use of irradiated blood
Depletes T cells So useful for graft vs host disease
50
CLL patient becomes suddenly unwell
Ritcher transformation into Non Hodgkin lymphoma
51
Graft vs host disease sx
Painful Maculopapular rash Jaundice Diarrhoea N+V
52
Medical tx of TACO
Furosemide
53
SE of chemotherapy
Asparagine- neuro Cisplatin- ototoxic/nephro Vincrinstine- nerve, blastine- bones Doxorubicin- heart Cyclophosphamide- bladder Methotrexate- nephrotic
54
Tx of ABO incompatibility
Stop and give fluids
55
Most common Hodgkin lymphoma
Nodular sclerosino
56
Best and worst prognosis of Hodgkin lymphoma
Lymph depleted - worst Lymph predominant - best
57
Plt level before surgery or invasive procedure
>50 50-75 if high risk of bleeding >100 if critical site q
58
Mx of DAT+ haemolytic anaemia
Steroids and rituximab
59
Rituximab moa
CD20- B cells
60
When to give irradiated blood
Immunodeficiency Allogenic- 6 months Auto- 3 months
61
Guidelines for neutropenic sepsis
Known cause for neutropenia- recent cancer tx Temp >38 RR >20 Do not delay ABx
62
Order of tests in IDA
FBC Then if low Hb and MCV check ferritin But if infected- check iron status If ferritin <15- colonoscopy and gastroscopy
63
Dx of ABO incompatibility
Direct Coombs test
64
Pigmented gallstones associated with
Sickle cell anaemia
65
IDA vs ACD
TIBC is high in IDA and low/normal in ACD Ferritin high in ACD
66
Tx of hyper viscosity due to waldenstroms
Plasmaphoresis
67
Dx of polycythaemia ruba
JAK 2
68
Sx of thalassaemia
Mediterranean Hepatosplenomegaly Failure to thrive Maxillary overgrowth
69
Dx of thalassaemia
Electrophoresis
70
Myelodysplasia features
Low myeloid cells Progress to AML Ring sideroblasts
71
Features of lead poisoning
Sideroblastic anaemia High iron and ferritin Normal TIBC
72
Common haemolytic anaemia in northern europue and fx
Hereditary spherocytosis Splenomegaly Jaundice
73
Dx of HS
EMA binding- if HS will show less binding of EMA
74
Features and diagnosis of Paroxysmal nocturnal haemaglobinuria
Dark urine in mornings jaundice Flow cytometry
75
B12 deficiency with neuro deficits treatment
Hydroxycobalamin 1mg IM on alternate days for 1 weeks Injections every 2 month lifelong
76
AML Vs CML
AML- present within weeks, blasts CML- months, WCC >100, all across germ line
77
Blood results of beta thalassaemia
Microcytic anaemia Absent HbA Raised HbF and HbA2
78
Main precipitate in Cryoprecipitate
VIII
79
Tumour lysis syndrome prophylaxis tx
IV allopurinol or IV rasburicase if high risk- high tumour burden PO allopurinol if low risk
80
When should cryoprecipitate be used
If fibrinogen is low
81
Anaemia with epilepsy cause
Taking phenytoin- folate
82
SLE anaemia blood results
High bilirubin High LDH Jaundice DAT +
83
Sideroblastic anaemia iron/blood results
Anaemic High iron Low TIBC High ferritin
84
Haptoglobin in haemolytic anaemia
Low since binds to haemoglobin
85
Haptoglobin in haemolytic anaemia
Low since binds to haemoglobin
86
Ix if new B symptoms in CLL
Lymph biopsy- pitcher transformation
87
Ethnicity with neutropenia is common
Black afro carribean
88
Sickle cell crisis management
Analgesia Fluids Exchange transfusion- if vaso occlusive or organ failure, splenic crisis
89
Basophillic stipping of red cells
Sideroblastic anaemia
90
Multiple myeloma x ray
Osteolytic lesions Rain drop skull
91
Acute haemolytic reaction Anti bodies
IgM
92
Cryoprecipitate
VIII, fibrinogen, VWF, XIII
93
Most common non Hodgkin lymphoma
Diffuse large B cell
94
Mx of thala major
Transfusions Chelation therpay- desferrioxamine
95
Bite and blister cells on blood film
G6PD
96
Echinocytes on blood film
Pyruvate kinase deficiency
97
Basophillic stippling causes
Pyrimidine 5' nucleotidase deficiency
98
Cold vs warm causes of Haemolytic anaemia
Cold- Myco, EBV, CMV- IgM Warm- SLE, CLL, lymphoma- IgG
99
How long should non urgent blood transfusions take
90-120 mins
100
How long should urgent blood transfusions take
STAT
101
Which conditions require pneumococcal vaccine and how often
COPD- 1 off Sickle/hypospelnism- 5 years
102
RBC results of alcoholic liver disease
Macrocytic anaemia Low plt
103
SE of EPO
Bone aches, flu-like symptoms and skin rashes
104
Cause of Heinz body anaemia
Mesalazine
105
TRALI vs acute haemolytic reaction
TRALI- crackles in bases Acute- immediate- more systemic- vomiting, flushed, dark urine, pain in loin
106
Tx of VWD
Desmopressin
107
Starry sky dx
Burkitt lymphoma
108
Feature of B thala trait
Slightly anaemic Disproportiate microcytic High A2
109
Waldenstroms features
High IgM Hypervisocity- causing strokes
110
Red welts on abdomen whilst transfusion management
Temporarily stop Antihistamine
111
What increases risk of anaphylactic reaction to blood transfusions
IgA deficiency
112
Iron deficiency anaemia before surgery mx
Oral iron works in 2-4 weeks So if time interval is less - use IV
113
Combination of azathioprine and allopurinol
Pancytopaenai
114
TRALI sx
Fever, SOB, bilateral infiltrates, hypotension, hypoxia
115
CML vs myelofibrosis
Both cause splenomegaly and low cell count CML- high WBV vs low in MF
116
Cause of massive splenomegaly
CML, MF, malaria and lymphoma

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