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PHASE 2A > HAEMOTOLOGY > Flashcards

HAEMOTOLOGY Flashcards

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1
Q

What is polycythaemia?

A

Too many red blood cells or not enough plasma volume

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2
Q

What is ruba vera/ polycthaemia vera?

A

A JAK2 mutation causing increased red blood cell production as more sensitive to bone marrow cells

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3
Q

What can cause secondary polycythaemia?

A

Hypoxia, high altitudes, sixkle cell, tumours, kidney problems

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4
Q

What are the symptoms of polycythaemia?

A

Easy brusing and bleeding, itchy skin

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5
Q

How do we treat polycythaemia?

A

Blood letting, aspirin

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6
Q

Where does eryptosis occur?

A

The spleen, liver and bone marrow

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7
Q

Where are red blood cells made?

A

Bone marrow

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8
Q

Where are platelets derived from?

A

Megakaryocytes in bone marrow

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9
Q

What clotting factors are vitamin K dependant?

A

2,7,9 + 10

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10
Q

What is haemoglobin made off?

A

2 alpha and 2 beta chains

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11
Q

What are the 3 main causes of microcytic anaemia?

A

Iron deficiency
Thalassaemia
Chronic disease

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12
Q

What are the 3 main causes of normocytic anaemia?

A

Bleeding
Chronic disease
combined haematinic deficiency

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13
Q

What are signs of iron deficiency?

A

Koilonychia, angular atomatitis, atrophic glossitis and brittle hair and nails

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14
Q

What are the causes of macrocytic anaemia?

A

B12/folate deficiency
Alcohol excess
Metabolic disease e.g. hypothyroidism

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15
Q

What is the test for B12 deficiency?

A

Shilling test

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16
Q

What is the test for pernicious anaemia?

A

Intrinsic factor antibodies

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17
Q

What diseases can cause B12 deficiency?

A

Coeliac disease, Crohn’s, atrophic gastritis

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18
Q

What is DIC?

A

Cytokins activate the clotting cascades and fibrin deposition. Platelet consumption occurs leading to bleeding whilst organ failure occurs.

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19
Q

what can cause DIC?

A

Sepsis
Trauma
Pancreatitis
Malignancy

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20
Q

What is the treatment for DIC?

A

Treat the underlying cause
Maintain blood volume
Many transfusions
Activated protein C

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21
Q

What is ITP?

A

Immune thrombocytopenic purpura

Ig G binds to platelets which are removed by the reticuloendothelial system

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22
Q

What is TTP?

A

Reduction of ADAMTS13 enzyme leading to spontaneous platelet aggregation in microvascular

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23
Q

What is the treatment for ITP or TTP?

A

Corticosteroids, IV Ig and anti D, remove spleen

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24
Q

What are signs of thrombocytopenia?

A

Purpura, epistaxis (nose bleed) and menorrhagia

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25
What are the investigations for a DVT?
Ultrasound, d-dimer and venography
26
What is the treatment for a DVT?
Low molecular weight heparin, anti-coagulation
27
What is Virchow's triad?
Stasis Hypercoagulability Endothelial damage
28
What is Myeloma?
An immunoglobulin overproduction from a mutation in bone marrow plasma cells
29
What are the signs and symptoms?
``` CRAB Hypercalcaemia Renal impairment Anaemia Lytic lesions and osteoporosis ```
30
What is seen on a blood film for myeloma?
Roleaux formation
31
What is seen on protein electrophoriesis for myeloma?
Monoclonal proteins
32
What is seen on urine protein electrophoresis for myeloma?
Bence- Jones proteins
33
What is high on FBC for myeloma?
High ESR, urea and creatine
34
What is the treatment for myeloma?
``` Rehydration with saline MRI and Dexamethasone Plasmaphersis (Hyperviscosity) Bisphosphonates Fluids and dialysis (AKI) ```
35
What is lymphoma?
A malignancy of mature lymphocytes arising in the lymphatic system
36
What is leukaemia?
Malignancy of lymphocyte precursors in the bone marrow
37
Which lymphoma has Reed Sternberg cells?
Hodgkin's
38
What ages are most commonly effected in Hodgkin's lymphoma?
The young and old
39
What are symptoms of Hodgkin's lymphoma?
Painless non-tendery rubbery lymph nodes, weight loss, fever, night sweats, lethargy
40
What are the signs of Hodgkin's lymphoma?
Enlarged lymph nodes and hepatosplenomegaly
41
What is the treatment of Hodgkin's lymphoma?
Radio and chemotherapy
42
How do we diagnose Hodgkin's lymphoma?
Biopsy Histology Reed-Sternberg cells
43
What is the Ann Arbor system used to stage?
Hodgkin's lymphoma
44
What is associated with Non-hodgkin's lymphoma?
MALT | Mucosa associated lymphoid tissue
45
What are the risks for non-hodgkin's lymphoma?
H.pylori HIV Toxins
46
What is the treatment for Non-hodgkin's lymphoma?
Chemo Radio Rituximab Steroids
47
What cells are cancerous in chronic myeloid leukaemia?
Neutrophils, basophils and eosinophils
48
What is the philadelphia chromosome linked to?
Chronic myeloid leukaemia
49
What are the signs of chronic myeloid leukaemia?
SPLENOMEGALY Anaemia Bruising Hepatomegaly
50
What are the diagnostic results for chronic myeloid luekaemia?
Raised WCC | Cytogenetics- Philadelphia chromosome
51
What is the treatment for chronic myeloid luekaemia?
Imatinib 2nd stage- dasatinib, nilotinib Hydroxycarbimide
52
What age does CML affect?
40-60
53
What is Chronic lymphocytic leukaemia a cancer of?
Mature B cells | most common type
54
What symptoms does CLL present with?
None- usually asysmptomatic
55
What are the signs of CLL?
Enlarged rubbery non-tender nodes | splen and hepatomegaly
56
What is seen on a full blood count for CLL?
Raised lymphocytes
57
What staging is used for chronic lymphocytic leukaemia?
Rai staging
58
What is a complication of CLL?
Autoimmune haemolysis (high WCC and normal platelet) Infection Marrow failure
59
What is the treatment for CLL?
Rituximab Chemo and radio Stem cell transplant
60
What is the rule of thirds associated with?
Chronic Lymphocytic Leukaemia
61
Which Leukaemia is associated with childhood?
Acute lymphoblastic leukaemia
62
What is ALL a malignancy of?
B/T lymphocyte cell lines?
63
What are signs/symptoms of ALL?
``` CNS invlovement Bone pain Marrow failure Lymphadenopathy Orchidomerglay ```
64
What are the results of investigations for ALL and AML?
Low RBC and platelets Blood film will have blast cells DIC may occur on a clotting screen
65
What is the treatment for ALL and AML?
Support with blood chemo Bone marrow transplant 70-90% cured
66
What is Acute myeloid leukaemia?
Malignancy of myeloid cell lines
67
What is a sign of AML?
Fever, bone pain, fatigue, pale skin, GUM HYPERTROPHY
68
What micro-organism causes malaria?
Plasmodium falcifurum
69
What are the investigations for malaria?
Thin and thick blood smear | Rapid diagnostic test and if clear repeat at 12 and 24 hours
70
What is the treatment for uncomplicated malaria?
Po Riamet, PO Quinine and doxycycline
71
What is the treatment of none faliciparum malaria?
PO Chloroquine
72
What is beta thalassemia?
A mutation in beta globlin genes on chromosome 11 leading to underproduction of red blood cells
73
Which of alpha and beta thalassemia is more commom?
Alpha
74
What is the treatment for thalassemia?
Mild- exercise and give folate | Regular transfusions, iron chelators and ascorbic acid
75
In sickle cell what is the mutation?
Glu for val in b chain to create Hbs instaed of HbA
76
What are the signs of thalassemia major?
Mexican hat cells in alpha | Bossing of the head
77
What is haemophillia a?
Factor viii deficiency
78
What are investigation results for haemohillia a?
High APTT | Low factor viii
79
What is haemophillia B?
Factor ix deficiency

PHASE 2A (14 decks)

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