Hematology

Question 1

What possible cause of microcytic anemia?

Answer 1

Iron deficiency
Thalessiema
Siderblastic anemia

Question 2

What possible causes of iron deficiency?

Answer 2

Blood loss ( Pregnancy, haematuria)
Coeliac disease
Autoimmune gastritis
H.pylori infection
Anemia of chronic disease( renal failure or bone marrow failure)
Reduced intake of food with irons

Question 3

What some investigations of iron deficiency?

Answer 3

FBC
ferritin
Serum iron (low)
Total Iron Binding Capacity (TIBC)/Serum transferrin (High)
Transferrin Saturation (low)

Question 4

Symptoms of Iron deficiency

Answer 4

Fatigue
Low exercise tolerance
SOB
Irritability
vertigo
Headache
Angina (severe chest pain)
Pica
Craving ice

Question 5

Thalassaemia definition

Answer 5

An inherited blood disorder, charaterised by abnormal he haemoglobin production. The patient have a defect in the either the alpha orsiderblastic beta globin causing production of abnormal red blood cells and this results in anemia.
Alpha (usually asymptomatic)
Beta (is symptomatic unless you just have the trait)

Question 6

Sideroblastic anaemia definition

Answer 6

This is where the bone marrow produces ringed sideroblasts (erythroblasts with iron loaded mitochondria)- so the body has enough iron but because of genetic or acquired defects is unable to incorporate iron to the red blood cells leading to anemia.
It can be acquired or congenital

Question 7

Name some cause of vitamin B12 Deficiency

Answer 7

Percious anemia
Metformin
PPI
H2antagnoist
Malabsorption- Crohns disease
Nutrient deficiency

Question 8

What are some symptoms of B12 deficiency ?

Answer 8

Tired
Paratheisia
fatigue
Exercise intolerance
Exertional dyspneoa
Irritability
Muscle weakness
Vertigo
Ataxia
Symmetrical neuropathy
Optical neuropathy
Loss of cutaneous sensation

Question 9

What type of anaemia is folate deficiency?

Answer 9

Macrocytic Megaloblastic anemia

Question 10

Management for B12 deficiency

Answer 10

Neuro involvement - Urgent referal to haem
Loading of B12
Hydrococobalmin 1mg IM STAT every other day

No Neuro involment -Hydroxocobalmin 1mg -(weeks)
not diet related -Hydroxocobalmin 1mg IM every 3 months
Diet related -Hydroxocobalmin 50-150mcg oral daily + diet in high B12 (eggs,meat)

Question 11

What are the causes of folate deficiency?

Answer 11

Pregnancy(increased requirement)
Alcohol
Anticonvulsant e.g pheyntoin
Mexothrate
Trimphetoin
IBD
Reduced dietary intake
Malignancy
Blood disorder e.g sickle cell anemia, haemolytic anaemias)

Question 12

What are investigations for folate deficiency ?

Answer 12

B12 serum
Serum folate

Question 13

Treatment folate deficiency

Answer 13

B12
Folic acid 5mg ( orally once a day)

Question 14

Name some causes for normacyctic anemia

Answer 14

Anemia of chronic disease e.g CKD,lupus,RA
Haemolytic anemia (can be found in sickle cell, Hodgkin lymphoma ,RA patients)

Question 15

Name some cause of macrocytic anemia

Answer 15

Excess alcohol
B12 defiencency
Reticulocytosis
* Cytotoxic medications
* Myelodysplastic syndrome
(MDS)

Question 16

what are clinical signs of iron deficiency

Answer 16

Conjunctival Pallor
Angular Stomatitis
Atrophic glossitis
(Red, shiny tongue)
(Dry mouth / Tongue pain)
Koilonychia
(Spoon nails)

Question 17

What is hemaolytic anaemia?

Answer 17

Hemolytic anemia is a type of anemia caused by the premature destruction of red blood cells (hemolysis). This destruction happens faster than the body can replace them, leading to a lower-than-normal red blood cell count and reduced oxygen delivery to tissues

Question 18

What some symptoms of hemolytic anemia?

Answer 18

Fatigue and weakness due to lack of oxygen.
Jaundice (yellowing of the skin and eyes) due to a buildup of bilirubin (a waste product of hemoglobin breakdown).
Pale skin.
Dark urine.
Enlarged spleen or liver.
Dizziness
shortness of breath

Question 19

Name some causes of hemolytic anemia?

Answer 19

Inherited
Sickle cell anemia
Thalassanemia
G6PD defiency
Acquired
Autoimmine
metallic valves
infection- mycoplasma

Question 20

what are some possible triggers of a sickle cell crisis?

Answer 20

Physical/Emotional stress/Extreme exercise
– Hypoxia
– Infection/Sepsis
– Dehydration
– Cold temperature/Hot temperature
– Acidosis

Question 21

Name some symptoms of a sickle cell crisis

Answer 21

. Severe pain (chest, abdomen, skeletal)
* Swollen hands/Feet (especially in children)
* Tachycardia .tachypnoea
* Lethargy
* Pneumonia like syndrome
* Fever
* Jaundice (always look in the eyes)
* Avascular Necrosis of Bone

Question 22

Name some preventive treatment for sickle cell anaemia

Answer 22

Hydroxycarbamide
Increases HbF production
* Reduces frequency of crisis, chest episodes, stroke/thrombotic event risk,
reduced transfusions
Crizanlizumab
– Biologic
* Binds to sickle cells
* Reduced VOC

Question 23

What is HBS blood transfusion?

Answer 23

used to both increase oxygen-carrying capacity and reduce the percentage of sickle hemoglobin (HbS). It helps prevent or reverse complications of vaso-occlusion and can be achieved through simple transfusion or exchange transfusion

Question 24

What is exchange blood transfusion?

Answer 24

This is more commonly used to reduce HbS percentage, as it allows for the removal of sickle cells and their replacement with normal red blood cells.

Question 25

What is DIC?

Answer 25

a widespread hypercoagulable state that can lead to micro- and macrovascular clotting and compromised blood flow, ultimately resulting in multiple organ dysfunction syndrome.Symptoms may include chest pain, shortness of breath, leg pain, problems speaking, or problems moving parts of the body. As clotting factors and platelets are used up, bleeding may occur

Question 26

What cold AIHA?

Answer 26

a rare type of autoimmune hemolytic anemia where the immune system attacks red blood cells, particularly at cooler temperatures. This occurs due to the presence of cold-reactive antibodies, most commonly IgM, that bind to red blood cells and cause their destruction

Question 27

What TTP?

Answer 27

It is a rare life threatening condition that causes blood clots in the blood vessels throughout your body and this can affect the blood flow in the vessels causing occlusion. This will impact blood flow to vital organs: brain, heart, lungs etc. It is caused by a deficiency in ADAMTS13 which is responsible for the breakdown of the VWF.

Question 28

What hot AIHA?

Answer 28

is a condition where the body's immune system mistakenly attacks and destroys red blood cells. This happens because the body produces antibodies (IgG) that bind to red blood cells at normal body temperatures (37°C or higher), marking them for destruction by the spleen and other immune cells. wAIHA is the most common type of autoimmune hemolytic anemia

Question 29

what are the symptoms of cold AIHA?

Answer 29

Symptoms of CAD are often triggered or worsened by cold exposure, including fatigue, weakness, shortness of breath, dizziness, pale or bluish skin, and Raynaud's phenomenon (bluish fingers and toes).

Question 30

What are the symptoms of hot AIHA?

Answer 30

fatigue, weakness pale skin jaundice shortness of breath

Question 31

Symptoms of DIC

Answer 31

chest pain, shortness of breath, leg pain, problems speaking, problems moving parts of the body Bleeding, from many sites in the body. Blood clots. Bruising. Drop in blood pressure. Confusion, memory loss or change of behavior Fever

Question 32

What are the causes of DIC?

Answer 32

Sepsis Trauma Malignancy

Question 33

What is G6PD defiency?

Answer 33

G6PD deficiency is when the body is missing or doesn't have enough of an enzyme called G6PD (glucose-6-phosphate dehydrogenase). This enzyme helps red blood cells work correctly. A lack of this enzyme can cause hemolytic anemia. This is when the red blood cells break down faster than they normally would. It is an inherited condition affects the X chromosome.