Flashcards in Interactive cases - haem and endo Deck (37)
what are the different Hb abnormalities?
- polycythaemia (primary or secondary)
what are the WCC abnormalities?
what are the platelet abnormalities?
what are the causes of a microcytic anaemia?
- iron def (diet or blood loss)
- beta thalassaemia
what are the causes of a normocytic anaemia?
- inflammation (ACD, ferritin is an acute phase protein so is raised in inflammation)
what are the causes of macrocytic anaemia?
- alcohol (hx, raised GGT)
- myelodysplasia (pancytopenia, bone marrow problems)
- hypothyroidism (low T4, high TSH)
- liver disease (hx, exam)
- folate/B12 def
how do you remember these?
what are the features of polycythaemia?
- choreiform movements
- pruritis after hot bath
- thrombosis (stroke, DVT)
- blurred vision
what are the complications of sickle cell anaemia?
- Acute painful crises
- stroke (tx: exchange blood transfusion)
- sequestration crisis (tx: splenectomy)
- gall stones, chronic cholecystitis (tx: cholecystectomy)
how do you treat acute painful crises?
- analgesia, oxygen, IV fluids, ABs
- hypoxia leads to sickling
- dehydration can lead to sickling
what is sequestration?
- can occur in LUNGS or in SPLEEN
- pooling of RBCs into one of these organs
- causes SOB, cough and a fever in LUNGS
- causes exacerbation of any anaemia (SPLEEN)
what are the causes of mutliple myeloma?
- Calcium (hypercalacemia)
- Renal failure
- Bone problems (fratcure, bone pain, osteoporosis)
- Cord compression (spastic paraparesis)
what symptoms does hypercalcaemia cause?
- makes you resistant to ADH
- causes a nephrogenic DI
- also causes constipation (psychic moans, abdo groans and bones)
how do you differentiate between multiple myeloma and malignancy in liver enzymes?
MM does not raise ALP as plasma cells produced in MM suppress osteoblasts and so reduce ALP production
what are reticulocytes?
what can be the causes of anaemia with INC reticulocytes?
what can be the causes of anaemia with DEC reticulocytes?
infecting bone marrow
- Parvovirus B19 infection
- aplastic crisis in pt with SCD
- blood transfusion
what is diabetes defined as?
- fasting glucose >7
- random glucose > 11.1
what are the 4 types of cancer?
- follicullar (consequence of mets)
- medullary (HHx)
- anaplastic (worst prognosis)
what atypical organisms cause pneumonia?
- mycoplasma pneumoniae
- chlamydia pneumoniae
- legionella pneumophila
what are the investigations you should do if you suspect microcytic anaemia?
- coeliac screen (TTG Ab)
- remember red flags
- diagnosis confirmed on duodenal biopsy (villous atrophy)
what are the causes of bloody diarrhoea?
- infection: infective colitis
- inflammation: UC/ Chron's
- Ischaemia: ischaemic colitis
what are the signs of portal HT?
- spontaneous bacterial peritonitis
- variceal bleed
what are the causes of microangiopathic HA?
- haemolytic uraemic syndrome
- thrombotic thrombocytopenic purpura
what would your blood results show in DIC?
- dec platelets and fibrinogen
- inc PT/APTT
- inc D-dimer, fibrin degradation products
what would the blood results show in HUS?
- haemolysis (dec Hb, inc bilirubin)
- dec platelets
what are the symptoms of TTP?
- neurological manifestations
what are the hereditary causes of HA?
- red cell membrane (hereditary spherocytosis)
- enzyme def (G6PD def)
- haemoglobinopathy (SCD, thalassaemia)
what are the acquired causes of HA?