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Flashcards in Revision Deck (275):
1

Ach receptor blocked by autoantibodies resulting in weak , but not atrophied, muscles

Myaesthenia gravis

2

Pernicious anaemia is lack of absorption of what? Why?

B12 due to lack of intrinsic factor

3

what does ANCA stand for?

anti-neutrophil cytoplasmic antibodies

4

3 forms ANCA vasculitis

Microscopy polynagitis
Granulomatosis with polyangitis
Eosinophilic granulomatosis with polyangitis

5

All forms of ANCA vasculitis have what? Some have what?

All- polyangitis
Some- granulomatosis

6

ANA is positive in what type of raynauds?

Secondary

7

Skin fibrosis and tightening in fingers and face, finger ulcers, lung fibrosis=? What antibody?

Scleroderma
ANA

8

What is a positive predictive value?

Proportion of people with a positive test who have the target disorder (true positive/all positives)

9

Type II hypersensitivity reaction called what? Which antibodies? Example?

Cytotoxic
IgM and IgG
Rh incompatibility

10

Type III hypersensitivity reaction called what? Which antibodies? Example?

Immune complex
IgG/M (+ antigen = complex)
SLE
Serum sickness

11

Type IV hypersensitivity reaction called? Mediated by what? Example?

Delayed
T cells
Contact dermatitis

12

In a type I hypersensitivity reaction, Th2 cells secrete what, and what stimulates them to do so?

APCs stimulate them (using the allergen)
to secrete IL4 to B cells
and
IL-3,5,GM-CSF to eosinophils

13

In a type I hypersensitivity reaction, B cells, having been activated by IL-4, do what?

Produce IgE which degranulates mast cells to stimulate the initial and late responses.
Also releases IL3 and IL5 to stimulate eosinophils

14

In a type I hypersensitivity reaction, eosinophils, having been activated by IL3,5,GM-CSF, do what?

Degranulate and activate the late phase response.

15

T cell deficient patients present with what? How to treat?

Opportunistic infection
Stem cell transplant, somatic gene therapy

16

B cell deficient patients present with what? Treatment?

Recurrent pyogenic bacterial infection
Antibiotics then IV IgG

17

X linked agammaglobulinaemia is a type of?

B cell deficiency

18

Phagocyte deficient patients present with what?

Recurrent, prolonged infections that respond poorly to Abx.
Staphylococcal
Skin and mucous membranes
Supporative lymphadenopathy

19

C1,2,4 deficient patients present with what?

Immune complex symptoms e.g malar rash, vasculitis

20

C3 deficient patients present with what?

Increased susceptibility to bacterial infection- pneumonia, sepsis, meningitis

21

C5-8 deficient patients present with what?

Recurrent neisserial infection (meningococcal meningitis)

22

Immune stimulants other than immunisation?

alpha, beta, gamma interferons
IL-2
G/GM-CSF

23

3 classes of immune suppressant

Corticosteroids
Lymphocyte targeting
DMARDs

24

4 lymphocyte targeting therapies

Antimetabolites
Calcineurin inhibitors
M-TOR inhibitors
IL-2 receptor MABs

25

What are the classical HLA antigens? What region codes for them?

A, B, C
Class I region

26

Class II region encodes which HLAs?

HLA-DR, DQ, DP

27

Class III region encodes which MHCs?

HSP70, TNF, C4a, C4b, C2, BF, CYP21

28

Where are all of the classical HLAs found?

All nucleated cells

29

What sort of expression do MHC genes have?

Codominant

30

3 types of recognition of the foreign body in transplantation?

Direct (T cells bind directly to graft)
Indirect (graft peptides)
Semi-direct (in lymph nodes)

31

What is cRF/sensitisation percentage?

percentage of deceased donors that will not be a suitable match

32

What is the minimum inhibitory concentration of an antibacterial agent?

Minimum concentration at which visible growth is inhibited

33

Aminoglycosides bind to what to inhibit protein synthesis?

30S

34

Macrolides etc. bind to what to inhibit protein synthesis?

50S

35

Tetracyclines bind to what to inhibit protein synthesis?

30S

36

Oxazolidinones bind to what to inhibit protein synthesis?

50S

37

Cephalosporins treat what?

Gram negative bacilli

38

Action of aciclovir? Used to treat?

Nucleoside analogue
HSV, VZV

39

Rx CMV?

Ganciclovir

40

Rx influenza?

Oseltamivir and zanamavir

41

Rx Hep C and RSV

Ribavirin

42

Rx Hep C and B

Interferons

43

Ciprofloxacin is what type of antibiotic?

Quinolone

44

Co-amoxiclav is what type of antibiotic?

penicillin

45

Which antifungal is nephrotoxic?

Amphotericin B

46

Which antifungals are hepatotoxic?

Allylamines and azoles- ergosterol synthesis inhibitors

47

Ascariasis type of pathogen

Nematode (helminth)

48

Ascariasis where in body?

Digestive system, migrates to lung (Loeffler's syndrome)

49

Rx ascariasis?

Albendazole-benzimidazole

50

Schistosomiasis action in body?

Matures in GI blood vessels, exists in faeces after sexual reproduction

51

Definitive and intermediate hosts in schisto?

Def- human
Int- snails

52

Definitive and intermediate hosts in hyatid?

Def- dogs
Int- sheep

53

Type of pathogen in hyatid

Platyhelminth- tape worm

54

4 plasmodiums in malaria and which is most common

Ovale
Malariae
Vivax
Falciparium

55

Cryptosporidium spread

Faeco-oral human to human

56

Measles type of virus

Paramyxovirus

57

What involves cough, conjunctivitis, coryza?

Measles

58

What do you get prior to measles rash?

Koplik spots

59

Slapped cheek syndrome caused by which virus?

Parvovirus B19

60

'everything else' infant viral rash? Dx of exclusion

Enteroviral

61

Croup is caused by what?

Parainfluenza

62

Respiratory virus with conjunctivitis and diarrhoea is likely to be what?

Adenovirus

63

The frequency of reactions decreases with number of doses in live or inactivated vaccines?

Live

64

Difference between sterilisation and disinfection?

Sterilisation is killing all micro-organisms, disinfection is just killing sufficient numbers to make an item safe to use.

65

Disinfection applied to the skin is what?

Antisepsis

66

Decontamination method of surgical equipment

Moist heat

67

Decontamination method of syringe needle

gamma irradiation and disposal after use

68

Decontamination method of surgeons hands

surgial scrub

69

Decontamination method of flexible endoscope

Chemical

70

Decontamination method of catheter insertion site

Chemical

71

Pa O2 of respiratory failure

more than 8.0kpa

72

Type 1 resp failure pa O2 and what is driving it?

less than 6.3kpa, hypoxic

73

Type 2 resp failure pa O2 and what is driving it?

more than 6.3kpa, hypercapnic drived

74

4 types non-small cell lung carcinoma

Squamous
Adenocarcinoma
Undifferentiated large cell
Large cell neuroendocrine

75

What type of cancer can mimic pneumonia?

Bronchioloalveolar

76

CD56 detects what?

Neuroendocrine lung tumours

77

4 features typical carcinoid tumours? (lung cancer)

No necrosis, bland
Distant mets are rare
NOT assoc with smoking
May occlude bronchioles

78

TTF is expressed by which 3 lung cancers?

Adenocarcinoma
Undifferentiated large cell
Small cell

79

What colour asbestos is the worst?

Blue

80

Small plaques on parietal pleura + effusion =?

Mesothelioma

81

Which type of pneumonia in elderly and diabetic and alcoholic?

Klebsiella

82

3 distributions of emphysema

Centrilobar (smoking)
Panlobar (alpha-1-anti trypsin)
Paraseptal

83

Acute interstitial lung disease is?

Adult resp distress synd

84

What cellular change is seen in acute interstitial lung disease?

Type II pneumocyte hyperplasia

85

Appearance of chronic interstitial lung disease?

Honeycomb lung

86

What 2 serum substrates are increased in sarcoidosis?

Calcium and ACE

87

Dx criteria for chronic bronchitis?

Productive cough on most days during at least 3 months of 2 successive years (with no alternative cause)

88

90% lobar pneumoniae is due to which pathogen?

Strep. pneumoniae

89

2 pathogens that cause hospital acquired pneumonia?

Enterobateraceae
Pseudomonas ssp

90

2 pathogens that are spread from person to person causing community acquired pneumonia

S pneumoniae
H influenzae

91

Pathogen from the environment that might cause community acquired pneumonia

L pneumophilia

92

Animal derived cause of community acquired pneumonia

C psittaci

93

4 atypical pneumonias

Mycoplasma pneumonia
Legionella pneumophilia
Chlamydophila pneumonia
Chlamydophila psittaci

94

Rare complications of Mycoplasma pneumonia?

Neuropathies, guilliane barre

95

Incidence of Chlamydophila pneumonia is highest in what group?

Elderly

96

What score is used to quantify the severity of pneumonia?

CURB65

97

Paul Bunnell Test is for what?

EBV

98

Rx malignant otitis externa

ceftazidime then ciprofloxacin

99

3 features mycobacteria

waxy cell wall (high in lipids)
slow growing
acid fast
intracellular
combination therapy required
latent phase

100

2 mycobacteria that cause TB
BCG is against which?

m. tuberculosis and m.bovis
Bovis is BCG

101

how does primary TB present?

influenza like

102

What is another name for disseminated TB?

Miliary

103

After the TB pathogen has multiplied, what are the 2 things that can happen?

Latency or dissemination

104

Rx TB?

Rifampicin, isoniazide (4 months), pyrazinamide, ethambutol or streptomycin (2 months)
If pericarditis or meningitis then add steroids
Sites other than meninges- 6 months

105

Tuberculoid leprosy is what cell type response? What symptoms?

Th1
Skin plaques and nerve involvement

106

Lepromatous leprosy is what cell type response? Symptoms?

Th2
Subcut tissue accumulation
Leonine facies
Earlobes and face

107

Rx m. leprae?

Dapsone, rifampicin, clofazimine

108

2 types oesophageal carcinoma?

Squamous cell
Adenocarcinoma

109

Barrett's oesophagus leads to which cancer?

Adenocarcinoma of the oesophagus

110

4 types gastric carcinoma, which is most common?

ADENOCARCINOMA
Endocrine
MALT
Stromal

111

CDH1/E-cadherin mutation = ?

Hereditary diffuse type gastric cancer

112

Pathogenesis of coeliac disease?

Gliadin in gluten induces epithelial cells to express IL-15
Causes actiation of CD8+ and IELs
These are cytotoxic

113

2 cancer types assoc with coeliac?

Enteropathy- associated T cell lymphoma
Small intestinal adenocarcinoma

114

3 investigative tests for coeliac?

IgA antibodies to TTG
IgA or G antibodies to deamidated gluten
Biopsy- diagnostic

115

Where in the bowel are diverticula, commonly?

Sigmoid colon

116

Where on the circumference of the bowel are diverticula often positioned?

Between the mesenteric and antimesenteric taenia coli

117

Pathogenesis of diverticula?

Increased intra luminal pressure + points of relative weakness in the bowel wall

118

short bowel syndrome is a complication of what?

IBD

119

Apthoid and fissuring ulcers are in crohns or UC?

Crohns

120

Strictures are common in crohn's or UC?

Crohns

121

No spontaneous fistulae are present in crohns or UC?

UC

122

Crypt abscesses are common and crypt distortion is severe in crohn's or UC?

UC

123

Granulomas present in crohns or UC?

Crohns

124

7 extra-intestinal manifestations of IBD?

Hepatic
Skeletal
Mucocutaneous
Renal
Heamatological
Systemic

125

Which hyperplastic polyps may give rise to microsatellite unstable carcinoma?

Large, right sided

126

What benign polyp is a CRC precursor?

Adenoma

127

2 genetic traits that increase susceptibility to colorectal cancer

FAP
HNPCC

128

FAP is due to a mutation in what?

APC tumour supressor gene

129

HNPCC also increases risk of which cancers?

Endometrial, ovarian, gastric, small bowel, urinary tract, biliary tract

130

HNPCC what mutation?

DNA mismatch repair genes

131

Pathogens that cause intra abdominal infection

Pseudomonas ssp
Clostridium spp
Bacteriodes ssp
Enterococcus ssp
Enterobacteraceae
Prevotella ssp

132

Rx of intra abdominal infection of intestinal source

Cefuroxime and metronidazole if under 65
Piperacillin/tazobactam if over 65
Then depends on culture results

133

Pain in shoulder
Hiccoughs
Apparent hepatomegaly
Pleural effusion/lung collapse

Subphrenic abscess

134

Pathogens that cause gastroenteritis?

Bacterial:
Bacillus cereus
Vibrio cholerae
Salmonella
C diff
Staph aureus
E coli
Shigella
Campylobacter

Viral:
Norovirus and Rotavirus

Parasitic:
Entamoeba histolytica
Cryptosporidium
Giardia lamblia

Non-infective

135

How might you catch cryptosporidium gastroenteritis?

Waterborne- e.g. swimming pool or salad washed in infected water

136

Of the bacterial causes of gastroenteritis, which produce enterotoxins and which act by adherence?

Enterotoxins:
Bacillus cereus
Vibrio cholerae
C. diff and C. perfringens
Staph aureus
E. coli

Adherence:
Shigella sonnei/flexneri
E. Coli
Campylobacter jejuni
Salmonella

137

EHEC/VTEC form of E.coli =?

Enterohaemorrhagic
Colitis/HUS

138

ETEC form of E.coli =?

Enterotoxigenic
Traveller's diarrhoea

139

EAggEC

Enteroaggregative
Traveller's diarrhoea

140

EIEC form of E.coli =?

Enteroinvasive dystentry like

141

EPEC form of E.coli =?

Enteropathogenic
Childhood

142

E Coli 0157 releases what virulence factor?

Shiga toxin

143

Shiga toxin mechanism?

Like cholera

144

Salmonella mechanism?

It is the bacteria itself not the toxin.

145

Typhoidal strains of salmonella do what?

Affect cells outside of GI tract and spread

146

Rx gastroenteritis?

Supportive
Avoid abx unless very young/old, campylobacter infection or it has invaded (positive blood cultures)
Abd may make e coli hus worse or increase the duration of salmonella carriage

147

Type of colitis in abx associated diarrhoea?

Pseudomembranous

148

rx c diff

metronidazole or vancomycin
faecal transplant

149

8 causes aseptic meningitis

Viruses
Partially treated bacterial
Listeria
TB
syphilis
Malignancy
autoimmune
drugs

150

2 main causes of viral meningitis?

Enteroviruses
Herpes virus (HSV2, VZV)

151

2 extra signs of viral meningitis seen in neonates/infants?

Nuchal rigidity
Bluging anterior fontanelle

152

What is Kernig's sign?

Tight hamstrings

153

Brudzinski's sign?

Flexing neck causes hips and knees to flex

154

What investigation must you do ASAP in viral meningitis (and what would contraindicate it?) What is the gold standard test?

Lumbar puncture unless raised ICP (do a CT to check)
Gold standard is viral PCR

155

difference in CSF between bacterial and viral meningitis?

White cell count- B very high, V high
Predominant WBC- B neutrophils, V lymphocytes
Protein- B high or very high, V normal or high
Glucose- B low, V normal

156

Rx viral meningitis

If risk of bacterial then abx
Otherwise supportive

157

What is Mollaret's meningitis?

Recurrent aseptic, normally HSV2

158

Viral meningitis + fever, lymphadenopathy, pharyngitis, rash =?

HIV meningitis

159

Viral encephalitis causes that are different to meningitis?

HSV1, rubella, rabies, acute disseminated encephalomyopathy

160

Rx viral encephalitis

High dose aciclovir

161

What is ADEM?

Immune mediated CNS demyelination

162

Difference between onset of encephalitis and brain abscess?

Encephalitis is acute

163

3 causes of bacterial meninigitis?

Neisseria meningitidis
Haemophilus influenza
Strep pneumoniae

164

Rx of bacterial meningitis?

Ceftraixone and cefotaxime
Rifampicin to contacts
+steroids for s. pneumoniae

165

3 causes neonatal meningitis

Group B strep
E coli
Listeria monocytogenes

166

Rx neonatal meningitis

Cefotaxime
Ampicillin and gentamicin

167

Marfan syndrome is associated with what valvular heart disease?

Aortic regurg

168

Cyanosis in R to L or L to R shunts?

R to L

169

Downs syndrome is associated with which heart defect?

AVSD

170

Which 3 heart conditions require a shunt to survive?

Transposition great arteries
Tricuspid atresia
Total anomalous pulmonary venous connection

171

Coarctation of the aorta is associated with what genetic defect?

Turner's syndrome

172

Murmur in aortic regurg

Diastolic

173

Murmur in mitral stenosis

Opening snap and diastolic

174

Murmur in aortic stenosis

Ejection systolic

175

Murmur in mitral regurg

Pansystolic

176

3 types endocarditis

Infective
Non bacterial thrombotic
Endocarditis of SLE (Libman-Sacks Disease)

177

What pathogen found to be causing infective endocarditis should prompt investigation for bowel cancer?

Strep bovis

178

Signs of infective endocarditis

FROM JANE
fever, roth spots, osler's nodes, murmur, janeway lesions, anaemia, nail haemorrhage, emboli

179

In whom does non-bacterial thrombotic endocarditis occur?

Debiliated patients in hypercoagulable state

180

Which valves affected in Libman-Sacks endocarditis?

Mitral and tricuspid (atrioventricular valves)

181

Aschoff bodies are found in what?

Rheumatic fever

182

3 pathogens that cause infective endocarditis

Strep viridans
Staph aureus
Strep bovis

183

5 types acute pericarditis and their causes

1. purulent (infection)
2. serous (adjacent inflammation)
3. Caseous (TB or fungal)
4. Fibrinous/serofibrinous (Dressler's syndrome post MI)
5. Haemorrhagic (trauma, neoplasm, surgery, infection)

184

3 types chronic pericarditis

-Adhesive
-Adhesive mediastino pericarditis (follows pericarditis caused by infection, surgery, radiation)
-Constrictive

185

4 classes of cardiomyopathies

-Dilated
-Restrictive
-Hypertrophic
-Arrythmogenic right ventricular

186

4 causes of dilated cardiomyopathy

Genetic, myocarditis, alcohol/toxin, autoimmune

187

Cause hypertrophic cardiomyopathy

Genetic

188

Sign of hypertrophic cardiomyopathy on examination?

Systolic ejection murmur

189

Restrictive cardiomyopathies are either idiopathic or secondary to which 5 things?

Amyloidosis
Fibrosis
Inborn errors of metabolism
Sarcoidosis
Tumours

190

Myocarditis is caused by which two infections?

Coxsackie virus A+B
Chagas disease

191

Giant cell arteritis is a type of? It involves what sort of inflammation?

Vasculitis. Granulomatous.

192

What type of cells are seen in giant cell arteritis?

Multi-nucleated giant cells

193

Rx giant cell arteritis?

Corticosteroid, anti TNF

194

6 types aneurysm

Atherosclerotic
Dissecting
False
Berry
Micro and syphilitic
Mycotic

195

Which type of aneurysm is associated with subacute bacterial endocarditis?

Mycotic

196

3 signs nephrotic syndrome

Oedema
Proteinurea
Hypoalbuminaemia

197

5 signs acute nephritis

Oedema
Haematuria
Proteinuria
HTN
AKI

198

What is nephrotic syndrome?

Glomerular damage

199

5 causes nephrotic syndrome

Membranous nephropathy
Diabetes
FSGS
minimal change disease
SLE

200

6 causes acute nephritis?

IgA nephropathy
Post infective
HUS
Vasculitis
Henoch schonlein purpura
SLE

201

Myeloma can have what effect on the kidneys?

Immunoglobulins in the tubules

202

Major cause of CKI and 3 other causes

DIABETES
Malformation
Reflux nephropathy
Glomerulonephritis

203

Haematuria + ear and eye problems = ?

Alport type hereditary nephrophathy

204

4 caues proteinuria

SLE
FSGS
Diabetes
Henoch schonlein purpura

205

4 possible composition of renal stones?

Calcium
Struvite (Mg NH4+ P)
Urate
Cystine

206

Cause of struvite stones

Urease producing bacterial infection (urease converts urea to ammonia)

207

Staghorn caliculi are a sign of which type of stone?

Struvite

208

What is the gold standard investigation for renal stones?

Non-contrast CT

209

Majority of renal cancers are what tyoe?

Clear cell

210

Renal cancer is associated with which genetic disease?

Von Hippel-Lindau syndrome

211

Foamy cell renal tumours are likely to be

Papillary tumours

212

True or false renal cell carcinoma responds well to chemo?

False

213

Urothelial cell carcinoma is found in the?

Bladder

214

Prostate carcinomas normally arise from which zone of the prostate?

Peripheral

215

Seminoma or teratoma is after puberty?

Teratoma

216

What serum substrates are increased in seminoma?

PLAP and hCG

217

True or false teratomas do not secrete tumour markers

True

218

Pain and swelling in the epididymis following a vasectomy

Sperm granuloma

219

Inflammatory and myofibroblastic mass in the testis of unknown aetiology

Myofibroplastic pseudotumour of testis

220

Swollen, tender testis with flu-like illness and a granulomatous mass

Idiopathic granulomatous orchitis

221

Painless scrotal swelling
Caseating, granulomatous inflammation, fibrosis

Tuberculous orchitis

222

Infarcted seminiferous tubules

Epididymoorchitis

223

Yellow/brown nodules and histiocytes in testis

Malakoplakia

224

Rx pyelonephritis

Cefuroxime, ciprofloxacin (or pip and tazo if over 65)

225

3 common pathogens that cause UTIs

E coli
Staph saprophyticus (GP)
Enterococcus ssp (hospital)

226

Rx cystitis

Nitrofurantoin
Pivmecillinam
Trimethoprim
Fosfomycin

227

What is urethral syndrome?

Symptoms UTI w/o infection

228

When would you treat asymptomatic bacteriuria

Pregnancy
Infant
Prior to urological procedures

229

Thalassaemia leads to what type of anaemia?

Microcytic hypochromic

230

Megaloblastic macrocytic anaemia can be caused by what?

B12 or folate deficiency

231

Pathogenesis of acute haemolytic reaction (ABO incompatibility)

Release of free Hb

232

Fatigue, jaundice and fever 3-14 days post blood transfusion =? Due to what?

Delayed haemolytic reaction
Due to RBC antigens other than ABO

233

What does coomb's test detect?

IgG antibodies

234

True or false febrile non haemolytic transfusion reaction is life threatening?

False

235

Prothrombin time measures which pathway?

Extrinsic

236

Time from thrombin to fibrin is measured by what test?

Thrombin clotting time

237

4 in vivo anticoagulants

protein c
protein s
anti-thrombin III
fibrinolytic system

238

What does the fibrinolytic system involve?

Plasmin an ezyme that causes fibrin breakdown
Plasminogen cleaved by plasminogen tissue activator to plasmin
Alpha 2 anti plasmin mops up excess plasmin in plasma

239

Coagulation problems that are platelet/vessel wall defects give rise to what sort of symptoms?

Mucosal and skin bleeding e.g. heavy periods, nose bleeds

240

Coagulation problems that are coagulation defects give rise to what sort of symptoms?

Deep muscular and joint beds

241

VW disease affects what part of clotting?

Aggregation

242

True or false haemophilias VIII and IX have different presentations to each other

False

243

Which clotting test is abnormal in VWD and haemophilia?

APTT

244

What is a treatment of VWD that stimulates VWF release?

DDAVP a vasopressin/ADH analogue

245

Patients with liver disease invariably have what blood problem?

Impaired haemostasis

246

4 features of impaired haemostasis in liver disease?

Low and dysfunctional platelets
Reduced synthesis of all coagulation factors except VIII
Fibrin polymerisation is delayed
Excessive plasmin activity

247

Massive transfusion can have what 2 problems?

DIC
Dilutional depletion of platelets and coagulation factors

248

What chromosomes are the different Hbs found on?

Alpha- 16
Gamma, delta and beta- 11

249

4 acute complications of sickle cell disease

Vaso-occulsive crisis
Septicaemia
Aplastic crisis
Sequestration crisis

250

Chronic complications of sickle cell disease

Hyposplenism
Renal disease
Avascular necrosis
Leg ulcers, osteomyelitis, gall stones, retinopathy, cardiac, respiratory

251

True or false sickle cell is an inflammatory condition in some ways

true

252

Alpha thalassaemia results in which 2 types of Hb?

Hb Barts and HbH

253

True or false alpha thalassaemia trait is clinically significant

False

254

Thalassaemia beta major has what 6 features?

Severe aneamia
Skeletal abnormalities and stunted growth
Increased BM activity so increased iron absorption
Splenomegaly (RBC pooling)
Abnormal dentition
Frontal bossing

255

Rx thalassaemia beta major?

Transfusion to maintain Hb and suppress rbc production
And chelation with desferrioxamine to get rid of excess iron.

256

What do most thalassaemia maj beta patients die of?

Heart disease

257

Blood differences in pregnancy?

MCV +
Prothrombotic
Fe and folic acid used
Neutrophilia
Haemodilution
Reduced platelets

258

3 main areas of chronic myeloproliferative disorders

Polycythaemia vera
Essential thrombocytosis
Idiopathic myelofibrosis

259

Symptoms polycythaemia vera

Redness, itching, gout, splenomegaly

260

Some causes of secondary polycythaemia?

Chronic lung disease
R-L shunts
Smoking
altitude
renal disease
EPO producing tumours
drugs
congenital

261

Rx polycythaemia

Aspirin
Venesection

262

What mutations are associated with thrombocytosis and myelofibrosis?

JAK2 and CALR

263

Thrombocytosis is increase in what?

Megakaryocytes and platelets

264

What are the two types of thrombocytosis?

Primary essential
Reactive

265

What is myelofibrosis?

BM fibrosis

266

What are the symptoms of myelofibrosis?

Pancytopenia
Fever, weight loss, night sweats
Splenomegaly

267

Chronic myeloid leukaemia symptoms

Leucocytosis ++
Leukoerythroblastic blood picture
Anaemia
Splenomegaly
Venous occulsion
Gout

268

What chromosome is associated with CML?

Philadelphia (9 and 22 swap= cell proliferation = active tyrosine kinase. Inhibited by imatinib)

269

Name the two light chains of Igs

Kappa and lambda

270

What 2 states precede myeloma?

MGUS, asymptomatic myeloma

271

What are the diagnosis criteria for myeloma?

more than 10% BM plasma cells neoplastic
OR
Lump of plasma cells found

AND

One of more of either CRAB or MDEs
hyperCalcaemia, Renal insufficiency, Anaemia, Bone lesoins

272

What can myeloma go on to become?

Plasma cell leukaemia

273

AKI and myeloma is what?

A medical emergency! Give steroids

274

Non hodgkins lymphoma is what?

Too many follicles in lymph nodes, lump on neck

275

Hodgkins lymphoma has what cells? Linked to what virus?

Hodgkin Reed-Sternberg cells with infiltrate of non-malignant inflammatory cells.
EBV