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shit to know 1 Flashcards

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1
Q

normal MCV

A

76-96

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2
Q

3 things that cause microcytic anaemia

A

iron deficiency
thalassaemia
siderblastic anaemia

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3
Q

causes of macrocytic anaemia

A 
B12 and folate 
alcohol excess/liver disease 
reticulocytosis (haemolytic event)
myelodysplasic syndome 
drugs: cytotoxic and antifolates
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4
Q

example of an anti folate drug that cause macrocytic

A

phenytoin (anti epileptic)

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5
Q

what blood results will suggest siderblastic anaemia

A

microcytic anaemia but high levels of ferritin = has iron but cannot use it

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6
Q

what will be seen on film of siderblastic anaemia

A

ring siderblasts: in marrow, perinuclear ring of iron granules

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7
Q

treatment for diet related iron deficient anaemia

A

ferrous sulphate

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8
Q

ferrous sulphate side effects

A 
nausea 
vomiting 
constipation
diarrhoea
black stool
abdominal discomfort
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9
Q

how long do you give iron replacement therapy

A

return to normal Hb levels then for 3 more months to build up stores

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10
Q

when will you give IV iron

A

if can’t absorb oral iron, renal failure

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11
Q

suspect what if anaemia not responding to iron replacement

A

siderblastic anaemia (can’t be used)

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12
Q

rouleax formation suspect

A

myeloma

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13
Q

cabot ring suspect

A

pernicious anaemia and lead poisoning

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14
Q

burr cells appearance

A

star like (smaller projections that acanthocytes)

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15
Q

when will you see acanthocytes

A

normally removed in spleen: post-splenectomy, hyposplenomy,

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16
Q

RBC with a small dark spot

A

howell-jolly bodies

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17
Q

howell-jolly bodies suggest

A

post-splenectomy

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18
Q

schistocytes suggest

A

intravascular haemolysis

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19
Q

red granules

A

eosinophil

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20
Q

dark granules

A

basophils

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21
Q

Chronic lymphocytic leukaemia (CLL) is what cells

A

monoclonal proliferation of well-differentiated lymphocytes which are almost always B-cells

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22
Q

CLL is usually what type of lymphocyte

A

B cells

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23
Q

smudge/smeer cells suggest what pathology

A

Chronic lymphocytic leukaemia

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24
Q

what malignancy do you get warm autoimmune haemolytic anaemia

A

chronic lymphocytic leukaemia

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25
who get chronic lymphocytic leukaemia
adults
26
unfractionated heparin inhibits (5)
thrombin and factors 9, 10, 11, 12
27
heparin activates what
antithrombin III
28
LMWH mode of action
Activates antithrombin III. Forms a complex that inhibits factor Xa
29
LMWH is not usually monitored, but if you did need to measure it what test
anti factor Xa
30
test to measure non fractionated hearing
PPT
31
side effects of heparins
heparin induced thrombocytopenia and osteoporosis (less so in LMWH) and hyperkalaemia
32
heparin overdose treatment
protamine sulphate, although this only partially reverses the effect of LMWH.
33
drug treatment for DVT
warfarin + minimum of 5 days of heparin till warfarin kicks in and causes an INR of 2
34
how long should warfarin be given following a DVT
provoked: 3 months unprovoked: 6 months
35
causes of unprovoked DVT
malignancy and thrombophilia
36
scoring system for suspected DVT
two-level DVT Wells score
37
two-level DVT Wells score: wha score will suggest a DVT
2+
38
investigations for suspected DVT
a proximal leg vein ultrasound scan should be carried out within 4 hours and, if the result is negative, a D-dimer test
39
what do you do if you can't get a proximal leg vein ultrasound wishing 4 hours
D-dimer test should be performed and low-molecular weight heparin administered whilst waiting for the proximal leg vein ultrasound scan (which should be performed within 24 hours)
40
anti-phospholipid syndrome will increase what test
aPTT
41
investigation for suspected antiphospholipid syndrome
anti-Cardiolipin antibody
42
a low level of VIII will suggest what and why
Von Willebrand's disease, because it stabilises/carries factor VIII
43
which conditions will have a long PTT
Von Willebrand's disease | haemophilia A
44
management of Von Willebrand's disease
- tranexamic acid for mild bleeding - desmopressin (DDAVP): raises levels of vWF by inducing release of vWF from Weibel-Palade bodies in endothelial cells - factor VIII concentrate
45
JAK2 mutation
Polycythaemia rubra vera
46
what is Polycythaemia rubra vera
myeloproliferative disorder caused by clonal proliferation of a marrow stem cell leading to an increase in red cell volume (+excess neurtrophil and platelets)
47
pruritus after bath
Polycythaemia rubra vera
48
Polycythaemia rubra vera investigations
JAK2 mutation | haematocrit
49
rubbery enlarged lymph nodes
lymphoma
50
which cancer do kids get
acute lymphoblastic leukaemia
51
what is thrombophilia
increased tendency to form clots
52
bence jones proteins in urine
multiple myeloma
53
diagnosis of spherocytosis
osmotic fragility test
54
who get s fucked up by parvo virus
those with hereditary spherocytosis
55
treatment for spherocytosis
folate replacement | splenectomy
56
heinz bodies
G6DP deficiency
57
site of heamolysis for spherocytosis
extravascular
58
site of heamolysis for G6DP deficiency
intravascular
59
genetics of G6DP deficiency
X-linked (men)
60
Hodgkin's lymphoma - most common type
nodular sclerosing
61
Reed-Sternberg cell
hodgkin's lymphoma
62
The causes of massive splenomegaly
myelofibrosis | chronic myeloid leukaemia
63
Philadelphia chromosome
Chronic myeloid leukaemia
64
t(9:22)
chronic myeloid leukemia
65
treatment for chronic myeloid leukaemia
imitinib
66
Factor V Leiden is
a mutation that makes factor V resistant to factor C that controls/inhibits clotting - these people are thrombophilic
67
increased gall stone incidence
spherocytosis - gallstones secondary to chronic heamolysis

Haematology (7 decks)

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