TG-1 Flashcards
(103 cards)
1
Q
RBCs life span
A
120 day
2
Q
where is B12 absorbed
A
terminal ileum
3
Q
what can cause B12 deficiency
A
pernicious anaemia
4
Q
where is folate absorbed
A
duodenum/jejunum
5
Q
pernicious anaemia treatment
A
B12 injections
6
Q
bence jones proteins
A
multiple myeloma
7
Q
what are bence jones proteins
A
monoclonal proteins (IgG or IgA)
8
Q
treatment for hereditary sperocytosis
A
folate replacement and splenectomy
9
Q
diagnosis of hereditary sperocytosis
A
osmotic fragility test
10
Q
diagnosis: heinz bodies
A
G6PD deficiency
11
Q
pathogen thats not good in hereditary sperocytotis
A
parvovirus
12
Q
who gets G6PD deficiency
A
men - x linked recessive
13
Q
how do you diagnose G6PD deficiency
A
measure enzyme activity of G6DP
14
Q
DVT treatment
A
LMWH till INR >2 for a minimum of 24 hrs (usually takes 5 days to get here) also start warfarin 24 hrs of admission. 3 months if provoked and 6 months if unprovoked
15
Q
reed-sternberg cells
A
hodgkins lymphoma
16
Q
most common type of hodgkins lymphoma
A
nodular sclerosing
17
Q
which type of leukaemia causes a large spleen
A
chronic myeloid leukaemia
18
Q
philadelphia chromosome
A
CLL
19
Q
CLL treatment
A
imatinib
20
Q
what blood changes can steroids cause
A
neutrophilia
21
Q
which immune cell is most commonly seen in CLL
A
mono clonal B cells
22
Q
investigations for CLL
A
blood film (fragile broken up lymphocytes) immunophenoptyping
23
Q
Blood film: smudge cells
A
CLL
24
Q
pathophysiology of acute leukemias
A
blast cells (myeloid or lymphocytic) lose ability to differentiate = loss of other cells + accumulation of blast cells
25
in acute leukemias how do you tell if it is myeloid or lymphocytic
```
lymphoblasts = TdT stain (DNA polymerase)
myeloblasts = aur rod
```
26
in which blood disease do you get gallstones
hereditary sperocytosis (if someone with this condition presents with epigastric pain)
27
INR in first DVT
2.5
28
INR in recurrent DVT
3.5
29
INR in AF
2.5
30
INR and prosthetic valves
target INR depends on the valve type and location. Mitral valves generally require a higher INR than aortic valves
31
drugs that are P450 enzyme inhibitors
amiodarone, cipro, erythro, sulphonamides
32
drugs that are P450 enzyme inducers
phenytoin, carbamazepine, rifampin, st johns wart
33
JAK2 mutation
polycythaemia vera
34
how does rivaroxiban work
direct factor Xa inhibitor
35
haemophilia A what is deficient
factor VIII
36
haemophilia B what is deficient
factor IX
37
haemophilia: what will blood test show
prolonged APTT
| bleeding time, thrombin time, prothrombin time normal
38
tear drop ploikilocytes
myelofibrosis
39
'B' symptoms
weight loss
fever
night sweats
40
genetics: burkitts lymphoma
c-myc gene translocation (8;14)
41
Activated protein C resistance is also known as
factor V leiden
42
RBC break down produces what
LDH
amino acids
iron
unconjugated bili
43
c-myc gene translocation
burkitts lymphoma
44
MCV, ferritin and transferrin in iron deficiency anaemia
low MCV
low ferritin
high transferrin
45
what is siderblastin anaemia
Inability to incorporated iron into Hb - leading to iron accumulation in nucleated precursors
46
investigation for siderblastic
bone marrow to look for ring siderblasts
47
high MCV without anaemia think
myeloma
48
investigations for pernicious anaemia
B12 (low)
folate (normal)
anti-intrinsic factor
49
name if test for pernicious anaemia
schillings
50
pernicious anaemia treatment
B12 injections
51
haemolytic anaemia investigation
direct coombs test (tests for autoimmune)
52
what is aplastic anaemia
failure of erythropoiesis
53
haemolytic anaemia treatment
folate (rapidly deficient), consider transfusion, steroids, splenectomy
54
what can cause pancytopenia
aplastic anaemia
55
aplastic anaemia treatment
- BM transplant if severe or young people
| - cyclosporin (immunosuppresant) if less severe/older
56
PT measures what
extrinsic pathway
57
when will a PT be prolonged
warfarin, liver disease, DIC
58
APTT measures what
intrinsic pathway
59
when will a APTT be prolonged
heparin, haemophilia, vWF disease
60
what does vWF do
platelet plug formation and binds VIII
61
epistaxis and menorrhagia thing
vWF deficiency
62
```
vWF deficiency:
platelets
vWF/factor VIII
APTT
PT
```
platelets: normal
vWF/factor VIII: low
APTT: prolonged
PT: normal
63
what must be avoided in vWF deficiency
NSAIDs
64
vWF deficiency treatment
mild: desmopressin (stimulates vWF release from endothelial cells) severe: give vWF
65
haemophilia inheritance
x-linke recessive (boys get it)
66
type A haemophilia
factor VIII deficiency
67
type B haemophilia
factor IX deficiency
68
type B haemophilia affects which clotting pathway
intrinsic: factor IX
69
type A haemophilia affects which clotting pathway
extrinsic: factor VIII
70
spontaneous haemathrosis
Type A haemophilia
71
How do you treat heamopophilia
give missing factor
A: factor VIII
B: factor IX
72
what is Thrombotic thrombocytopenic purpura (TTP)
vWF cleaving protein deficiency
73
anemia, reticulocytosis, high LDH
TTP
74
Thrombotic thromboctopenic purpura treatment (TTP)
plasmapheresis
75
what is thrombotic thrombocytopenic purpura (TTP)
clots form in small vessels through put body, causing organ damage
76
what is DIC
clot followed by bleeding due to clotting factors being used up
77
investigations for DIC
PT: prolonged
APTT: prolonged
D-dimer positive
78
hair on end on X-ray
beta thalassaemia
79
thalassaemia investigations
Hb electrophoresis
80
thalassaemia treatment
life long transfusion
81
which blood conditions are autosomal recessive
thalassaemia
| sickle cell
82
sickle cell investigations
blod film and electrophoresis
83
x-linked blood diseases
G6DP deficiency
| haemophilia
84
autosomal dominate blood disease
hereditary spherocytosis
85
what is myelofibrosis
Clonal proliferation of haemopoietic stem cells with myeloid metaplasia (ectopic cells)
86
who gets myelofibrosis
men and ashkenazi jews
87
fever, night sweats, weight loss, bone / LUQ pain, anaemia, splenomegaly ++
myelofibrosis
88
tear drop poikilocytosis
myelofibrosis
89
what is polycythemia vera
high RBC
90
JAK2
polycythaemia
91
polycythaemia treatment
thromboprophylaxis
| venesection
92
tear drop poikilocytosis
myelofibrosis
93
pencil poikilocytosis
iron deficiency
94
acanthocytosis (thorn RBCs)
liver disease
95
heinz bodies
G6PD crisis
96
howell-Jolly bodies
hyposplenism
97
hyperhsegmented neutrophils
megaloblastic anaemia (B12 and folate)
98
Rouleaux formation
myeloma/high ESR
99
target cells
beta thalassaemia
sickle cell
iron deficiency
100
schistocytes
haemolysis, DIC, TTP
101
smudge cells
CLL
102
Reed-sternberg cells
multinucleate giant cells - hodgkins
103
basophilic stippling
thalaxxaemia. lead poisoning
