Haematology Flashcards Preview

Finals > Haematology > Flashcards

Flashcards in Haematology Deck (59)
Loading flashcards...
1

What different information can you get from bone marrow aspirate v trephine

aspirate = myeloid:erythroid, orderly/complete maturation, presence of abnormal cells

trephine = cells:fat, no of diff cells present, presence of abnormal infiltrates, changes to stroma/bone

2

Which area does a leukaemia affect

bone marrow

3

Which area does a lymphoma affect

lymph nodes

4

What is the difference between acute and chronic haematological malignancies?

acute = cell growth arrested at early stage of differentiation`

chronic = cell growth arrested at later stage of development. already partially developed

5

What are the features of ALL

most common in children 2-4y
infection
bleeding/brusing
tiredness
bone pain (secondary to bone marrow infiltration)
splenomegaly
hepatomegaly
testicular swelling

6

What are the risk factors for ALL

genetics

7

What investigations need to be done in ALL

FBC, clotting, LDH, U+E LFT
blood film
bone marrow aspirate and trephine
immunophenotyping

8

what is the management of ALL

remission induction - chemo
maintenance
CNS prophylaxis

9

What are the features of AML

most common 50-60y
anaemia: pallor, lethargy, weakness
neutropenia: whilst white cell counts may be very high, functioning neutrophil levels may be low leading to frequent infections etc
thrombocytopenia: bleeding
splenomegaly
bone pain

10

What conditions can progress into AML

Myelodysplastic syndrome
aplastic anaemia
myelofibrosis

11

What investigations need to be done in AML

FBC, clotting, LDH, U+E, LFTs
blood film
bone marrow aspiration

12

what is the management of AML

induction
post remission consolidation
stem cell transplantation

13

Which cells are affected in CLL

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

immature, unreactive, accumulate in bone marrow, don't die when they should

14

What are the features of CLL

often none
constitutional: anorexia, weight loss
bleeding, infections
lymphadenopathy more marked than CML
splenomegaly

15

What investigations need to be done in CLL

FBC
blood film
bone marrow aspirate and trephine
lymph node biopsy
immunophenotyping

16

What cells are seen on a blood film in CLL

smear/smudge cells

17

What is the genetic abnormality present in most CML

philadelphia chromosome
translocation between 9 and 22
BCR-ABL gene codes for a fusion protein which has tyrosine kinase activity in excess of normal

18

Which cells are affected in CML

myeloproliferative disorder of haemopoeitic stem cells affecting one or all cell lines - erythroid, platelet, myeloid

19

Describe the phases of CML

chronic - 4-5y. asymptomatic, immune system fine

accelerated - 15-29% blasts in the marrow/blood, low platelets, RBC and granulocytes

blastic - >=30% blasts in blood/marrow plus severe constitutional symptoms

20

What are the features of CML

anaemia: lethargy
weight loss
splenomegaly/hepatomegaly
night sweats

21

What investigations need to be done in CML

FBC LDH
Blood film
bone marrow aspirate and trephine
cytogenetics - philadelphia chromosome

22

What is the difference between a group and save and a cross match?

group and save - gives blood group and screens for abnormal antibodies. no blood is issued

cross match - patient and donor blood mixed. blood issued if no immune reaction

23

How are blood samples like group and save and cross match meant to be taken

two separate samples
three points of ID
informed consent from patient for blood transfusion
label bottles by bedside by hand
complete request form by patient's bedside

24

What is the threshold for red cell transfusion

Hb <70g/L

Hb <80g/L if acute coronary syndrome

25

What does FFP contain

clotting factors, albumin, immunoglobulin

26

What are the indications for giving FFP

(i) Disseminated Intravascular Coagulation (DIC);
(ii) Any haemorrhage secondary to liver disease;
(iii) All massive haemorrhages (commonly given after the 2nd unit of packed red cells)

27

What are the indications for giving platelets

(i) Haemorrhagic shock in a trauma patient;
(ii) Profound thrombocytopenia <20 x 109/L
(iii) Bleeding with thrombocytopenia - if < 100 x 10 9 for patients with severe bleeding, or bleeding at critical sites, such as the CNS
(iv) Pre-operative platelet level <50 x 109/L

28

What does cryoprecipitate contain

fibrinogen
von willebrand factor
factor VII
fibronectin

29

What are the indications for giving cryoprecipitate

(i) DIC with fibrinogen <1g/L;
(ii) von Willebrands Disease; or
(iii) Massive haemorrhage

30

When is CMV -ve blood inidcated

if risk of congenital CMV infection - causes cerebral palsy or sensorineural deafness

pregnancy
intrauterine transfusion
neonates <28 days