Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
50 Cards in this Set
- Front
- Back
What are the normal haemoglobin levels in men and women?
|
M : 13.5-17.5
F : 10.5-15.5 |
|
Which drug's common side effect is a syndrome of inappropriate ADH
|
carbamezapine
|
|
Normal values for MCV?
|
80-95 fL
|
|
What's the pathology behind a microcytic anaemia
|
When inadequate levels of haemoglobin available the RBC division increases leading to smaller cells (MCV <80)
|
|
What 4 causes of a microcytic anaemia do you know?
|
<Iron - iron deficiency anaemia
Odd Globin chains - thalassaemia odd haem ring - Congenital sideroblastic anaemia poor iron utilisation - chronic disease |
|
What's the pathology behind a megaloblastic anaemia?
|
An inabilit to synthesise new DNA bases or rasied plasma lipids results in fewer divisions and larger RBCs
|
|
What 4 causes do you know for a Megaloblastic anaemia?
|
B12/Folate deficiency
Cytotoxic drugs Myelodysplasia High plasma lipids (liver disease, hypothyroid, alcohol, pregnancy) |
|
Max Fe possibly absorbed /day
|
3.5mg / day
|
|
How is Fe transported in blood
|
Transferrin
|
|
How is iron stored in the body (3)
|
65% haemoglobin
29% ferritin 3% myoglobin |
|
What two specific signs do you know that identifies the anaemia as iron deficient?
|
Atrophic glossitis
Koilonychia |
|
What 3 categorial causes of iron deficiency are there?
|
Malabsorption - Post-gastrectomy, coeliac disease
>Blood loss - GI, renal, uterine >Demand - pregnancy, growth |
|
How would you resolve someone's iron deficiency (4)
|
Treat cause
FeSO4 tablets Fe Sorbital IM Blood transfusion |
|
What foods contain Vit B12
|
Animal liver, fish, dairy
(Vegans) |
|
How does Vit B12 get from your fork to your marrow? (3phases)
|
Binds to IF from gastric parietal cells
IF binds to terminal ileal cells, B12 absorbed B12 bound to transcobalanin II in serum |
|
Is there much storage of Vit B12 to keep you going?
|
Liver - 3yrs
|
|
What makes up 80% of the causes of Vit B12 deficiency?
|
Pernicious Anaemia
|
|
What's the age/sex distribution of Pernicious anaemia
|
45-65 yrs
M=F |
|
What antibodies are present?
|
Anti-parietal cell
Anti-IF |
|
What's the test for pernicious anaemia?
|
Schilling test
|
|
What is Schilling test?
|
Radio B12 orally with Norm B12 IM - measure urine B12 radio
Radio B12 orally + IF with B12 IM - if much increased radio urine = +ve |
|
How is sickle cell trait inherited?
|
recessive - blacks
|
|
What sickle crises (4) do you know and what are their main features?
|
Vaso-occlusive - small vessel plugging (acute bone pain, fever, tachycardia)
Sickle chest - bone marrow infarction leads to pulmonary fat emboli, fatal. Sequestrian crises - venous outflow thrombosis spleen/liver Aplastic crisis - follows erythrovirus 19 infection leads to severe self-limiting red cell aplasia. |
|
How do you investigate a suspected sickler? (2)
|
Blood film - sickle cells
Electrophoresis - HbS/HbC bands |
|
How do you manage a sickler? (4)
|
Prophylaxis - folic acid, pen V, vaccination (hyposplenism)
Rehydration, O2, Analgesisa, Antibiotics Transfusion (top-up/exchange) BM transplant |
|
What is the pathology of Thalassaemia?
|
Partial/Complete failure to produce a/b globins
|
|
What are is the geographical distributions of the Thalassaemias (2)?
|
a = mediterranean
b = south-east asia |
|
What is hereditary spherocytosis?
|
A autosomal dominant condition where the RBC's are spherical not donuts and therefore haemolyse more rapidly.
|
|
What is a hepatic complication of haemolytic anaemias?
|
pigmented gallstones
|
|
What is the physiology behind G6PDH deficiency causing a haemolytic anaemia
|
Unable to produce NADPH in RBCs thus reduced coping to oxidative stress, so periodic haemolysis
|
|
whose affected with this fascinating G6PDH deficiency you've mentioned?
|
10% of the world population!
mainly in malaria belt (provides some protection) males affected while females carry |
|
What do doctors give to cause the stresses bringing on the haemolysis (3)
|
3A's
Analgesia (aspirin) Antimalarials (chloroquine, quinine) Antibiotic (sulphonamides, nitrofurantoin) |
|
Which haemolytic anaemia is caused by reduced ATP production in the RBC
|
Pyruvate Kinase deficiency - chronic non-periodic haemolysis
|
|
What is the test for Autoimmune Haemolytic anaemias?
|
Comb's test - complement binding reagent binds to RBC and causes agglutination
|
|
50% of autoimmune haemolysis have no precipitating cause. What about the other 50%(4)
|
Malignancy - lymphoma, solid
SLE/RA Drugs - quinine, methyldopa UC HIV |
|
Treatment for autoimmune haemolysis (4)
|
Prednisolone
Transfusion Splenectomy Immune suppression |
|
What 3 causes are there for a non-immune haemolytic anaemia
|
Physical trauma (burn, march, heart valve)
Infection (falciparum, clostridium) Chemical (arsenic, dapsone) |
|
Other than infection, inflammation and malignancy, what can cause a Neutrophilia (3)
|
Trauma (surgery, burns)
Infarction (MI, PE) Physiological (Exercise, Preg) |
|
What are eosinophils primarily involved with (3)?
|
These puppies with their peroxidase granules are aimed at taking out parasites.
Their also induced by allergy (hayfever/asthma) and hypersensitivity (gold/sulphonamides) |
|
What are basophils about?
|
Granules contain histamine and primarily induced by acute hypersensitivity and myeloproliferation
|
|
Which acute leukaemia is commonest in children
|
ALL
(AML is 4x in adults) |
|
What blood results would you expect from ALL
|
FBC - normal? raised/low/norm WCC, thrombocytopaenia
Blood film - blasts Marrow - >30% blasts >Uric Acid, >LDH |
|
Which leukaemia is this?
Philadelphia chromosomal abnormality, 55yrs old, Massive smooth painless spleen |
CML
|
|
Which leukaemia is this?
Commonest leukaemia in westerners. Male 70yr old. |
CLL
|
|
Which leukaemia is this?
Philadelphia chromosomal abnormality, 55yrs old, Massive smooth painless spleen |
CML
|
|
Which leukaemia is this?
Commonest leukaemia in westerners. Male 70yr old. |
CLL
|
|
What's the pathology of multiple myeloma?
|
Malignant plasma cell proliferation resulting in a monoclonal paraproteinaemia with hypercalcaemia and Bence Jones Proteinuria
|
|
In Hodgkin's Lymphoma (with Reed-Sternberg cells) what is the age distribution
|
Bimodal
20-35 & 50-70 |
|
LIST THE P450 INHIBITORS
|
Omeprazole
Fluoxetine/Fluconazole Disulfiram Erythromycin/Clarithromycin Valproate Isoniazid Cimetidine/Ciprofloxacin EtOH acute Sulphonamides |
|
LIST P450 INDUCERS
|
Phenytoin
Carbamezapine Barbituates Rifampicin Alcohol Sulphonylureas/St John's Wort |