50 HYQs

• Liver -> Protein C -> Factor V
• ACD - chronic inflammatory condition, low serum iron, low TIBC, increased ferritin. The body decreases absorption and increases storage of iron to prevent potential infection/bacteria using the iron
• Crohn’s disease affects the terminal ileum, so can result in B12 deficiency
• In B12 deficiency there is increased homocysteine and methylmalonic acid but in folate deficiency methylmalonic acid is normal.
• DIC is the only thrombocytopenia with elevated D-dimer, doesn't occur in healthy patients, and the misuse of clotting factors means there is not enough when needed in injury.
• DIC - D-dimer Dripping Ill Clots (DDIC)
• Thrombocytic thrombocytopaenic purpura - Fever Anaemia Thrombocytopaenia Renal failure Neurologic symptoms (FAT RN)
• Thrombocytic thrombocytopaenic purpura manifestations caused by high von Willebrand factor due to a deficiency in ADAMTS13 enzyme
• Iron deficiency anaemia - decreased serum iron, decreased ferritin, increased TIBC
• In Non-Hodgkin lymphoma, a PET/CT scan may show extranodal involvement in the GI tract
• Chronic Myelogenous Leukaemia is like to be treated with tyrosine kinase inhibitors (Imatinib)
• Mainstay treatment for haemochromatosis is phlebotomy.
• Chronic lymphocytic leukaemia often display smudge cells
• Chronic Lymphocytic Leukaemia = Crushed Little Cells (CLL smudge cells)
• Auer Rods and Myeloperoxidase Positivity are present in Acute Promyelocytic Leukaemia, a subtype of acute myelogenous leukaemia
• Burkitt lymphoma, a subtype of non-Hodgkin lymphoma, is endemic to Africa, involves jaw and facial pain, histiocytes that are scattered across a darker background of basophilic tumour cells, creating an appearance of stars in a dark sky.
• Nodular sclerosis is the most common type of Hodgkin lymphoma
• Hydroxyurea helps build HbF to prevent frequency and severity of future sickle cell episodes
• Acute lymphoblastic leukaemia is the most common childhood malignancy
• Metformin can cause B12 deficiency due to reduced intestinal absorption
• >20% lymphoblasts in bone marrow biopsy indicates Acute Lymphoblastic Leukaemia, the most common childhood malignancy, which may present with fever, bruising, hepatomegaly, splenomegaly, anaemia, thrombocytopenia and neutropenia
• Neck (cervical, supraclavicular) is the most common site to have lymphadenopathy in Hodgkin lymphoma
• Reed Sternberg cells are ‘owl eye’ like on Hodgkin lymphoma histology
• In polycythaemia vera, mutation in JAK2 can cause flushing and itching after a hot bath/shower, accompanied by headache and blurred vision due to hyperviscosity of blood
• Iron deficiency anaemia presents with fatigue, pallor, koilonychia (spooning of nails) and atrophic glossitis (smooth tongue)
• Multiple myeloma is more prevalent in african american males, with bone pain (involving the vertebra), fatigue, renal insufficiency, hypercalcaemia, and Bence-Jones proteins on urine electrophoresis
• Multiple Myeloma - Bone pain Recurrent infection Elevated calcium Anaemia Kidney injury (BREAK)
• Carbamazepine can cause aplastic anaemia
• Partial thromboplastin time (PTT) measures the common coagulation and intrinsic pathway in the clotting cascade
• B12 deficiency can have neuro symptoms but folate does not
• Desmopressin (DDAVP) increases release of endogenous von Willebrand factor to stabilise and retain factor VIII for longer in mild haemophilia A - this doesn’t work in haemophilia B as von Willebrand factor only stabilises factor VIII, not IX
• Rouleaux formation (stack of coins) - appearance of RBCs in multiple myeloma
• Isolated thrombocytopenia + all other normal labs = Immune Thrombocytic Purpura
• Plasmapheresis (plasma exchange) is the initial treatment for thrombotic thrombocytopenic purpura
• Cola or tea coloured urine in the middle of the night and clearing up by midday indicates paroxysmal noctural hemoglobinuria
• A HFE protein mutation reduces the iron regulating peptide hormone, hepcidin, increasing iron absorption in the intestinal tract
• Hemarthrosis (joint spaces) are the most common site for bleeding in ambulatory haemophilia A & B patients
• Desmopressin (DDAVP) is the treatment of choice for mild to moderate bleeding in Type I von Willebrand disease
• CML involves a 9 an 22 translocation on the philadelphia chromosome