Findings in PRV on bloods?
- low ESR, raised leucoyte ALP.
- raised RBCs, and neutrophils/platelets in 50%.
- JAK 2 mutation.
pt presents with previous gallstones, normocytic anaemia and a family history of splenectomy. Dx?
- Hereditary spherocytosis is most common genetic haemolytic anaemia.
- requires osmotic fragility test.
Drugs that predispose to gallstones?
Causes of megaloblastic anaemia?
- vit b12 def
- folate def (if both, make sure to treat with b12 first due to risk of SACDC)
- drugs e.g. hydroxyurea.
- liver disease
- reticulocytosis e.g. due to haemolysis
- aplastic anemia
Management of severe thrombocytopenia in ITP?
- Not pooled platelets as these are only destroyed by antibodies.
- only managed if patient has other risk factors, or needs surgery etc.
- oral prednisolone
- IV Ig
- pooled platelets (only for acute situation not maintenance)
Poor prognostic factors in ALL?
- older age at Dx
- B, T cell type
- philadelphia chromosome (normally present for CML)
- CNS involvement
- high white cell count (>100)
large red beefy tongue and lemon yellow tinge to skin?
- megaloblastic anaemia due to folate or b12 def.
- (iron def causes painless glossitis and angular stomatitis. May also see koilonychia, pica and dysphagia due to pharyngeal web).