Hematological Diseases Flashcards

(45 cards)

1
Q

what is the etiology of sickle cell anemia

A

chronic, congenital, and hereditary hemolytic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

sickle cell anemia affects what population

A

black individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the symptoms of sickle cell anemia

A
episodic abdominal crisis 
jaundice 
bone pain 
dactylitis 
splenomegaly 
osteonecrosis 
bone deformities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

sickle cell anemia predisposes the patient to what

A

salmonella osteomyelitis

secondary to ischemic injury of bone and GI tract - high incidence of infarct beds with GI flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

sickle cell anemia causes early death due to what

A

infection
visceral infarcts
cardiac decompensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

vascular compromise in sickle cell anemia causes an __ appearance

what is this appearance due to

A

H vertebrae
or
fish vertebrae

ischemia/osteonecrosis of the central endplate due to vascular compromise - less blood vessels in the middle so the middle thins quicker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

H vertebrae occurs in what conditions

A

sickle cell anemia
thalassemia
gauchers disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

sickle cell anemia dactylitis common occurs when? what is dactylitis? what aggravates the sludging?

A

during infancy

painful swellings of hands and feet due to infarction or infection

cold weather aggravates the sludging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

sickle cell dactylitis is also called

A

hand foot syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

bone infarction is difficult to distinguish between what

whats more common

A

osteomyelitis

osteomyelitis > bone infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the xray findings of bone infarction caused by sickle cell?

what is the preferred method to visualize these bone infarcts?

A

periostitis
osteopenia

patchy subchondral sclerosis indicates prior infarcts

MR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is preferred imaging for bone infarction due to sickle cell?

high signal on what?

what is the most sensitive?

A

MR

high signal on T2 and SPIR - spectral presaturation inversion recovery

MR T1 with contrast**
- most sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how do femoral heads appear in sickle cell anemia

A

femoral head ischemic changes in 8-20% of patients

AVN tends to be bilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

repeated episodes of splenic infarctions occur in what disease

what does this do to the spleen size

whats the end stage

A

sickle cell anemia

decrease in size - could be normal but nonfunctional

end stage - spleen contains perivascular fibrosis with deposition of hemosiderin and calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

the end stage of sickle cell anemia ends with the spleen becoming perivascular fibrosis with deposition of __ and __ that has been termed the process of __

A

hemosiderin and calcium

autosplenoectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

advanced dactylitis due to sickle cell causes what radiographic findings

A

lytic process in 1st and 5th metacarpals
and
periostitis in the 3rd metacarpal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

hair on end appearance is seen in what condition

what causes this

A

sickle cell anemia and thalassemia

hair on end appearance - in the skull

expanded marrow cavity due to marrow hyperplasia - trabeculae are oriented perpendicular giving it its appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does osteonecrosis look like in sickle cell

A

flattening of the femoral heads with a mixture of sclerosis and lucency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the bone deformities seen in sickle cell anemia

what are these bone deformities due to

A

shortening of 3rd and 4th metacarpals and phalanges

early fusion of growth plates

osteonecrosis in infancy

20
Q

what is thalassemia also called

A

cooleys anemia

mediterranean anemia

21
Q

what is the etiology of thalassemia

A

hereditary disorder of hemoglobin synthesis

22
Q

what are the 3 forms of thalassemia

which one is of greatest severity and worst prognosis

A

major ** - worst prognosis - death in infancy is common

minor

intermedia

23
Q

in less severe forms of thalassemia, what is the typical end road in disease

how does it occur

A

repeated transfusions result in hemochromatosis and heart failure

death by 2nd or 3rd decade

dilated and restrictive cardiomyopathy due to iron deposits in cardiac tissue

24
Q

what are common characteristics of thalassemia

A

retarded growth - due to anemia

hepatosplenomegaly - due to hemolytic anemia

mongoloid facies - ineffective erythropoiesis and marrow hyperplasia

maxillary overgrowth - rodent facies

inhibited sexual development

25
in children, thalassemia affects __
the entire skeleton
26
what are the radiographic findings of thalassemia
expansion of medullary space due to marrow hyperplasia thinning of cortices and loss of tubulation expansion of bone diameter - erlenmeyer flask deformity osteoporosis resorption of fine trabeculae with thickening of remaining honeycomb trabeculae - coarse trabeculae pattern squaring of metacarpals
27
what are the growth disturbances seen in thalassemia complications
erlenmeyer flask deformity premature fusion of growth plates fracture, avn, hemochromatosis, arthropathy
28
how do you tell the difference between sickle cell and thalassemia on xray skull
both have hair on end appearance thalassemia has obliterated sinuses and rodent facies - due to stem cells in sinus converting to marrow to produce new rbcs
29
what causes intramedullary hematopoiesis what is this
thalassemia masses noted in chest/ribs and paraspinal muscles
30
what is the clinical presentation of thalassemia
appear first 2 years of life fatigue pale skin or jaundice protruding abdomen with enlarged spleen and liver
31
what is hemophilia
deficiency in specific clotting factors - coagulopathies
32
what are the 2 most common bleeding disorders with skeletal abnormalities
(classic) hemophilia A | (christmas) hemophilia B
33
what is the etiology of hemophilia who does the disease manifest in
sex linked recessive females are carriers for the gene hemophilia manifests only in males
34
when do hemorrhages occur in hemophilia
hemorrhages occur spontaneously or after minor trauma that can cause skeletal changes within or around joints/bones
35
what is a intraosseous hemorrhage where does it most commonly occur what joints is this seen in
destructive expansile lesion - pseudotumor of hemophilia MC in ilium and femur weight bearing joints - knees hips
36
what are some characteristics of hemophilic arthropathy
repeated intra-articular bleeding that leads to joint effusion from hemosiderin/iron deposits - increases density of soft tissues around joint intraosseous hemorrhage osteoporosis and epiphyseal growth from hyperemia subchondral cysts bone erosion widening of intercondylar notch from cartilage destruction (pannus)
37
what does hemophilia arthropathy resemble
neurotrophic arthropathy #charcotjoint
38
what can intraosseous hemorrhage lead to
neoplasm in 1-2% of hemophiliacs
39
CT of hemophilia pseudotumor will appear like what
large expansile lesion with inhomogeneous internal attenuation
40
what is leukemia
myeloproliferative malignant disease of the marrow proliferating WBCs
41
what are the different populations and types of leukemia
childhood - acute adult - chronic
42
what is the most common childhood malignancy
acute leukemia
43
what are the radiological findings of leukemia
osteopenia radiolucent submetaphyseal bands - leukemic lines bone destruction periostitis
44
what is the clinical presentation associated with leukemic lines
pain in the legs or refusal to walk associated with leukemic lines
45
when children are over the age of __, bilateral lucent bands called __ are indicative of leukemia
2 leukemic lines