Medicine Notes Haematology Notes
Clinically relevant notes covering the main subjects within Haematology including malignancies, anaemias and pre-malignant disorders. Concise but with enough depth to answer SAQs for Finals. I have also included some notes on history and examination of a haematology patient - very useful for OSCEs.
These notes greatly aided me in passing my final exams with distinction. The notes were made using information from a variety of text books, lecture notes and workbooks. Each topic is colour-coded....
The following is a more accessible plain text extract of the PDF sample above, taken from our Haematology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:
Lymphomas
Malignant disorder of lymphoid tissue
Hodgkin’s Lymphoma
Reed-Sternberg cells present
Epidemiology
Two peaks in incidence
20-30yrs
> 50yrs
Clinical features
Asymmetrical painless lymphadenopathy
Most often cervical lymph nodes (feel rubbery)
Hepatosplenomegaly
20-30% also have systemic features
Fever
Night sweats
Weight loss
Pruritis
Fatigue
Alcohol-induced pain
Staging
Ann Arbor system
1 = nodal involvement restricted to 1 region
II – 2 or more lymph nodes regions on the same side of diaphragm
III – nodal involvement on both sides of diaphragm or splenic involvement
IVa – extra-nodal disease – liver/bone no systemic symptoms
IVb – extra-nodal disease – liver/bone plus systemic symptoms
Unexplained fever > 38 degrees
Drenching night sweats
Loss of >10% body weight in 6 months
Investigations
Blood count (FBC, LDH, ESR/PV)
Mild normochromic anaemia
Eosinophilia
BM aspirate and trephine
Can show infiltration
FNA of lymph nodes (excision biopsy of node preferred)
CXR
CT (of neck,chest, abdo, pelvis)
Management
In early stages, can be cured by radiotherapy
In advanced stages the main treatment is chemotherapy
+ Radiotherapy
+ Autologous stem cell transplant
Prognosis
Good curative rates
Risk of secondary malignancies in long-term survivors
Poor prognostic factors
Non-Hodgkin’s Lymphoma
Absence of Reed-Sternberg cells
Epidemiology
Commonest haematological malignancy
Most common age of presentation = 50yrs
Aetiology
Varies depending on type
Genetic mutations
Viruses
Classification
Can be classified with REAL system
Usually divided into
High grade = large poorly differentiated lymphoid cells, aggressive course but often curable
Low grade = smaller, better differentiated lymphoid cells, slower clinical course but relapse common
Clinical presentation
Nodal involvement causes painless rubbery lymphadenopathy
Commonest in cervical nodes
Extra-nodal involvement
Intestinal – abdo. pain, dysphagia
CNS – headache, CN palsies, cord compression
Skin – mycosis fungoides
BM – pancytopenia
Systemic features less common
Diagnosis
Depends on tissue biopsy for histology
CT (staging)
BM aspirate
Staging
As for Hodgkins lymphoma – less use in management and...
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Clinically relevant notes covering the main subjects within Haematology including malignancies, anaemias and pre-malignant disorders. Concise but with enough depth to answer SAQs for Finals. I have also included some notes on history and examination of a haematology patient - very useful for OSCEs.
These notes greatly aided me in passing my final exams with distinction. The notes were made using information from a variety of text books, lecture notes and workbooks. Each topic is colour-coded....
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