Haematology
Anaemia, clotting, haemoglobinopathies and haematological malignancy.
- Iron Deficiency Anaemia The commonest cause of anaemia worldwide. Recognising the microcytic hypochromic picture, why unexplained iron deficiency in an adult means a GI cancer hunt, and how to replace iron.
- Vitamin B12 and Folate Deficiency The two causes of megaloblastic anaemia. Pernicious anaemia, why folate must never be given alone in B12 deficiency, and subacute combined degeneration of the cord.
- Anaemia of Chronic Disease The commonest anaemia in hospital inpatients. How hepcidin locks iron away from erythropoiesis, why ferritin misleads, and why giving iron rarely helps.
- Haemolytic Anaemia Premature red cell destruction: separating inherited from acquired, intravascular from extravascular, and proving haemolysis with reticulocytes, LDH, bilirubin and haptoglobin.
- Sickle Cell Disease An autosomal recessive haemoglobinopathy causing chronic haemolysis and vaso-occlusion. Recognising and treating the acute painful crisis, why acute chest syndrome is the leading cause of death, and lifelong preventive care.
- Thalassaemia An inherited imbalance of globin chain production. Alpha versus beta disease, why severity depends on how many genes are affected, lifelong transfusion and chelation, and why iron overload is the leading cause of death.
- Aplastic Anaemia and Pancytopenia Bone marrow failure with an empty marrow. Working through the causes of pancytopenia, why bone marrow biopsy is the key investigation, and immunosuppression versus curative transplant.
- Polycythaemia A raised haemoglobin or haematocrit. Separating relative from true polycythaemia, primary from secondary, and why JAK2 and the erythropoietin level do most of the diagnostic work.
- Myeloproliferative Disorders Clonal overproduction of myeloid cells. Essential thrombocythaemia, primary myelofibrosis and chronic myeloid leukaemia - the driver mutations, the thrombotic and marrow-failure risks, and why imatinib transformed one of them completely.
- Myelodysplastic Syndromes A clonal, pre-leukaemic bone marrow disorder of the elderly. Recognising dysplastic, ineffective haematopoiesis, why bone marrow cytogenetics drives prognosis, and the narrow group who are curable.
- Leukaemia Malignant clonal proliferation of white cell precursors. Acute versus chronic, myeloid versus lymphoid - the age patterns, defining cytogenetics, and why acute leukaemia is a same-day emergency.
- Lymphoma Malignancy of lymphoid tissue. Hodgkin versus non-Hodgkin, the Reed-Sternberg cell, B symptoms and Ann Arbor staging, and why an excision biopsy - not a needle - makes the diagnosis.
- Multiple Myeloma A clonal plasma cell malignancy. The CRAB criteria, why the paraprotein and light chains damage the kidney, and separating myeloma from its premalignant precursor, MGUS.
- Neutropenia and Neutropenic Sepsis A low neutrophil count and the emergency that follows it. Why fever in a neutropenic patient is treated before it is explained, and antibiotics within the hour.
- Immune Thrombocytopenic Purpura Isolated low platelets from immune-mediated destruction. Why children usually recover alone and adults usually don't, and why organomegaly means it probably isn't ITP.
- Platelet Disorders Too few platelets, too many, or platelets that do not work. A structured approach to thrombocytopenia and thrombocytosis, the emergencies hiding among them, and why HIT causes clots rather than bleeding.
- Haemophilia and Von Willebrand Disease The inherited bleeding disorders. X-linked haemophilia A and B, the commonest inherited bleeding disorder von Willebrand disease, and using the PT and APTT to tell them apart.
- Thrombophilia An inherited or acquired tendency to thrombosis. Factor V Leiden and the other inherited defects, antiphospholipid syndrome, and why testing changes management far less often than students expect.
- Disseminated Intravascular Coagulation Simultaneous widespread clotting and bleeding. Why consuming clotting factors and platelets produces both, the everything-is-deranged clotting screen, and why treating the trigger matters more than the numbers.
- Deep Vein Thrombosis Thrombosis in the deep veins of the leg. Working the Wells score through to D-dimer or ultrasound, choosing and timing anticoagulation, and deciding who needs it for life.
- Venous Thromboembolism Prophylaxis Preventing hospital-associated thrombosis. Assessing every admitted patient, balancing thrombotic against bleeding risk, and the mechanical and pharmacological options.
- Anticoagulation The anticoagulant drugs in practice. How heparins, warfarin and DOACs differ in mechanism and monitoring, when each is the right choice, and how to reverse them when bleeding.
- Blood Transfusion and Transfusion Reactions Blood components, compatibility and consent, and the reactions that follow. Recognising acute haemolytic reactions, TACO and TRALI, and the checks that prevent the wrong blood reaching the wrong patient.
- Hyposplenism and Splenectomy Life without a working spleen. Recognising hyposplenism on the blood film, the encapsulated organisms that threaten these patients, and the vaccination and prophylaxis that prevent overwhelming sepsis.
- Interpreting the Full Blood Count and Blood Film A systematic approach to the commonest blood test in medicine. Working through each cell line in turn, using the MCV and reticulocytes to classify anaemia, and the film findings that make a diagnosis at a glance.