16 heme onc

Question 1

transfusion reactions list them all, what txs

Answer 1

1. acute febrile non hemolytic–tylenol, hold transfusion 30min then restart
2. simple allergic (urticarial) – benadryl. continue transfusion if mild
3. anaphylactic – epi
4. acute hemolytic – high fever, shocky. stop transfusion, ivf and pressors
5. trali - supportive no lasix
6. taco - lasix

Question 2

someone getting blood transfusion, now has SOB, think what reactions

Answer 2

1. anaphylaxis 2. taco 3. trali

Question 3

hemophilia chart

bleed type, % factor level required, dose required

Answer 3

chart attached.

also remember fingers: V for VIII, I for IX

Question 4

von willebrands dz patient is bleeding

give what

Answer 4

DDAVP , Factor VIII

NOT FFP (does not have vwF)

2015–FDA approved a form of VWF you can give

Question 5

INR reversal:

1. <5
2. 5-9
3. >9
4. severe bleed

Answer 5

1. skip next dose coumadin
2. skip 1-2 doses, can give Vit K 5 mg po
3. hold coumadin until therapeutic. Give Vit K 5-10mg po
4. give FFP/PCC, give IV Vit K 5-10 mg

Question 6

name the leukemia types

Answer 6

Acute leukemias need smear for dx. WBC can be up or down

ALL - kids

AML - adults, auer rods, dic

Chronic leukemia have high WBC, relatively asx.

CML - adult. poly high

CLL - elderly. lymp high

Question 7

tumor lysis

what labs abnormal

Answer 7

high K, uric acid, phos

low Ca

Question 8

heparin induced thrombocytopenia

mnemonic, including time

Answer 8

4 Ts

thrombocytopenia

Time 5-14d

thrombosis

no oTher cause