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Haem > Blood dyscrasias > Flashcards

Blood dyscrasias Flashcards

1
Q

Four hematological disorders with the highest mortality rate

A
  • Aplastic anemia
  • Immune thombocytopenia
  • Agranulocytosis
  • Hemolytic anemia
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2
Q

Drugs causing aplastic anemia

A

Dose-dependent:
- Chemo
- Chloramphenicol

Idiosyncratic:
- Carbamazepine
- Phenytoin

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3
Q

Management of aplastic anemia

A
  • Immunosuppressants (steroid, ciclosporin, cyclophosphamide, azathioprine, antithymocyte Ig)
  • Transfusion of erythrocytes & platelets
  • Symptomatic treatment of infections
  • GM-CSF & G-CSF
  • Hematopoietic stem cell transplant
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4
Q

Drugs causing immune thrombocytopenia

A
  • Heparin
  • Sulfonamides
  • Carbamazepine, phenytoin
  • Glycoprotein IIb/IIIa inhibitors (abciximab, eptifibatide, tirofiban)
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5
Q

Management of immune thrombocytopenia

A
  • Immunosuppressants
  • Platelet transfusion for significant bleeds
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6
Q

Drugs causing agranulocytosis or neutropenia

A

Direct toxicity:
- Thiamazole
- Chlorpromazine
- Ticlopidine
- Busulfan
- Zidovudine

Toxic metabolite:
- Clozapine
- Carbimazole (metabolite: thiamazole)

Immune:
- Beta-lactams
- Propylthiouracil

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7
Q

Management of agranulocytosis or neutropenia

A
  • Prophylactic GM-CSF or G-CSF
  • Routine monitoring of white count (esp for clozapine)
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8
Q

Drugs causing immune haemolytic anemia

A

Drug-induced true autoAb production:
- Methyldopa

Innocent bystander (immune complex) autoAb production:
- Quinidine, quinine

Hapten-induced hemolysis:
- Penicillins
- Cephalosporins
- Streptomycin

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9
Q

Drugs causing non-immune hemolytic anemia

A

Via protein adsorption
- Cisplatin, oxaliplatin
- Beta-lactamase inhibitors

Oxidative stress in RBCs (G6PD)
- Fluoroquinolones
- Primaquine
- Sulfonylureas
- Nitrofurantoin, bactrim
- Fava beans
- Hanna compounds
- Napthalene

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10
Q

Management of haemolytic anemia

A
  • RBC transfusion (for very low Hb count)
  • Hemodialysis (for acute renal failure)
  • Steroids and Ig (severe cases)
  • Rituximab (autoimmune haemolytic anemia) which targets CD20
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11
Q

Methaemoglobinaemia

A

Cause:
- Phenazopyridine
- Dapsone
- Benzocaine, prilocaine

Management:
- Administer oxygen & methylene blue

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12
Q

Megaloblastic anemia

A

Cause:
- Methotrexate
- Azathioprine
- Allopurinol
- Tetracyclines
- Phenytoin
- PPI
- Metformin

Management:
- Vit B12
- Folic acid

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13
Q

Sideroblastic anemia

A

Cause:
- Isoniazid
- Chloramphenicol
- Linezolid
- Penicillinamine

Management:
- Pyridoxine (vit B6)

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14
Q

Pure red cell aplasia

A

Cause:
- Allopurinol
- Azathioprine
- Isoniazid
- Carbamazepine

Management:
- Immunosuppressants

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15
Q

Thrombotic microangiopathy

A

Cause:
- Clopidogrel
- Ticlopidine
- Ciclosporin
- Tacrolimus
- Cisplatin

Management:
- Plasma exchange if needed

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16
Q

Platelet dysfunction

A

Cause:
- Beta-lactams
- Aspirin
- NSAIDs
- Fluoxetine

Management:
- Withdrawal, usually reversible

17
Q

Hypercoagulability

A

Cause:
- COX2 inhibitors
- Estrogen / progestin
- Tamoxifen
- Erythropoietin

Management:
- Emergency treatment of thrombosis

18
Q

Circulating anticoagulants

A

Cause:
- Isoniazid
- Hydralazine
- Procainamide

Management:
- Immunosuppressants

19
Q

Hypoprothrobinemia

A

Cause:
- Heparin
- Ticlopidine
- Aspirin
- NSAIDs
- Tetracyclines
- Sulfonamides

Management:
- Monitoring & dose adjustment

20
Q

Eosinophilia

A

Cause:
- Penicillins
- Sulfonamides
- Allopurinol
- Phenytoin

Management:
- Usually reversible

21
Q

Neutrophilia

A

Cause:
- Glucocorticoids
- Epinephrine
- Bactrim

Management:
- Usually reversible

22
Q

Polycythemia

A

Cause:
- Erythropoietin
- Anabolic steroid

Management:
- Usually reversible

23
Q

Acute leukaemia / myelodysplasia

A

Cause:
- Alkylating agents
- Topoisomerase II inhibitors
- Doxorubicin

Management:
- Treat the leukaemia & myelodysplasia

24
Q

Types of anemia

A

Macrocytic, hyperchromic anemia
- Vit B12 & folate deficiency

Microcytic, hypochromic anemia
- Iron-deficiency

Haem (5 decks)

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