clotting - tests and disorders Flashcards
what are some causes of neutropenia
myeloma, feltys disease, SLE, haem malignancy, chemo, EBV
what do blood show in DIC
-prolonged APTT
-prolonged PT
-low fibrinogen
-raised fibrin degradation products
-thrombocytopenia
-blood film - schistocytes (MAHA)
target INR in afib
2.5
target INR in RECURRENT DVT
3.5
when does warfarin need to be stopped before surgery
5 days
where should INR results be recorded and what should you be aware of
the yellow book, need to be aware of the reasons for anticoagulation, target INR and duration of treatment
how do you reverse warfarin when someone has major bleeding
IV vit K1 and prothrombin
contraindications to warfarin
clinically significant bleeding, severe hepatic impairment and pregnancy
advice for patients on warfarin
take yellow book with them where ever they go, take warfarin at the same time each day, limit alcohol and be careful when brushing teeth
what tests do you do for haemachromatosis
Transferrin and ferritin (transferrin saturation should be kept below 50% and the serum ferritin concentration below 50 ug/l)
target cells seen in
IDA, hyposplenism, liver disease
spherocytes seen in
spherocytosis and autoimmune haemolytic anaemia
Burr cells (echinocytes) seen in
pyruvate kinase deficiency and uraemia
what is thrombotic thrombocytopenic purpura
normally in women - pentad of signs: fever, Neuro signs, MAHA, thrombocytopenia, renal failure
what do reed Sternberg cells have
a bilobed nucleus
what test do you do to monitor UFH
APTT
what test do you do to monitor LMWH
platelets and antiXa if overwight/underweight/renal impairment/preg
monitor platelets before starting normally
haemophilia causes a prolonged what
APTT
tests for a haemolytic anaemia
1) FBC
2) blood film (show shistocytes and spherocytes)
3) Coombs
4) haptoglobin
5) MCHC (raised in hereditary spherocytosis)
6) LDH (raised when increased cell turnover)
7) reticulocytes
how is hereditary spherocytosis inherited
autosomal dominant
