haem Flashcards
mx of post-thrombotic syndrome
compression stockings
when does post-thrombotic syndrome occur
6 months to 2 years after a DVT
causes of petechiae in adults
ITP bone marrow failure (secondary to leukaemias, myelodysplasia or bone mets) senile purpura drugs nutritional deficiencies
non-emergency mx of ITP in adults
platelet count >30 - observe
platelet count <30 - oral prednisolone
ix for polycythaemia vera (after FBC)
JAK2 mutation screen
sickle cell with high reticulocyte
sequestration crisis
sickle cell with low reticulocytes
aplastic anaemia caused by Parvovirus
diagnostic criteria for tumour lysis syndrome (TLS)
positive laboratory TLS (raised uric acid, hyperkalaemia, hyperphosphataemia or hypocalcaemia)
AND
positive clinical TLS (increased creatinine, cardiac arrhythmia or seizure)
ABX for neutropenic sepsis
IV Tazobactam and Piperacillan (Tazocin)
what can myelodysplasia transform into?
AML
what can CML transform into?
AML or ALL
what can CLL transform into?
non-Hodgkin’s lymphoma (Richter’s transformation)
CML bloods
increase in granulocytes at different stages of maturation
anaemia
CLL bloods
lymphocytosis
anaemia
smudge cells
transfusion threshold NO ACS
70 g/L
transfusion threshold ACS
80 g/L
features of TTP (thrombotic thrombocytopenic purpura)
FAT RN Fever Anaemia Thrombocytopenia Renal failure Neuro features
myeloma bloods
raised Ca
normal/high phosphate
normal ALP
mx of antiphospholipid syndrome
primary thromboprophylaxis - low dose aspirin
secondary thromboprophylaxis - lifelong warfarin
- initial VTE - target INR of 2-3
- recurrent VTE - target INR of 3-4 (if occurred whilst taking warfarin then consider adding low-dose aspirin)
- arterial thrombosis - target INR 2-3
features of multiple myeloma
CRABBI
Calcium raised Renal failure Anaemia Bone lesions Bleeding (thrombocytopenia) Infection
FBC in beta thalassaemia trait
Microcytosis disproportionate to anaemia
what are acute haemolytic transfusion reactions the result of
RBC destruction by IgM antibodies
features of tumour lysis syndrome
hyperkalaemia
hyperphosphataemia
hypocalcaemia
mx of tumour lysis syndrome
Allopurinol
which leukaemia may polycythaemia rubra vera transform into
AML
ITP in adults
thrombocytopenia
any of: purpura, epistaxis or major haemorrhage (e.g. intracranial)
universal donor of fresh frozen plasma
AB RhD negative blood
inheritance pattern of G6PD deficiency
X-linked
direct Coombs test
autoimmune haemolytic anaemia
blood film findings in AML
Auer rods
dx for painful vaso-occlusive crisis in sickle cell
clinical - no additional tests will confirm this
when to think about autoimmune haemolytic anaemia
anaemia in Mycoplasma infection with raised LDH and raised unconjugated bilirubin
antibodies to measure in macrocytic anaemia
INTRINSIC FACTOR
blood film findings of G6PD deficiency
bite and blister cells
bloods in DIC
low platelets and fibrinogen
prolonged PT, APTT and bleeding time
bloods in alcoholic liver disease
macrocytic anaemia
thrombocytopenia
when to transfuse platelets
platelet count <30x10^9 and clinically significant bleeding
platelet count <10x10^9 if no active bleeding
bloods in von Willebrand disease
normal platelets
prolonged bleeding time
prolonged APTT
bloods in anaemia of chronic disease
normocytic anaemia
low serum iron
low TIBC
raised ferritin
