Haem Flashcards
What blood tests make up a confusion screen?
B12 / folate –> deficiency may worsen confusion
TFTs –> hypothyroidism
glucose –> hypo
bone profile –> hypercalcaemia
A 28-year-old woman has given birth vaginally 2 days ago and is now complaining of constant dizziness. She has a full blood count sent which shows:
Hb 67 g/L Male: (135-180)
Female: (115 - 160)
You decide to consent and prescribe two units of red blood cells to improve her anaemia. A midwife calls for you to come see the patient, who has just been started on a blood transfusion. After assessing the patient, you decide that she is suffering from a transfusion reaction.
Which of these signs/symptoms would you find most concerning?
Hypotension
could be a sign of anaphylaxis, acute haemolytic reaction or transfusion-related acute lung injury (TRALI).
what is the major component of cryoprecipitate?
Factor VIII
How would porphyria classically present?
abdominal pain and potentially the neuropsychiatric symptoms of hallucinations
how would you treat acute intermittent porphyria?
IV haem arginate
IV glucose if not available
What is a classic clinical finding of porphyria?
urine turns deep red on standing
A 64-year-old male with non-Hodgkin lymphoma (NHL) attends the emergency department with fever, shivering, and feeling generally unwell. Observations reveal a temperature of 38.6ºC, pulse rate of 116 beats/min, blood pressure of 102/62mmHg, and a respiratory rate of 24 beats/min. On chest auscultation, there are crackles and bronchial breathing in the left upper zone. Urine dip is negative for leucocytes and blood tests show a neutrophil count of 0.4. His last cycle of chemotherapy was 10 days ago.
What is the Dx and the most appropriate antibiotic treatment to start for this patient?
neutropenia sepsis
Tazocin (Piperacillin with tazobactam)
if CI: Intravenous aztreonam and vancomycin
What blood results would you expect to find in primary hyperparathyroidism?
High calcium, high parathyroid hormone and low phosphate
What is the most common cause of primary hyperparathyroidism?
solitary adenoma
What is a major criteria for determining the use of cryoprecipitate?
low fibrinogen - replaces fibrinogen
A 44-year-old man undergoes a distal gastrectomy for cancer. He is slightly anaemic and therefore receives a transfusion of 4 units of packed red cells to cover both the existing anaemia and associated perioperative blood loss. He is noted to develop ECG changes that are not consistent with ischaemia. What is the most likely cause?
Hyperkalaemia
Infusion of packed red cells has been shown to increase serum potassium levels
