haem

Question 1

explain DIC

Answer 1

simultaneous coagulation and haemorrhage whilst consuming plateleets and clotting facotrs leadign to excess bleeding.

d dimer then raised due to increase clot formation adn the degredation raises it

fibrinogen down as nroamlly clots but down due to excess clot formation
reduced platelets as used up

Question 2

differnce between warma nd cold

Answer 2

Warm autoimmune haemolytic anaemia (AIHA) pathophysiology
Warm AIHA is an IgG mediated extravascular haemolytic disease in which the spleen tags cells for splenic phagocytosis

Causes of warm AIHA
Idiopathic
Lymphoproliferative neoplasms (CLL and lymphoma)
Drugs including methyldopa
SLE
Cold autoimmune haemolytic anaemia (AIHA) pathophysiology
Cold AIHA is an IgM-mediated haemolytic disease in which IgM fixes complement causing direct intravascular haemolysis (also known as cold agglutinins)

Causes of the cold AIHA:
Idiopathic
Post-infectious haemolytic anaemias: occurring 2-3 weeks after infection (examples include EBV and mycoplasma)

Question 3

what drugs can cause addisonian crisis

Answer 3

corticosteriods

In serious cases this can lead to shock, typically seen as hyperkalaemic hypotension. The management for this is to give more steroids usually as IV hydrocortisone.

Question 4

how does platelet plug form

Answer 4

Von Willebrand Factor binds to exposed collagen to begin the process of platelet plug formation

This is the correct answer. Damage to a blood vessel causes exposure of collagen. vWF binds to collagen which acts as a molecular anchor for platelets to join and begins the process of platelet plug formation

Question 5

active cancer what anticoagualtn

Answer 5

Low-molecular-weight heparin (LMWH) for 6 months

LMWH is the anticoagulant of choice in patients with active cancer; NICE recommends a course length of 6 months.

Question 6

ITP

Answer 6

Immune thrombocytopenic purpura (ITP) is characterised by low platelets leading to bruising (purpura) and petechiae. It is common in children and usually occurs after a viral infection or vaccination. Most cases of paediatric ITP resolve within 6 weeks

Thrombotic thrombocytopenic purpura (TTP) is another cause of thrombocytopenia. clots in small blood vessels leading to thrombocytopenia and haemolytic anaemia. Due to the blood clots, TTP often presents with neurological symptoms such as headaches, visual changes and kidney failure. organ failure.

Disseminated intravascular coagulation (DIC) is another cause of thrombocytopenia. leads to excessive activation of the body’s coagulation system. This presents with both haemorrhage and thrombosis. DIC is usually associated with sepsis in children; in these cases, the child is very unwell.

Haemolytic uraemic syndrome (HUS) is another cause of thrombocytopenia. acute renal impairment and microangiopathic haemolytic anaemia. It is most common in children and is usually caused by certain strains of E. coli bacteria. In these cases, the first symptom is usually diarrhoea.

Question 7

with intermittently red/pink urine in the morning (following concentration of urine overnight).

Answer 7

noctural

Question 8

in ramsay h