haem Flashcards
management of post-thrombotic syndrome (swelling, varicose veins, pruritis, heavy calves)
compression stockings
keep leg elevated
the most common inherited clotting bleeding disorder
Von willebrand’s disease
- usually prolonged bleeding after dental extraction
what is the mode of inheritance of von willebrand’s disease
autosomal dominant
there are 3 types of von willebrand disease - what differs between them
Type 1: partial vWF reduction (80%)
Type 2: abnormal vWF
Type 3: complete lack of vWF
what carrier molecule does von willebrand factor help
factor 8
it also promotes platelet adhesion
Prolonged PT
Prolonged APTT
Reduced factor 8
Defective platelet aggregation with ristocetin
Nosebleeds
Heavy periods
What is the diagnosis
von willebrand’s disease
Management of von willebrand’s disease bleeding
Tranexamic acid - for mild bleeding
Desmopressin
Factor 8 concentrate
Cancer patients with VTE treatment and length
6 months of DOAC
Patients taking bone marrow suppression drugs (especially methotrexate) should avoid which eye drops
CHLORAMPHENICOL
can cause aplastic anaemia
In cancer patients who are neutropenic, what type of exam should not be done
PR EXAM
avoid translocation of flora through rectal mucosa
what is neutropenic sepsis defined as
Neut <0.5 * 10^9
And one of:
temp >38 or
septic
What bacteria are the most common cause of neutropenic sepsis
Staphylococcus epidermidis
(Gram +ve coagulase negative)
Management of neutropenic sepsis
Tazocin
If unwell after 48 hours, add meropenem +/- vancomycin
If no response after 4-6 days, investigate for fungal infections e.g. CT-HR
Consider G-CSF
CRAB myeloma
Calcium high
Renal failure
Anaemia
Bony pain and bleeding
in people aged 60 and over with persistent bone pain, particularly back pain, or unexplained fracture, to assess for myeloma what tests should be done
FBC
Calcium
Plasma viscosity
ESR
then if these are positive, do bence-jones protein and protein electrophoresis
+ bone marrow aspiration
+ imaging for bone lesions (MRI whole body)
sickle cell patients need to pneumococcal polysaccharide vaccine how often
every 5 years
long term management of sickle cell anaemia
hydroxyurea - to increase HbF
pneumococcal vaccine every 5 years
tamoxifen therapy effect on the risk of VTE
increases risk of VTE
COCP - which generations have high risk of VTE
3rd gen > 2nd gen
which two hormone cancer medications increase risk of VTE
raloxifene
tamoxifen
DVT investigation: if the scan is negative, but the D-dimer is positive
what should be done
stop anticoagulation
repeat USS scan in 1 week
tamoxifen increases the risk of which cancer
endometrial cancer
which haemophilia accounts for 90% of cases of haemophilia
haemophilia A
what is the mode of inheritance of haemophilia
x-linked recessive