haem Flashcards
myelodysplastic syndromes
< 20 blasts in plasma
30% leads to AML
more susceptible to infection
give antibiotics
blood transfusion w iron chelation
AML
> 20 blasts
bone failure- anaemia, thrombocytopenia, infections
FBC, bone marrow aspirate- blast cells, blood film- auer rods
supportive care
chemo
remission- <5% blasts
haemolytic disease of newborn
anti D prophylaxis at 28 weeks and 34 weeks
jaundice
neg mum pos baby
indirect coombs test
Positive Direct Antiglobulin Test (DAT)
Anaemia, Jaundice
hyposplenism
howell jolly bodies
pitted erythrocytes
antibiotic prophylaxis
vaccinations
G6PD defic
normocytic, intravascular haemolytic anaemia
low haptoglobin
high retic
raised
antimalarials
fava beans
infection
spherocytes
heinz bodies
bite/ blister cells
negtaive coombs
treat folic acid
haemorrhagic disease newborn
vit K deficient
bulging fontanelle
prolonged PT AND APTT
caused by drugs in pregnancy
give vit K
Intracranial bleeding
Gastrointestinal bleeding
Post-circumcision bleeding
Umbilical stump bleeding
thalassemia
most common- beta 1
autosomal recessive
hair on end appearance on CT
clotting cascade
Xa they join
subendothelial contact is intrinsic
cellular damage is extrinsic
APTT is intrinsic
PT is extrinsic
Xa turns prothrombin into thrombin
anaemia of chronic disease
normocytic or microcytic
cancers
COPD
infection
RA
low ferritin
high total binding iron
give iron 3 months- doesnt work then anaemia of chronic disease
treat underlying cause
EPO
folate or B 12
IM B12 and folate
first B12 because paraesthesia gets worse if u give folate first
MGUS
<9% of bone marrow is plasma one cell
>9% is myeloma
haemophilia
bleeding after trauma
haemarthroma
big bulges
A- vonwillebronjames associated. 8. more common and more severe
B- 9
drainage
IV recombinant factor
give fresh frozen plasma
tranexamic acid
lemon yellow tinge
b12 and folate
macrocytic
megaloblastic
ALL
tumour marker CD19
blast cells on blood film
blast cells >20% of bm
neuropathic symptoms more than CML
chemo 4-6 weeks
methotrexate 18 months
CLL
lymphocytes >5
B cells
smudge and smear cells
binet
watch and wait
chemo
rituximab- monoclonal
treatment ET
aspirin
hydroxycarbamide
PRV
extra cells
itchy in shower
venesection weekly
aspirin
primary myelofibrosis
everything decreased
tear drop poikolyctes
dry tap aspirate
give epo
give platelets
give hydroxycarbamide
cure w allogeneic stem cells
hereditary spherocytosis
normocytic haemolytic
spherocytes
anaemia
pigment gallstone
DAT/ coombes - pos. extravascular
autoimmune
autosomal recessive
folic acid
transfusion
aplastic
parvovirus B19
treatment von willedbrand
Type 1: Tranexamic acid or Desmopressin (DDAVP) more please. stimulation
Type 2 and 3: Factor VIII and von Willebrand factor (vWF). theres is useless or they have none
type 1 quantitative
2 qualitative
3 none
OCP for menorrhagia
sickle cell
autosomal recessive
HbS trait
HbSS is the disease
manage crisis conservatively
prophylaxis for malaria- proguanil
vaccines
hydroxycarbamide- get rid of bad cells
bone marrow transplant
but protective for malaria weirdly
aplastic crisis
breathlessness
fatigue
unwell and random
factor V leiden
autosomal dominant
too much clotting
protein C is like no stop but he doesnt listen to C he keeps clotting
recurrent miscarriage
shortened APTT
preventation anti coags
doacs
heparin induced thrombocytopenia
lose 30% within 5-10 days
TTP
hereditary or aquired anti adam
fatigue
purpura
organ damage
too many thrombi
when u actually need it u dont have enough platelets
stops the inactivation of VWD
antibodies against adam ts 13
plasma
aspirin
heparin
HUS
haemolysis
thrombocytopenia
AKI
bloody diarrhoea
abdo pain
caused by gastroenteritis
treat- monitor kidneys
give saline
avoid toxic drugs
DIC
prolonged PT and APTT
increased D dimer
decreased fibrinogen
thrombocytopenia
schistocytes
Microvascular thrombosis leading to tissue ischaemia
Mucosal bleeding, poor healing and bleeding from wounds
ulceration and gangrene formation
fresh frozen plasma
supportive
treat underlying cause
APLS
miscarriages recurrent ≥3 recurrent miscarriages
Coagulation Screen (Partial Thromboplastin Time: aPTT)
Anticardiolipin antibodies
Control cardiovascular risk
if had venous event lifelong Warfarin (INR 2-3) and consider a higher INR if its inadequate
History of Recurrent miscarriage: Active Monitoring along with Low Molecular Weight Heparin (LMWH) and Aspirin throughout pregnancy
Systemic Lupus and APLS: Hydroxychloroquine (thromboprotective)
universal donor of platelets
AB
universal recipient of other stuff
myeloma is normally paraproteins for what
IgG and IgA
waldenstrom IgM
myeloma
chemo, steroids, bisphosphonates
serum electrophoresis
bone aspirate
bence jones protein in urine
neutropenic sepsis
rigor
fever
source of infection
neutropenia
ITP
caused by vaccinations
children
chicken pox
CLL
sick
FBC low platelets
purpura
coagulopathy screen
steroids first line
IV immunoglobulins
non hodgkins
not got reed sternberg
not painful lymphoma
mid life
chemo and CD20 straight away
burkitts- starry nighst sky on aspiration
lymphoma risk factors
EBV
HIV
immunosuppression
smoking
ann arbour
hodgkins
hurts when drinking alcohol
reed sternberg
chemo first
then CD30
haemochromatosis
recessive
accumulation of iron in the body
bronze pigmentation of the skin
pearls prussian blue positive in liver
defective hepcidin (he usually says im done in give me no iron)
stop eating iron
venesection
iron chelation
