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Finals round 2 lol > Haem > Flashcards

Haem Flashcards

1
Q

What antibiotic is contraindicated in G6PD deficiency

A

ciprofloxacin

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2
Q

how does factor v leiden increase risk of VTE

A

factor V is a clotting agent
protein c inactivates it 10 times slower

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3
Q

Role of von willibrand factor

A

large glycoprotein that triggers platelet adhesion to damaged endothelium
Normal platelets, raised APTT, raised bleeding time

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4
Q

What is used to monitor heparin

A

APTT
Activates antithrombin III. Forms a complex that inhibits thrombin, factors Xa, IXa, Xia and XIIa

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5
Q

What is used to monitor LMWH

A

Factor Xa
Activates antithrombin III. Forms a complex that inhibits factor Xa

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6
Q

polycythaemia vera long term management

A

aspirin

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7
Q

what factors does warfarin affect?

A

2,7,9,10

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8
Q

treatment of von willibrand

A

desmopressin

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9
Q

TTP deficiency

A

ADAMTS13 which breaks down large clumps of von willebrand factor

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10
Q

polycythaemia vera complications

A

AML or myelofibrosis

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11
Q

trasnfusion thresholds

A

normally 70g/L but 80g/L if ACS

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12
Q

drugs contraindicated in G6PD

A

sulph- drugs: sulphonamides, sulphasalazine and sulfonylureas can trigger haemolysis
anti-malarials: primaquine
ciprofloxacin

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13
Q

first line investigation for PRC

A

JAK2 mutation

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14
Q

AIHA treatment

A

steroids + rituximab

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15
Q

secondary cause of PRV

A

copd: hypoxia leads to increased EPO

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16
Q

Wide distribution of red blood cells/High RDW

A

mixed anaemia e.g. iron deficiency with b12.

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17
Q

Blister cells

A

G6PD

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18
Q

electrolyte abnormality with packed red blood cells

A

hyperkalemia

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19
Q

what viral infection causes facial flushing

A

dengue fever

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20
Q

waldenstroms macroglobulinaemia

A

secretion of a monoclonal IgM paraprotein

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21
Q

platelet transfusion before invasive procedure

A

must be above 50

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22
Q

1st line imaging for multiple myeloma

A

whole body MRI

23
Q

acute haemolytic transfusion reaction patho

A

Binding of IgM-type antibodies to red blood cells causing haemolysis
39%

24
Q

how to differentiate AML and CML

A

AML: neutropenia
CML: neutrophillia

25
Q

atypical lymphocytes

A

glandular fever

26
Q

richters transformation

A

CLL -> non-hodgkins (DLBCL)

27
Q

reverseal of dabigatran

A

idarucizumab

28
Q

Reversal of other doacs

A

andexanet alfa

29
Q

why are irradiated blood products used

A

avoid transfusion-associated graft versus host disease e.g. hodgkins lymphoma

30
Q

most common type of hodgkins lymphoma

A

nodular scelrosing

31
Q

painful when drinking alcohol

A

hodgkins

32
Q

clinical TLS signs

A

increased serum creatinine (1.5 times upper limit of normal)
cardiac arrhythmia or sudden death
seizure

33
Q

gastric malt lymphoma association

A

h.pylori (non-hodgkin’s)

34
Q

G6PD diagnosis

A

enzyme assay at the time and in 3 months

35
Q

what effect can p450 inducers have on warfarin

A

increased clearance

36
Q

cause of acute haemolytic febrile reaction

A

ABO incompatible blood

37
Q

Name 2 immediate steps that need to be taken after a acute haemolytic reaction

A

Stop blood transfusion & inform the hospital Transfusion Laboratory
Take a post transfusion sample from patient & send to Transfusion Laboratory for direct Coombs test, repeat typing and cross-matching

38
Q

What can cause TACO

A

Excessive rate of transfusion, pre-existing heart failure

39
Q

what causes minor allergic reaction in transfusions?

A

reaction to foreign plasma proteins

40
Q

cause of non-haem febrile reaction

A

antibodies reacting with white cell fragments in the blood product and cytokines that have leaked from the blood cell during storage

41
Q

sickle cell management

A

pneumococcal polysaccharide vaccine every 5 years

42
Q

HbH vs Barts

A

HbH: beta chains form tetrameres (splenomegaly, hypochromic, microcytic anaemia)
Barts: gamma chains form tetramers (hydrops fetalis)

43
Q

How can warfarin lead to skin necrosis

A

when warfarin is first started biosynthesis of protein C is reduced
this results in a temporary procoagulant state after initially starting warfarin, normally avoided by concurrent heparin administration
thrombosis may occur in venules leading to skin necrosis

44
Q

features of haemochromatosis

A

fatigue, erectile dysfunction and arthralgia (often of the hands)
‘bronze’ skin pigmentation
diabetes mellitus

45
Q

vitamin k dependent clotting factors

A

2,7,9,10

46
Q

blood products

A

Fresh frozen plasma (FFP)
- universal donor of FFP is AB blood because it lacks any anti-A or anti-B antibodies

Cryoprecipitate
- contains concentrated Factor VIII:C, von Willebrand factor, fibrinogen, Factor XIII and fibronectin
- fibrinogen concentration < 1.5 g/L

Prothrombin complex concentrate
- emergency reversal of anticoagulation in patients with either severe bleeding or a head injury with suspected intracerebral haemorrhage

47
Q

factors to reduce risk of sickle cell crisis

A

avoid dehydration/cold/exhaustion
smoking + alcohol

48
Q

neutropenic sepsis organism

A

staph epidermis

49
Q

target cells
‘pencil’ poikilocytes

A

iron deficiency

50
Q

most common type of non-hodgkins lymphoma

A

diffuse large b cell

51
Q

contraindications to platelet transfusion

A

Chronic bone marrow failure
Autoimmune thrombocytopenia
Heparin-induced thrombocytopenia, or
Thrombotic thrombocytopenic purpura.

52
Q

complication of myelodysplasia

A

AML

53
Q

transformations

A

Myelodysplasia –> AML
CML –> ALL or AML
CLL –> NHL

Finals round 2 lol (24 decks)

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