Haem Flashcards by zaynah yousaf

What antibiotic is contraindicated in G6PD deficiency

ciprofloxacin

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how does factor v leiden increase risk of VTE

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

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Role of von willibrand factor

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

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What is used to monitor heparin

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

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What is used to monitor LMWH

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

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polycythaemia vera long term management

aspirin

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what factors does warfarin affect?

2,7,9,10

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treatment of von willibrand

desmopressin

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TTP deficiency

ADAMTS13 which breaks down large clumps of von willebrand factor

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polycythaemia vera complications

AML or myelofibrosis

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trasnfusion thresholds

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

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drugs contraindicated in G6PD

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

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first line investigation for PRC

JAK2 mutation

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AIHA treatment

steroids + rituximab

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secondary cause of PRV

copd: hypoxia leads to increased EPO

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Wide distribution of red blood cells/High RDW

mixed anaemia e.g. iron deficiency with b12.

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Blister cells

G6PD

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electrolyte abnormality with packed red blood cells

hyperkalemia

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what viral infection causes facial flushing

dengue fever

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waldenstroms macroglobulinaemia

secretion of a monoclonal IgM paraprotein

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platelet transfusion before invasive procedure

must be above 50

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1st line imaging for multiple myeloma

whole body MRI

acute haemolytic transfusion reaction patho

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

how to differentiate AML and CML

AML: neutropenia
CML: neutrophillia

atypical lymphocytes

glandular fever

richters transformation

CLL -> non-hodgkins (DLBCL)

reverseal of dabigatran

idarucizumab

Reversal of other doacs

andexanet alfa

why are irradiated blood products used

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

most common type of hodgkins lymphoma

nodular scelrosing

painful when drinking alcohol

hodgkins

clinical TLS signs

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

gastric malt lymphoma association

h.pylori (non-hodgkin's)

G6PD diagnosis

enzyme assay at the time and in 3 months

what effect can p450 inducers have on warfarin

increased clearance

cause of acute haemolytic febrile reaction

ABO incompatible blood

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

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

What can cause TACO

Excessive rate of transfusion, pre-existing heart failure

what causes minor allergic reaction in transfusions?

reaction to foreign plasma proteins

cause of non-haem febrile reaction

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

sickle cell management

pneumococcal polysaccharide vaccine every 5 years

HbH vs Barts

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

How can warfarin lead to skin necrosis

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

features of haemochromatosis

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

vitamin k dependent clotting factors

2,7,9,10

blood products

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

factors to reduce risk of sickle cell crisis

avoid dehydration/cold/exhaustion smoking + alcohol

neutropenic sepsis organism

staph epidermis

target cells 'pencil' poikilocytes

iron deficiency

most common type of non-hodgkins lymphoma

diffuse large b cell

contraindications to platelet transfusion

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

complication of myelodysplasia

AML

transformations

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