Haem

Question 1

Sickle Cell Crises

Thrombotic
Sequestration
Aplastic
Haemolytic

Answer 1

Thrombotic: various organ infarcts, precipitated by infection, dehydration, deoxygenation.

Sequestration: sickling within organs; acute chest syndrome, SOB, chest pain. Causes death in adults.

Aplastic: sudden fall in Hb after parvovirus infection

Haemolytic: rare.

Question 2

Splenectomy

Following a splenectomy patients are particularly at risk from pneumococcus, Haemophilus, meningococcus and Capnocytophaga canimorsus* (dog bites) infections

Answer 2

Antibiotic prophylaxis with penicillin V

Hib, meningitis A & C
Annual influenza vaccination
Pneumococcal vaccine every 5 years