Haem Flashcards
Treatment of neutropenic sepsis
IV tazocin (piperacilin and tazobactam)
Treatment of Waldenstroms macroglubulinaemia
Chemotherapy
Plasmapheresis
How long should you treat provoked DVT for?
3 months
How would you treat low fibrinogen levels?
Cryoprecipitate
When would you see a c-myc gene translocation?
Burkitt’s lymphoma
How would you treat von Willebrand’s disease
Tranexamic acid/desmopressin/factor VIII concentrate
What investigation should you do in polycythemia rubra vera?
Do JAK-2 mutation screen
Adverse effect of anthracyclines?
They can cause cardiomyopathy
danrubicin, doxorubicin, mephalan
Adverse effects of vinblastin/vincristine?
Can cause neuropathy
Adverse effect of cis-platin?
Nephrotoxicity
Auer rod
AML
Philadelphia chromosome
CML
How to reverse heparin
Protamine
How to reverse warfarin?
1) omit dose
2) administer vitamin K
3) administer clotting factors (FFP or factor concentrate)
What type of anticoagulant would you use for prophylaxis in elective hip and knee surgery?
NOAC e.g. apixaban, rivaroxiban, dabigatran
Normal quantity of free light chain production
Normally 0.5g/day (if more then excess can leak into urine as bence-jones protein)
CD20+ve cells
Follicular non-hodgkins
CD30+ve cells
Hodgkins lymphoma
Reed steernberg cells
Hodgkins
When is platelet transfusion contraindicated?
In HUS and TTP
Most common type of hodgkin lymphoma
Nodular sclerosing
This type of hodgkins lymphoma is associated with lacunar cells
Nodular sclerosing
Which type of hodgkin lymphoma carries the best prognosis?
Lymphocyte predominant
Which type of hodgkin lymphoma carries the worst prognosis?
Lymphocyte depleted
What does a raised LDH suggest?
Suggests cell lysis
Severe pain on alcohol consumption
Hodgkins
What is aplastic anaemia?
Normocytic anaemia
Leukopenia
Thrombocytopenia
Treatment of aplastic crises?
Treatment is by managing symptoms of anaemia –> usually with a blood transfusion
First line management of hairy cell leukaemia?
Chemotherapy
When should you give aspirin to pregnant women who have anti-phospholipid syndrome?
Initiate once a fetal heart is seen on ultrasound and continue up until 34 weeks
Mirror image nuclei?
These are reed sternberg cells - seen in Hodgkins
If you are giving more than two units of packed red cells, what should you also give?
Should give loop diuretic - giving more than two units can result in fluid overload
What blood product is most likely to cause an iatrogenic septicaemia with a gram positive organism?
Platelets
When would you see smudge/smear cells?
CLL
Diagnostic test for hereditary spherocytosis
Osmotic fragility test
Which condition might you see a rouleaux in?
Myeloma
What might you see on a blood film post-splenectomy?
Howell-Jolly bodies, target cells, pappenheimer bodies
What is evan’s syndrome?
ITP in association with warm AIHA
What happens during a sequestration crisis?
The sickle cells cause the spleen to become grossly enlarged. This causes abdominal pain.
This is more common in childhood and eventually repeated sequestration and infarction of the spleen results in auto-splenectomy.
A sequestration crisis may result in severe anaemia, marked pallor and cardiovascular collapse due to loss of circulating volume
Why might you use irradiated blood products?
They reduce the risk of graft versus host disease
What type of blood should you use for transfusions in pregnancy?
CMV negative blood
Which antibiotics can cause haemolysis in G6PD?
Co-trimoxazole and ciprofloxacin
The COC and surgery?
Stop pill 4 weeks before surgery
These are recommended for the treatment of post-thrombotic syndrome
Compression stockings (e.g. graduated compression stockings)
What might myelodysplasia progress to?
May progress to AML
“CRAB” features of multiple myeloma
hyperCalcaemia
Renal failure
Anaemia (and thrombocytopenia)
Bone fractures/lytic lesions
Investigation for myeloma
Serum electrophoresis
When does transfusion associated graft versus host disease occur?
Usually occurs 4-30 days after a transfusion
What can you give to stimulate release of von willebrand factor?
Desmopressin
Most common type of lymphoma in the UK?
Diffuse large B cell lymphoma
What is Ritcher’s transformation?
When CLL transformed to high grade lymphoma (non-hodgkins)
What is cryoprecipitate mainly made from?
Factor VIII
Abdominal pain, motor peripheral neuropathy and blue line around gums
Lead poisoning
Most useful test to establish polycythemia rubra vera?
JAK2 mutation screen
Most common inherited thrombophilia?
Activated protein C resistance (factor V leiden)
Common cause of tumour lysis syndrome
Burkitt’s lymphoma
Characteristic blood film finding of CLL
Smear cells (also called smudge cells)
