Haem Flashcards
Give the signs of iron deficiency anaemia
Koilonychia
Angular stomatitis
Atrophic glossitis
Hair loss
What are the SE of ferrous sulphate?
Black stools
Constipation
Vomiting
What would you seen on a blood smear in someone with thalassaemia?
Microcytic, target cells with nucleated RBC
How would you treat someone with thalassaemia who is symptomatic?
Transfusion + desferrioxamine
What does the Coombs test look for?
Looks for antibodies against RBC
What’s the difference between the direct and indirect Coombs test?
Direct test is done on RBC to detect abs that are already attached (abs directly on the RBC)
The indirect coombs is done to the serum of the blood to detect abs there - used in prenatal testing to screen for abs that could potentially cause haemolytic anaemia in the newborn
What abs are associated with TTP?
Anti-ADAM TS13 abs
How do you treat ITP?
Immunosuppression and transfusion
IVIG + prednisolone
Platelet transfusion
Explain what Thrombotic thrombocytopenic purpura is
Microangiopathic haemolytic anaemia with thrombocytopenic purpura
It is a very rare disease with a high fatality rate.
Usually presents in adults.
? Due to decreased ADAM TS13 - from Anti-ADAMTS13 abs
Causes lots of clots in the microvasculature –> end organ damage - kidneys, heart, brain + NS
How do you treat TTP?
Urgent plasma exchange
+ prednisolone
+ aspirin
What are some of the causes of DIC?
Shock, sepsis, obstetric, malignancy, trauma and burns
Explain what DIC is
DIC is a complication of an underlying condition.
Initial thrombosis causes an activation of coagulation pathways with fibrin deposition in microvascular circulation.
Consumption of coagulation factors and fibrin
Haemorrhage + organ dynsfunction due to vascular occlusion
What would the following blood tests show in DIC?
Plts, fibrinogen, PT, APTT, D dimer
Low platelets and fibrinogen
High PT, APTT and D dimer
What are some of the causes of prolonged PT?
Warfarin (extrinsic) VK deficiency from malabsorption Liver disease (decreased production of clotting factors) DIC Hypothermia
What are some of the causes of elevated APTT
Heparin use (intrinsic)
Lupus anti-coagulant (anti-phospholipid syndrome)
Haemophilia A&B
Factor XII + XI deficiencies
How do you treat DIC?
Supportive to stop the bleeding
Platelet transfusion
FFP - for the coagulation factors
Cryoprecipitate
What is haemophilia?
AR inherited disease in which people cannot form blood clots - bleeding problem
Haemophilia A = deficient in factor 8
Haemophilia B = deficient in factor 9
No activation of the coagulation cascade via the intrinsic pathway causing no fibrin to be produced via the intrinsic pathway
What are some of the complications of haemophilia?
Deep internal joint bleeding
Joint damage
Intracranial haemorrhage
What is polycythema ruba vera?
It is a myeloproliferative disorder which is predominantly red cells (but also WBC + Plts)
BM overactivity
What is the pathology behind polycythemia ruba vera?
JAK-2 mutation which is an on/off switch for the bone marrow - mutation means the production is on
How might someone with Polycythemia ruba vera present?
Hyperviscosity - headaches, flushing, Vessel congestion - facial plethora, ruddy look VTE - stroke, mi, PE, DVT Gout Pruritus on bathing HSM
What is immune thrombocytopenic purpura
It is an AI condition that leads to destruction of platelets
IgG to platelets against GP2b/3a - the spleen then destroys the platelets with these abs on them
