Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

A. MLA Map Clinical Haematology > Haematological Emergencies > Flashcards

Haematological Emergencies Flashcards

1
Q

Hypercalcaemia of malignancy is a medical emergency. What is the corrected calcium level that classifies hypercalcaemia?

1 - >1.5 mmol/L
2 - >2 mmol/L
3 - >2.6 mmol/L
4 - >4 mmol/L

A

3 - >2.6 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What % of patients with solid tumours experience hypercalcaemia of malignancy?

1 - 1-2%
2 - 12-20%
3 - 20-30%
4 - 50-70%

A

3 - 20-30%

Most common cause of hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Malignancy with metastasis typically cause hypercalcaemia by which of the following mechanisms?

1 - tumour stimulate osteoblasts to degrade bone and release Ca2+
2 - tumour stimulate osteoclasts to build bone but release Ca2+
3 - direct osteolysis of the bone by bone metastasis
4 - all of the above

A

3 - direct osteolysis of the bone by bone metastasis

Osteolysis causes release of Ca2+ into the blood stream

IL-1 and TNF-a in malignancy are also linked with stimulating osteoclast maturation and more breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Some patients can develop hypercalcaemia, even in the absence of metastasis. Tumours secrete parathyroid hormone related peptide (PHTP). This can then cause which of the following?

1 - increases Ca2+ absorption in GIT
2 - increases Ca2+ reabsorption in kidney
3 - increases Ca2+ release from bones
4 - all of the above

A

4 - all of the above

In bone PTHP binds to osteoblast, releases RANK and M-CSF that stimulates osteoclasts and breaks down bone, releasing Ca2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Some patients can develop hypercalcaemia, even in the absence of metastasis. What is the most common thing secreted by tumours that can cause hypercalcaemia?

1 - ace inhibitor
2 - calcitonin
3 - parathyroid hormone related peptide
4 - erythropoietin

A

3 - parathyroid hormone related peptide

Binds to PTH receptors and acts in the same way as PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In addition to boney metastasis and parathyroid hormone related peptide (PHTP) that can cause hypercalcaemia, overexpression of 1-alpha hydroxylase, the enzyme responsible for converting 25-hydroxyvitamin D to calcitriol leads to excessive production of calcitriol (the active form of vitamin D), resulting in increased intestinal absorption of calcium and increased osteoclast activity. Which malignancy is this common in?

1 - breast cancer
2 - lung cancer
3 - lymphomas
4 - ovarian cancer

A

3 - lymphomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

All of the following cancers have been shown to increase parathyroid hormone related peptide (PHTP), causing hypercalcaemia, EXCEPT which one?

1 - squamous cell carcinoma
2 - breast cancer
3 - renal cancer
4 - colon cancer
5 - prostate cancers, melanoma
6 - neuroendocrine tumours

A

4 - colon cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypercalcaemia is an increased level of Ca2+ in the plasma. Which of the following are acute affects on the body caused by hypercalcaemia?

1 - polydipsia (thirst in an attempt to dilute)
2 - polyuria (bodies attempt to remove Ca2+)
3 - abdominal pain
4 - all of the above

A

4 - all of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which of the following is NOT a chronic effects of hypercalcaemia?

1 - diarrhoea
2 - musculoskeletal aches / weakness
3 - neurobehavioral symptoms
4 - renal calculi (kidney stones)
5 - osteoporosis (weak, painful, fragile bones)
6 - raised blood pressure

A

1 - diarrhoea
- typically causes constipation

Use the mnemonic:
- Bones = pain and osteoporotic bones
- Stones = renal calculi
- Abdominal Groans = constipation and pancreatitis
- Psychiatric Moans = confusion and hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If left untreated is hypercalcaemia dangerous?

A
  • yes

Can cause coma and death

MEDICAL EMERGENCY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If a patient presents with >3mmol/L of Ca2+ but is asymptomatic, do they need hospital admission all the time?

A
  • No

May just need fluids, assessment and discharged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In a tumour, which of the following would be correct in the blood sample suggesting hypercalcaemia?

1 - high PTH and Ca2+
2 - low PTH and high Ca2+
3 - low PTH and Ca2+
4 - high PTH and low Ca2+

A

1 - high PTH and Ca2+

PTH as tumour releases this
Ca2+ as PTH causes this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which 2 of the following may we see on an ECG in a patient if they have suspected hypercalcaemia?

1 - shortened PT interval
2 - prolonged PR interval
3 - widened QRS
4 - shortened QRS

A

2 - prolonged PR interval
3 - widened QRS

Results in a shortened QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If a patient presents with potential hypercalcaemia, all of the following should be stopped, EXCEPT which one?

1 - zoledronic acid
2 - indapamide
3 - Ca+2 and vit D supplements
4 - vitamin A

A

1 - zoledronic acid

This stops bone break down, all others contribute to increasing serum Ca2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fluids are important to give in hypercalcaemia. How much of 0.9% saline should be given over 24h?

1 - 500ml - 1L
2 - 1-2L
3 - 3-4L
4 - 6-7L

A

3 - 3-4L

Slower rehydration rates in elderly and heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In addition to addressing Ca2+ in hypercalcaemia, which 2 of the following are likely and need correcting?

1 - hyperkalcaemia
2 - hypermagnesaemia
3 - hypomagnesaemia
4 - hypokalcaemia

A

3 - hypomagnesaemia
4 - hypokalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If a patients hypercalcaemia remains above 3 mmol/L, which of the following medications should be given?

1 - indapamide
2 - vitamin A
3 - zolendronic acid
4 - spironolactone

A

3 - zolendronic acid

Give 4mg over 15 mins
Avoid if Creatinine >400 µmol/L (unless benefit outweighs potential risk

Side effects: GI upset, flu like symptoms, exacerbation of metastatic bone pain.

Chronic use can cause osteonecrosis of the mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How long does it typically take zolendronic acids to reduce Ca2+ in hypercalcaemia?

1 - <12h
2 - <48h
3 - <72h
4 - <120h

A

2 - <48h

Do not give further bisphosphonates until at least 4 days after previous dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If a patient has refractory hypercalcaemia/life-threatening symptoms, which of the following can be given?

1 - Calcitonin
2 - Denosumab
3 - Glucocorticoids
4 - Dialysis
5 - all of the above

A

5 - all of the above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Malignant spinal cord compression (MSCC) and cauda equina syndrome is a structural/obstructive emergency. What is the incidence of this in cancer patients?

1 - >45%
2 - 25-35%
3 - 5-10%
4 - 1-2%

A

3 - 5-10%

Early diagnosis and treatment can prevent functional loss and preserve quality of life

In 20% of patients this is 1st sign of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

All of the following are common places are primary cancers that can cause metastatic disease, EXCEPT which of the following?

1 - prostate
2 - lung
3 - testicular
4 - breast
5 - multiple myeloma

A

3 - testicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which part of the spine doe the majority of malignant spinal cord compression (MSCC) and cauda equina syndrome occur?

1 - thoracic spine
2 - lumbosacral spine
3 - cervical spine
4 - sacral spine

A

1 - thoracic spine

Accounts for 60-70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The spinal cord ends at L1, if there is compression above L1, does this cause LMN or UMN symptoms?

A
  • UMN (everything is heightened)

Below L1 causes lower motor neuron symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which of the following is NOT a sign of malignant spinal cord compression (MSCC)?

1 - pain is 1st symptom and precedes neurology symptoms by by several weeks
2 - pain is felt generally throughout the spine
3 - localisation of pain can be misleading e.g T10 –L1 met causing lower lumbar pain
4 - pain worse at night
5 - pain can develop into radicular quality
6 - pain may be worse on movement and cause mechanical instability

A

2 - pain is felt generally throughout the spine

Severe and worsening local pain at level of the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which of the following is NOT a red flags for cauda equina?

1 - Saddle anaesthesia
2 - Loss of sensation in the bladder and rectum
3 - Urinary retention or incontinence
4 - Faecal incontinence
5 - Bilateral sciatica
6 - Unilateral or severe motor weakness in the legs
7 - Reduced anal tone on PR examination

A

6 - Unilateral or severe motor weakness in the legs

Typically bilateral in nature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What imaging must be performed within 24 hours if you suspect cauda equina?

1 - spinal CT
2 - spinal MRI
3 - whole body MRI
4 - PET-CT

A

3 - whole body MRI

Request as “suspected cord compression” and discuss request

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which medication should be given to patients alongside adequate analgesia?

1 - Memantine
2 - Dexamethasone
3 - Haloperidol
4 - Alendronic acid

A

2 - Dexamethasone

Always prescribe PPI and monitor blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Patients with malignant spinal cord compression (MSCC) and cauda equina are advised bed rest and to lie flat or maximum 30◦ upright with spinal precautions until stability assessed. What should they be given as they are likley to be emobilised for prolonged periods?

1 - tranexamic acid
2 - asprin
3 - thromboprophylaxis
4 - all of the above

A

3 - thromboprophylaxis

29
Q

Patients with malignant spinal cord compression (MSCC) and cauda equina will need to be staged using CT CAP. All of the following markers will be checked. Match the marker with the malignancy:

  • CEA, CA125, CA19-9, PSA, myeloma screen
  • multiple myeloma, pancreatic, ovarian, colon, prostate
A
  • CEA = colon
  • CA125 = ovarian
  • CA19-9 = pancreatic
  • PSA = prostate
  • myeloma screen = multiple myeloma
30
Q

What is the most common management of malignant spinal cord compression (MSCC)?

1 - chemotherapy
2 - surgical incision
3 - systemic anti-cancer treatment
4 - radiotherapy

A

4 - radiotherapy

Surgery should be explored if surgical fit

Systemic anti-cancer treatment may be more appropriate than radiotherapy for some malignancies, for example, lymphomas, plasma-cell tumours, germ cell tumours or untreated small cell cancers.

31
Q

Which of the following is NOT a red flag for sepsis?

1 - SBP < 90mmHg or MAP <65mm Hg
2 - Respiratory rate >25/min
3- Needs O2 to keep sats >92%
4 - Heart rate >90bpm
5 - voice or pain or unresponsive
6 - Lactate >2mmol/L
7 - Urine output< 0.5ml/L
8 - Not passed urine in last 18 hours
9 - Non blanching rash, mottled/ ashen/ cyanotic
1 - Chemotherapy/ SACT within past 4 weeks (neutropenic sepsis)

A

4 - Heart rate >90bpm

This is HR >130bpm

32
Q

Which 2 are part of the criteria that make up neutropenic sepsis?

1 - temp >38
2 - lactate >1.8
3 - neutrophils <0.5 x 109/L
4 - mottled rash

A

1 - temp >38
3 - neutrophils <0.5 x 109/L

33
Q

If a patient has chemotherapy, they may be at increased risk of neutropenic sepsis. Which of the following is NOT one of the sepsis 6?

1 - take blood sample
2 - take lactate sample
3 - measure urine output
4 - take lumbar puncture sample
5 - give antibiotics
6 - give oxygen
7 - give fluid challenge

A

4 - take lumbar puncture sample

34
Q

If someone is suspected of having neutropenic sepsis, how quickly should the sepsis 6 be completed?

1 - <30 mins
2 - <60 mins
3 - <120 mins
4 - <360 mins

A

2 - <60 mins

If suspect sepsis do not hold back on any of the sepsis 6, even if patient appears well

35
Q

If a patient has neutropenic sepsis, what treatment can be given in an attempt to raise the neutrophil count?

1 - Granulocyte colony stimulating factor (GCSF)
2 - Erythropoietin
3 - Anti-diuretic hormone
4 - All of the above

A

1 - Granulocyte colony stimulating factor (GCSF)

Called Filgrastim

MUST STOP ONCE NEUTROPHIL COUNT IS >1

36
Q

Patients with tumour lysis are typically given which of the following?

1 - rifampicin
2 - cyclizine
3 - omalizumab
4 - allopurinol

A

4 - allopurinol

This is given in low risk patients.
High risk patients given Rasburicase

High urate is common in malignancy due to lysis of tumours, which is the same medication used in acute gout

37
Q

Tumour lysis is when there is a rapid cancer cell death (lysis). Is this dangerous?

A
  • Yes

Can be life threatening

38
Q

Tumour lysis is when there is a rapid cancer cell death (lysis), which can be life threatening. During tumour lysis, which of the following are released in high amounts?

1 - uric acid
2 - phosphate
3 - K+
4 - all of the above

A

4 - all of the above

Can lead to hypocalcaemia and then hyperphosphataemia.

Essentially, causes acute nephropathy and acute renal failure

39
Q

Tumour lysis is when there is a rapid cancer cell death (lysis) can be life threatening, causing acute nephropathy and acute renal failure. What is the treatment for this?

1 - Na+ infusion to balance electrolytes
2 - blood drain to dilute
3 - hyperdiuresis via excessive and often forced fluids
4 - all of the above

A

3 - hyperdiuresis via excessive and often forced fluids

3L/24hr to maintain urine output > 100ml/m2/hour
If required diuretics to maintain urine output > 100ml/m2/hour

Given alongside allopurinol

40
Q

Patients who experience tumour lysis will typically have

  • Hyperkalaemia
  • Hyperphosphataemia
  • Hyeruricaemia
  • Hypocalcaemia

Which of the following can be caused by this electrolyte imbalance:

1 - arrhythmias
2 - neuromuscular irritability
3 - seizures
4 - death
5 - all of the above

A

5 - all of the above

Need to do an ECG to monitor cardiac rhythm

41
Q

Renal failure can occur in tumour lysis but this is typically secondary due to what?

1 - Hyperkalaemia
2 - Hyperphosphataemia
3 - Hyeruricaemia
4 - Hypocalcaemia

A

3 - Hyeruricaemia

42
Q

Nearly all cytotoxics can cause GIT irritation and diarrhoea, which can lead to dehydration and AKI. If the diarrhoea is caused by chemotherapy/radiotherapy, which 2 of the following should be prescribed to patients?

1 - loperamide
2 - codeine
3 - opioids
4 - senna

A

1 - loperamide
2 - codeine

Loperamide is an anti-diarrhoeal

43
Q

Which of the following may cause syncope, SOB, stridor, neck and facial swelling, dizziness and headaches, collateral development on the chest?

1 - heart failure
2 - superior vena cava obstruction
3 - pancost tumour
4 - COPD

A

2 - superior vena cava obstruction

Can occur following surgery for lung cancer
Cancer has come back and caused an obstruction that grows insidiously

44
Q

Which of the following would NOT be part of treatment for a patient presenting with superior vena cava obstruction?

1 - sit the up
2 - O2 as required
3 - antibiotics
4 - dexamethasone (steroids)
5 - stenting
6 - anticoagulant

A

3 - antibiotics

Steroids can affect patients sleep
Always prescribe PPI with steroids as they can cause ulcers

45
Q

Which of the following are common symptoms that present in superior vena cava obstruction?

1 - face and neck swelling
2 - headaches/dizziness
3 - syncope
4 - conjunctival oedema
5 - compensatory collaterals on the chest
6 - all of the above

A

6 - all of the above

46
Q

When transfusing blood, how much should the Hb go up following the transfusion of 1 unit?

1 - 10g/L
2 - 20g/L
3 - 40g/L
4 - 80g/L

A

1 - 10g/L

47
Q

In a healthy patient with no acute settings, what is the cut off of when they need to be transfused blood?

1 - 120g/L
2 - 100g/L
3 - 70g/L
4 - 40g/L

A

3 - 70g/L

48
Q

In a patient with cardiac or renal dysfunction, what is the cut off of when they need to be transfused blood?

1 - 120g/L
2 - 80g/L
3 - 70g/L
4 - 40g/L

A

2 - 80g/L

49
Q

In addition to giving a patient a blood transfusion, they should be given all of the following, EXCEPT which one?

1 - vitamin A
2 - iron
3 - folate
4 - B12

A

1 - vitamin A

1 unit of blood will give the patient the boost they need, then the other things will help increase Hb

50
Q

When transfusing blood, only one unit should be requested at a time. Following a transfusion, which of the following should be performed?

1 - check to see if patient remains anaemic
2 - signs/symptoms of transfusion reaction
3 - assess need for further transfusion
4 - re-assess Hb level
5 - all of the above

A

5 - all of the above

51
Q

When transfusing blood, what time period should this typically be given in a non-acute/trauma setting?

1 - 15mins
2 - 1h
3 - 3h
4 - 5h

A

3 - 3h

If cardiac/renal impairment, may adjust and give this over 4h

52
Q

When transfusing blood, what time period should this typically be given in an acute/trauma setting?

1 - 15mins
2 - 1h
3 - 3h
4 - 5h

A

1 - 15mins

Essentially as fast as possible

53
Q

In patients with cardiac failure, which of the following medications is most appropriate to be given alongside the blood transfusion?

1 - aspirin
2 - DOAC
3 - furosemide
4 - digoxin

A

3 - furosemide
Typically 20mg IV

Helps remove oedema without affecting the RBCs as these are too large to pass through the kidneys

54
Q

Which of the following should be done 1st if a patient has a blood transfusion reaction?

1 - vitals of patient
2 - contact superior
3 - stop the blood
4 - all done at the same time

A

3 - stop the blood

All important, but the offending agent needs to be stopped

55
Q

A patient receives 1 unit of blood and is discharged home. He then returns to A&E and appears jaundiced with the following results?

  • Hb 61g/L
  • WBC 10 x 109/L
  • Platelets 177 x 109/L
  • ALT 40
  • Bilirubin 77
  • Reticulocytes ++
  • Direct antiglobulin test +++ (IgG)

What is the most likely cause for the patients presentation?

1 - autoimmune haemolysis
2 - sickle cell disease
3 - blood transfusion reaction
4 - lupus

A

3 - blood transfusion reaction

Likely wrong blood was given, or blood given contains antibodies or antigens from the wrong blood group

56
Q

If a patient has a blood transfusion reaction due to the incorrect blood, which of the following should be started?

1 - dexamethasone
2 - supportive care with correct blood type
3 - plasmapheresis
4 - immunoglobulin therapy

A

2 - supportive care

Give correct blood
RBCs life is 120 days, after which the spleen will remove them, meaning the antibodies against incorrect blood will no longer be active

57
Q

Blood types:

  • Blood type A = A antigens on RBCs
    Anti B antibodies in plasma
  • Blood type B = B antigens on RBCs
    Anti A antibodies in plasma
  • Blood type AB = A and B antigens on RBCs
    No antibodies in plasma
  • Blood type O = no antigens on RBCs
    Anti A and B antibodies in plasma

Which blood type can be given to any other blood type?

1 - A
2 - B
3 - AB
4 - O

A

4 - O

There are no antigens on RBC surface, therefore no antibodies can attack this

UNIVERSAL DONOR

58
Q

Blood types:

  • Blood type A = A antigens on RBCs
    Anti B antibodies in plasma
  • Blood type B = B antigens on RBCs
    Anti A antibodies in plasma
  • Blood type AB = A and B antigens on RBCs
    No antibodies in plasma
  • Blood type O = no antigens on RBCs
    Anti A and B antibodies in plasma

Resus + cannot give or receive blood from resus - patients

Which blood type can be given to blood type A?

1 - A
2 - B
3 - AB
4 - O

A

1 - A
4 - O

59
Q

Blood types:

  • Blood type A = A antigens on RBCs
    Anti B antibodies in plasma
  • Blood type B = B antigens on RBCs
    Anti A antibodies in plasma
  • Blood type AB = A and B antigens on RBCs
    No antibodies in plasma
  • Blood type O = no antigens on RBCs
    Anti A and B antibodies in plasma

Resus + cannot give or receive blood from resus - patients

Which blood type can be given to blood type B?

1 - A
2 - B
3 - AB
4 - O

A

1 - A
2 - B
3 - AB
4 - O

Blood type AB has no antibodies, so regardless of present antigens there are no antibodies to attack them

UNIVERSAL ACCEPTOR

60
Q

Blood types:

  • Blood type A = A antigens on RBCs
    Anti B antibodies in plasma
  • Blood type B = B antigens on RBCs
    Anti A antibodies in plasma
  • Blood type AB = A and B antigens on RBCs
    No antibodies in plasma
  • Blood type O = no antigens on RBCs
    Anti A and B antibodies in plasma

Resus + cannot give or receive blood from resus - patients

Which blood type can be given to blood type AB?

1 - A
2 - B
3 - AB
4 - O

A

3 - AB

61
Q

Blood types:

  • Blood type A = A antigens on RBCs
    Anti B antibodies in plasma
  • Blood type B = B antigens on RBCs
    Anti A antibodies in plasma
  • Blood type AB = A and B antigens on RBCs
    No antibodies in plasma
  • Blood type O = no antigens on RBCs
    Anti A and B antibodies in plasma

Resus + cannot give or receive blood from resus - patients

Which blood type can be given to blood type O?

1 - A
2 - B
3 - AB
4 - O

A

4 - O

Blood group O has A and B antibodies, which would attack the antigens on all other blood groups

62
Q

Of the following which is most dangerous?

1 - transfusion associated circulatory overload (TACO)
2 - febrile non-haemolytic transfusion reaction
3 - acute haemolytic transfusion reaction (ABO)
4 - iron overload

A

3 - acute haemolytic transfusion reaction (ABO)

63
Q

If you suspect a patient with Transfusion associated circulatory overload (TACO), which of the following should be performed?

1 - stop bloods
2 - diuretic (furosemide)
3 - oxygen
4 - sit the patient up
5 - additional CHF medication as required
6 - all of the above

A

6 - all of the above

64
Q

When considering group and save vs. crossmatch, which of the following matches the following:

  • patients blood collected and tested for antibodies
  • blood type is identified
  • patients blood type is retained for future
A
  • group and save
    DOES NOT GET YOU BLOOD PRODUCTS

Crossmatch is the same as above, but is also matched to RBCs, platelets and other products for transfusion, but specific volume and needs for transfusion

65
Q

13 year/old girl who is semi-conscious presents to A&E. She has a petechial rash, fever, neck stiffness
and a BP 80/50mmHg. The blood results are in the image. What is the most likely diagnosis?

1 - peptic ulcer
2 - helicobacter pylori infection
3 - pernicious anaemia
4 - iron deficiency anaemia
5 - disseminated intravascular coagulation due to meningococcal meningitis

A

5 - disseminated intravascular coagulation

Bloods:
- thrombocytopenia
- prolonged PT (extrinsic pathway)
- prolonged APTT (intrinsic pathway)
- low fibrinogen
- high D-Dimer products

Blood clotting suggests all systems are affected

66
Q

13 year/old girl who is semi-conscious presents to A&E. She has a petechial rash, fever, neck stiffness
and a BP 80/50mmHg. The blood results are in the image. The most likely diagnosis is disseminated intravascular coagulation due to meningococcal meningitis. Which of the following should be done?

1 - A-E assessment
2 - ITU support (needs inotropes)
3 - Blood cultures
4 - Urgent antibiotics
5 - Blood products – platelets, cryoprecipitate and FFP
6 - Consider lumbar puncture
7 - all of the above

A

7 - all of the above

67
Q

Transfusion associated circulatory overload (TACO) is when a patient receives fluid overload. Which of the following is NOT an established risk factor for TACO?

1 - male gender
2 - underlying conditions affecting tolerance to fluids (heart failure)
3 - age (>50y/o)
4 - weight (<50kg)
5 - concomitant fluids onboard
6 - currently using diuretics

A

1 - male gender

68
Q

Transfusion associated circulatory overload (TACO) is when a patient receives fluid overload. Which of the following is NOT a common symptom of TACO?

1 - dyspnea, tachypnea, reduced sats
2 - peripheral oedema
3 - lung crackles/pulmonary oedema
4 - liver distress
5 - hypertension and tachycardia

A

4 - liver distress

A. MLA Map Clinical Haematology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions