haematological emergencies large group Flashcards
what are the coagulation tests that should be ordered for a COVID patient ?
D-dimer
Prothrombin
Platelet
Fibrinogen
in that order of imp
what is the management for PE ?
oxygen therapy
pain relief
anticoagulant therapy
what workup should be performed for a patient when looking for familial thrombophilia ?
1- test for protein c or protein s deficiencies
2- anti thrombin deficiency
3- factor V leiden or MTHFR mutation
what advice should patients with thrombophilia take ?
avoid oral contraceptives
wear compression socks when they have long flights
avoid smoking
get other family members tested
what is the advantage of LMWH over unfractionated heparin ?
LMWH has long half life and it has a more predictable dose-response
what is the normal INR value ?
in patient not on anticoaglation therapy - 1
therapeutic aim 2-3
what is the effect of warfarin on INR ?
warfarin slows down how long it takes for blood clots to form
so the INR increases
what does prolonged PT and PTT indicate ?
deficiency in coagulation factors
how does warfarin affect coagulation factors ?
warfarin depletes vitamin k which is necessary for the activation of coagulation factors
what drug is contraindicated to warfarin ?
amiodarone
what is coumadin ?
warfarin
what is the most appropriate management for warfarin toxicity ?
stop warfarin
continue on a low dose of warfarin only when the INR reaches 1.56
what does a short PTT indicate ?
higher chance of thrombus occurring
what is the pre op management of a patient with factor 12 deficiency ?
no management doesn’t cause bleeding
what further investigation can be done to find the specific cause of prolonged or abnormal Pt and PTT?
mixing study
what are the causes of isolated prolonged PTT ?
- Lupus anticoagulant
- von Willebrand disease with low facto VIII
- Intrinsic pathway coagulation factor defect like factors VIII & IX
what is the best management for a patient with factor 11 deficiency pre op ?
give plasma concentrate of factor 11
if a patient presents with isolated thrombocytopenia with nothing else what is the most appropriate diagnosis ?
ITP
is a marrow examination indicated in cases of isolated thrombocytopenia ?
only after a diagnosis of ITP has been made and an attempt to treat it has happened and deemed unsuccessful
what are the causes of microcytic anemia ?
thalassemia
anemia of chronic disease
iron deficiency anemia
lead poisoning
anemia secondary to defective iron absorption due to IL-6 is what type of anemia ?
anemia of chronic disease
what is the most common cause of inherited thrombophilia ?
factor V leiden
what is the best site for a bone marrow aspirate in a young patient ?
posterior superior iliac spine
