Haematology Flashcards
How does hereditary spherocytosis present?
- Anaemia
- Jaundice
- Splenomegaly
- Pigment gallstones
Describe the management of hereditary spherocytosis
- Folic acid
- Transfusion
- Splenectomy (if very severe anaemia)
How does G6PD present?
- Anaemia
- Neonatal jaundice
- Splenomegaly
- Pigment gallstones
- Drug, broad bean or infection precipitated jaundice and anaemia
How does sickle cell disease present?
- Bone crisis
- Chest crisis
- Stroke
- Increased infection risk (hyposplenism)
- Gallstones
- Aplastic crisis
- Sequestration crisis: spleen and liver
Describe the management of a sickle cell crisis
- Analgesia (opiates and NSAIDs)
- Hydration
- Oxygen
- Blood transfusion
- Consider antibiotics
Name some of the treatment options for sickle cell disease
- Vaccinations
- Penicillin
- Folic acid
- Blood transfusion
- DMARDs: hydroxycarbamide
- Bone marrow transplantation
- Gene therapy
What is beta thalassaemia major?
- No beta chains
- Transfusion dependent anaemia
What is thalassaemia minor?
- Carrier state
- Hypochromic microcytic red cell indices
How does beta thalassaemia major present?
- Severe anaemia
- Ineffective bone marrow
- Bony deformities
- Splenomegaly
- Growth retardation
How is beta thalassaemia major managed?
- Chronic transfusion support
- Iron chelation therapy (s/c desferrioxamine)
- MRI scans
- Bone marrow transplantation
What investigations might be done for the different types of anaemia?
- Microcytic: ferritin
- Normocytic: reticulocyte count
- Macrocytic: B12, folate and bone marrow
Name the causes of a microcytic anaemia with a normal ferritin
- Thalassaemia
- Secondary anaemia
- Sideroblastic anaemia
Name the causes of a normocytic anaemia with an increased reticulocyte count
- Acute blood loss
- Haemolysis
Name the causes of a normocytic anaemia with a normal or low reticulocyte count
- Secondary anaemia
- Hypoplasia
- Marrow infiltration
Name some of the causes of a haemolytic anaemia
- Congenital
- Autoimmune
- Mechanical e.g. artificial valve
- Severe infection/DIC
- PET/HUS/TTP
Describe the management of haemolytic anaemia
- Folic acid
- Immunosuppression
- Splenectomy
- Treat causes
- Transfusion
Name the causes of megaloblastic anaemia
- B12 deficiency
- Folate deficiency
Name the causes of non-megaloblastic macrocytic anaemia
- Myelodysplasia
- Marrow infiltration
- Drugs
Which drugs are given as prophylaxis for neutropenic sepsis in haematological malignancy?
- Ciprofloxacin
- Fluconazole
- Aciclovir
- Co-trimoxazole
How does neutropenic sepsis present?
- Fever
- Rigor
- Chest infection/pneumonia
- Cellulitis
- UTI
- Septic shock
How can neutropenic sepsis be managed?
- Resuscitate
- Tazocin + Gentamicin +/-vancomycin or tecoplanin
- Antifungal if no response within 72 hours
- CT CAP
Name the types of transfusion reactions
- Transfusion associated dyspnoea
- Transfusion related lung injury
- Transfusion associated circulatory overload
- Transfusion associated graft vs host
What is Factor V Leiden ?
- A autosomal dominant mutation in the gene for Clotting factor V
- Causes a hypercoagulable state
How can Factor V Leiden be managed?
Anticoagulation after VTE
