Haematology Flashcards
Clotting results for DIC
Low platelets
low fibrinogen
increased PT and APTT
Raised d-dimer
Antibodies in HIT
platelet factor 4
Which is more common, Haemophilia A or B
A
Clotting results in haemophilia A/B
normal bleeding time
normal PT
Raised APTT (intrinsic)
management of haemophilia A
factor VIII concentrate
Von willebrand disease presentation
epistaxis
menorrhagia
Chromosome where VWF gene is located
12
Management of von willebrand disease
Desmopressin
VXF infusion
factor VIII
Menorrhagia can be management with tranexamic/mefanamic acid, COCP, mirena
Clotting results in vitamin K deficiency
longer PT and APTT
Management of haemorrhage in vitamin K deficiency/warfarin
phytomenadione (vitamin K) 1-3mg IV
Dried Prothombin complex 25-50 units/kg
Guidance for treating warfarin overdose
INR >8 + bleed = Phytomenadione 1-3mg IV. Restart warfarin at INR of 5
INR >8 - bleed = Phytomenadione 3-5mg PO. Restart warfarin at INR of 5.
INR 5-8 + bleed = Phytomenadione 1-3mg IV. Restart warfarin at INR of 5.
Major haemorrhage: Phytomenadione 5mg IV + Prothrombin complex or FFP (PTC more preferable)
PTC = 25-50 untis/kg FFP = 15mL/lkg
Causes or increased destruction of platelets (thrombocytopenia)
PPI, methotrexate, ITP, TTP, HIT, HUS
Causes of decreased production of platelets (thrombocytopenia)
B12 deficiency, sepsis, liver failure, leukaemia, myeloproliferative disorders
At what point would low thrombocytopenia present with easy bruising and purpura
Platelet’s < 50x10^9/L
Patient presents with spontaneous purpuric rash and easy bruising. FBC shows low platelets. The rest of the FBC is normal.
1) Likely diagnosis
2) Pathophysiology
3) Mx criteria
4) Management options
1) ITP
2) Antibodies against platelets. Type 2 hypersensitive reaction
3) Mx criteria - platelets < 10 or active bleeding
4) Prednisolone, IV Ig, blood transfusions platelet transfusions.