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3B + Finals > Haematology > Flashcards

Haematology Flashcards

1
Q

Clotting results for DIC

A

Low platelets
low fibrinogen
increased PT and APTT
Raised d-dimer

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2
Q

Antibodies in HIT

A

platelet factor 4

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3
Q

Which is more common, Haemophilia A or B

A

A

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4
Q

Clotting results in haemophilia A/B

A

normal bleeding time
normal PT
Raised APTT (intrinsic)

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5
Q

management of haemophilia A

A

factor VIII concentrate

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6
Q

Von willebrand disease presentation

A

epistaxis

menorrhagia

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7
Q

Chromosome where VWF gene is located

A

12

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8
Q

Management of von willebrand disease

A

Desmopressin
VXF infusion
factor VIII
Menorrhagia can be management with tranexamic/mefanamic acid, COCP, mirena

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9
Q

Clotting results in vitamin K deficiency

A

longer PT and APTT

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10
Q

Management of haemorrhage in vitamin K deficiency/warfarin

A

phytomenadione (vitamin K) 1-3mg IV

Dried Prothombin complex 25-50 units/kg

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11
Q

Guidance for treating warfarin overdose

A

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
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12
Q

Causes or increased destruction of platelets (thrombocytopenia)

A

PPI, methotrexate, ITP, TTP, HIT, HUS

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13
Q

Causes of decreased production of platelets (thrombocytopenia)

A

B12 deficiency, sepsis, liver failure, leukaemia, myeloproliferative disorders

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14
Q

At what point would low thrombocytopenia present with easy bruising and purpura

A

Platelet’s < 50x10^9/L

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15
Q

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

A

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.

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16
Q

Management of ITP

A

Prednisolone
IVIG
Rituximab

17
Q

Malfomed protein involved in TTP

A

ADAMts-13

Normally inactivates von willebrand factor.

Damage to this protein leads to increase in small vessel clots –> uses up all clotting factors/platelets.

Bleeding and purpurururaaa

18
Q

Management of TTP

A

Involvement of haematology
Plasma exchange
Steroids
Rituximab

19
Q

Epidemiology of hereditary spherocytosis

A

Northern european

Autosomal dominant

20
Q

Patient with know hereditary spherocytosis presents new low Hb, blood film shows spherocytes and high reticulocytes. What is the likely cause

A

Aplastic crises, parvovirus infection

High reticulocyte count indicates aplastic crisis

21
Q

Management of hereditary spherocytosis

A

Splenectomy
Remove gallbladder if stones are a recurring issue
Folate supplementation

22
Q

Pathology of hereditary elliptocytosis

A

oval/elliptical shaped RBC

23
Q

G6PD epidemiology

A

x linked

Mediterranean

24
Q

What would be seen on the blood film G6PD

A

Heinz bodies

25
Q

What are common triggers for haemolysis of RBCs in G6PD

A

infection
antimalarial drugs
broad beans

26
Q

Prickle cells and reticulocytosis are positive findings on a blood film for what disease

A

Pyruvate kinase deficiency

27
Q

Alloimmune haemolytic anaemia is caused by what?

A

Reaction to blood transfusion, either foreign cells being attacked by hosts antibodies, or hosts cells being attacked by foreign antibodies

28
Q

AIHA is associated with which diseases

A

Lymphoma
SLE
Leukemia

29
Q

Management of AIHA

A

prednisolone
blood transfusions
rituximab
splenectomy

30
Q

Patient with sepsis has bruising in their arms where blood has been taken previously, they also had two nose bleeds.
They have a reduced renal output
Last FBC shows a sudden drop in Hb.
What is the possible cause

A

Sepsis –> DIC –> microangiopathic haemolytic anaemia

Structural abnormalities of small blood vessels result in haemolysis of RBC.

31
Q

6 year old Mediterranean boys presents with jaundice and splenomegaly following a throat infection.

1) Likely diagnosis
2) Sign seen on blood film
3) Triggers (5)
4) Inheritance pattern of disease

A

1) G6PD Deficiency
2) Heinz bodies
3) fava beans/broad beans. Sulfonylureas, sulphasalazine, anti-malarial, infection. Ciprofloxacin
4) Mediterranean. X-linked

32
Q

What cancer commonly develops from polycythmia

A

AML

33
Q

Sign seen in CML

A

Massive splenomegaly

34
Q

Symptoms of subacute degeneration of the spinal cord

A

Dorsal column - loss of vibration sense, ataxia

Lateral column - pyramidal weakness, upping plantars

35
Q

1) What are the three myeloproliferative disorders
2) What do they increase your risk of developing
3) What is seen on the blood film

A

1) Polycethmia vera. Primary myelofibrosis, Essential thrombocytosis
2) AML
3) Rain drop blood cells, Poikilocytosis

36
Q

Management of the three myeloproliferative disorders

A

Myelofibrosis - allogenic stem cell transplant
Polycethmia - venesection, aspirin
Essential thrombocytosis - aspirin

3B + Finals (15 decks)

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