Haematology Flashcards
What is the reversal agent of dabigatran?
Idarucizumab
What is the reversal agent for rivaroxiban and apixaban?
Andexanet alfa
What is the MOA of dabigatran?
Direct thrombin inhibitor
What is the MOA of rivaroxiban/apixaban/edoxaban?
Direct factor Xa inhibitor
How is dabigatran excreted?
Renally
How is rivaroxiban excreted?
Hepatic
How is apixaban excreted?
Faecally
How is edoxaban excreted?
Faecally
What are the classical symptoms of polycythaemia vera?
Intense itching which usually occurs after exposure to hot water or hot and humid weather
The absence of what type of cell indicates a lack of acute leukaemia?
Blast cells
What will be seen on an FBC in CML?
High white cell count which is due to high numbers of myeloid cells, but anaemia and thrombocytopenia due to bone marrow dysfunction
What is first-line management for CML?
The tyrosine kinase inhibitor - Imatinib
What is the first-line management for CLL?
Fludarabine and cyclophosphamide
In what type of blood cancers may rituximab be used?
Leukaemias and lymphomas of lymphocyte origin, rituximab being a chimeric monoclonal antibody directed at CD20, a lymphocyte marker
How does sequestration crises present in sickle cell anaemia?
Sickling within organs such as the spleen or lungs causes pooling of blood with worsening of the anaemia - it is associated with an increased reticulocyte count
What is the most common cause of death in adulthood in sickle cell crisis?
Acute chest syndrome
How does aplastic crisis occur in sickle cell anaemia?
A sudden fall in Hb, with bone marrow suppression causing a reduced reticulocyte count, cause by parvovirus
What is the typical blood panel picture in DIC?
Low platelets Low fibrinogen Raised PT & APTT Raised fibrinogen degradation products Schistocytes due to microangiopathic haemolytic anaemia
How would you expect a clotting panel to look in a warfarinised pt?
PT = prolonged APTT = normal Bleeding time = normal Platelet count = normal
What are the causes of paraproteinaemia?
Myeloma Monoclonal gammopathy of uncertain significance (MGUS) Benign monoclonal gammopathy Waldenstrom's macroglobulinaemia Amyloidosis CLL, lymphoma Heavy chain disease POEMS
What do you seen on a blood film in CLL?
Smudge cells (also called Smear cells)
What are the features of CLL?
Often none: may be picked up by an incidental finding of lymphocytosis
Constitutional: anorexia, weight loss
Bleeding
Infections
Lymphadenopathy more marked than chronic myeloid leukaemia
What is the empirical Abx of choice in suspected neutropenic sepsis?
Tazocin
How is sickle cell anaemia inherited?
Autosomal recessive
