Haematology Flashcards
what is thrombotic crisis in sickle cell anaemia?
multiple infarcts in various organs which can be precipitated by infection, dehydration or low oxygen. It is a clinical diagnosis and management includes IV fluids, oxygen
what is sequestration crisis in sickle cell anaemia?
sickling within organs such as spleen and lungs which causes pooling of blood and worsening anaemia.
Slow bleed so have high retic count
What is acute chest syndrome in sickle cell anaemia?
infarcts within the lung parenchyma. Get PE type symptoms (dypsnoea, low O2) and also lung infiltrates are seen on x ray.
Manage with pain relief, O2, Ab if needed, tranfusion
What is aplastic crisis in sickle cell anaemia?
Bone marrow suppression caused by parovirus. Leads to low haemoglobin (and low retic count), low WCC, low platelets
What is haemolytic crisis in sickle cell anaemia?
Excessive haemolysis leading to anaemia. Rare
Auer rods
Acute myeloid leukaemia
Philadelphia chromosome
Chronic myeloid leukaemia
Most common leukaemia in children
Acute lymphocytic leukaemia
Which leukaemia is most associated with Reichters transformation
Chronic lymphocytic leukaemia to non-hodgkins lymphoma
which leukaemia is most likely to present with insidious fatigue, mild anaemia and splenomegaly?
chronic myeloid leukaemia
blast cells
Acute leukaemias
band cells
chronic leukaemias
Which marker is associated with Hodgkins lymphoma
Reed Sternberg cells
how does non-hodgkins lymphoma typically present?
non tender symmetrical and widespread lymphadenopathy + B symptoms (night sweats, fever, weight loss)
how does Hodgkins lymphoma typically present?
non tender asymmetrical lymphadenopathy
what are risk factors for lymphomas?
viruses: EBV, HIV
smoking
immunosuppresion
how long for and at what temperature can red cells be stored?
35 days at 4 degrees
how long for and at what temperature can platelets be stored?
22 degrees for 7 days
how long for and at what temperature can FFP be stored?
-30 degrees for 3 years
which is the most common blood group?
O
which is the least common blood group?
AB
which blood group is the universal donar?
O
Which blood group is the universal recipient?
AB
What are the indications for red cell transfusion?
- symptomatic anaemia with Hb less than 70
- major bleed
What are the indications for platelet tranfusion?
- bleed and platelet less than 30
- thrombocytopenia
- platelet less than 10
- prophylaxis in transplant/chemo/bone marrow failure
what are the indications for FFP transfusion?
- bleeding patient with coagulopathy
- clinically significant bleed + PT/APTT >1.5
- prophylaxis prior to surgery or procedure in patient with coagulopathy
who do you need to give CMV-ve blood to?
pregnant women and neonates
which tranfusion product is most associated with bacterial contamination?
platelets
why would you use irradiated blood products?
to avoid tranfusion related graft versus host disease
tiredness, breathlessness, high bilirubin and reticulocytes, coombs test +ve
autoimmune haemolysis
what are the indications for cryoprecipitate
- clinically significant bleed + fibrinogen <1.5 such as DIC
what are the indications for prothrombin complex
- major bleed + on anticoagulant (used to reverse the anticoagulant effect)
what is non-haemolytic febrile transfusion reaction and how is it managed?
get fever following transfusions with no other systemic signs
slow the transfusion + paracetamol + monitor
what is minor allergic transfusion reaction and how is it managed?
histamine reaction to transfusion leading to itching and rash
temporarily stop the transfusion + antihistamine + monitor
what is acute haemolytic transfusion reaction and how is it managed?
get ABO incompatibility. Fever, abdo pain, hypotension
stop transfusion. Check patients ID and name, re do coombs test and cross match
IV fluid resus
what is transfusion associated circulatory overload (TACO) reaction and how is it managed?
transfusion went too fast leading to fluid overload and subsequently pulmonary oedema and hypertension
stop/slow transfusion and consider IV loop diuretic and O2
what is transfusion related acute lung injury (TRALI) and how is it managed?
non cardiogenic pulmonary oedema caused by molecules in blood
leads to hypoxia, pulmonary infiltrates on CXR, fever, hypotension
stop transfusion + O2 + supportive care
