Haematology Flashcards
What is DIC
- disorder of primary and secondary haemostasis
- widespread activation of coagulation cascade and platelet activation
Presentation of DIC
- bleeding
- ARDS
Investigations for DIC
bloods
- low platelets
- low fibrinogen
- high d-dimer
- long PT
- long APTT
blood smear → schistocytes
Treatment for DIC
- treat underlying cause
- low fibrinogen → cryoprecipitate
- low platelets → transfusion
Causes of DIC
- sepsis
- crush injury
- malignancy
What is alpha thalassemia
gene deletion of one or both alpha chains
4 gene deletion
- incompatible with life
- infants often stillborn
3 gene deletion
- moderate anaemia
- splenomegaly
- not transfusion dependent
2 gene deletion
- microcytosis
- carrier presentation
Diagnosis of alpha thalassemia
FBC
- microcytic anaemia
- raised serum iron
Hb electrophoresis
Treatment of alpha thalassemia
- transfusion during crises
- desferrioxamine → iron excretion
- folic acid
What is beta thalassemia?
- decreased/absent beta chains
- excess alpha chains
- point mutations in gene
Presentation of minor beta thalassemia
- mild anaemia
- hypochromic RBCs
- often asymptomatic
Presentation of intermedia beta thalassemia
- infections
- gallstones
- recurrent leg ulcers
- bone deformities
Presentation of major beta thalassemia
- failure to thrive
- severe anaemia from 3-6 months
- thalassemic faces
- bone abnormalities
Diagnosis of beta thalassemia
blood film
- reticulocytosis
- microcytic anaemia
- nucleated RBCs in circulation
Treatment of beta thalassemia
regular life long
- transfusions
- iron-chelating agents → deferipone
- ascorbic acid
- folic acid
What is tumour lysis syndrome?
collection of metabolic disturbances occurring with rapid destruction of neoplastic cells
Signs of tumour lysis syndrome
following chemo, rapid development of:
- hyperuricaemia, hyperkalaemia, hyperphosphatemia
- hypocalcemia
- AKI
Risk factors of tumour lysis syndrome
occurs more frequently with aggressive treatment of
- non-Hodgkin lymphoma
- leukaemia
Treatment for tumour lysis syndrome
allopurinol alongside chemo
What is heparin-induced thrombocytopenia
- heparin administration
- antibodies bind to drug
- prothrombotic state
problem with primary haemostasis
Presentation of heparin-induced thrombocytopenia
- onset of emboli → PE, DVT, CSVT
- suspect in any patient on heparin who’s platelets fall >50%
- bloods → low platelets, high D-dimer
Treatment of heparin-induced thrombocytopenia
- stop heparin
- anticoagulate
What is myelodysplasia
- heterogenous group of conditions
- defined by cell dysplasia
- often manifests as anaemia and bone marrow failure
- haemopoietic tissue is displaced by dysplastic cells
Presentation of myelodysplasia
- signs and symptoms of anaemia
- neutropenia → frequent infections
Investigations for myelodysplasia
- histological diagnosis
- wide variety of abnormalities
