Haematology Flashcards
Initial treatment of acute promyelocytic leukaemia?
All-trans retinoic acid (APML); promotes maturation of promyelocytes, alleviating the symptoms ofDIC.
In CLL, why do patients get recurrent infections?
Reduction in immuunoglobulins
Anaphylactic/ allergic transfusion reaction
Type 1 hypersensitivity; recipients mast cells react to plasma proteins
Acute haemolytic transfusion reaction
Usually due to ABO mismatch
e.g. recipient has type A blood and is given type B blood. Recipient will have Abs against B and cause intravascular haemolysis –> Jaundice and AKI
Can happen immediantly or up to 24 hours post transfusion.
Delayed haemolytic transfusion reaction
> 24 hours post transfusion
Usually due to Rh incompatibility
Recipient must have been exposed to these antigen previously, i.e. prev pregnancy/ transfusion
Extravascular haemolysis as happens in the RES
Febrile nonhaemolytic transfusion reaction
Fever following blood transfusion due to cytokine release or type II hypersensitivity reaction (Donor HLA reacts with recipient antibodies and causes release of cytokines)
How can reduce risk of Febrile nonhaemolytic transfusion reaction?
Remoce leukocytes from donor blood prior to transfusion (Leukoreduction)
TRALI
Within minutes to 6 hours
Trauma causes recruitments of neutrophils to lungs e.g. in sepsis. Then patient given tranfusion and neutrophils release ++ cytokines which increase pulmonary capillary permeability –> non cardiogenic pulmonary oedema –> resp distress
TACO
Fluid overload after transfusion
Treat with diuretics
How does desmopressin work in haemophilia treatment?
Promotes release of stores vWF and factor VIII
What should you check for when you suspect ITP?
HIV and Hep C
CD19 CD20 positive
B cells
t(11;14)
Mantle cell lymphoma
Graft vs host disease
HLA mismatch; if non-irradiated blood is given to immunocompromised e.g. lymphoma patients–> fever, diarrhoea, rash, deranged LFTs
CML treatment
Imatinib
Warfarin increases…
INR/PT
Warfarin MOA
Vitamin K antagonist
Inhibits synthesis of factors 2, 7, 9 10 and protein c
Heparin MOA
Activates antithrombin III which binds to and inhibits factor X
Heparin increases….
APTT and anti-factor Xa
DOAC MOA
Inhibits activated factor Xa
DOAC increases
APTT
DOAC increases
APTT
Reptilase time is used for…
Determining if heparin is in the sample.
It is similar to thrombin but resistant to inhibition by antithrombin III, so the reptilase time is not prolonged in samples containing heparin.
