Haematology Flashcards
How is heparin monitored ?
APTT
How is LMWH (enoxaparin monitored ) ?
Anti factor Xa - although not commonly monitored
What is pernicious anaemia ?
autoimmune disorder affecting the gastric mucosa that results in B12 deficiency and is the most common cause of B12 deficiency.
What type of anaemia is pernicious anaemia ?
Macrocytic
What are the risk factors for pernicious anaemia ?
- Female sex
-autoimmune disorders like thyroid disease, T1DM, addisons, rheumatoid and vitiligo - More common in blood group A
What are the features of pernicious anaemia ?
Anaemia features - Lethargy, pallor, dyspnoea
- Neurological features - peripheral neuropathy (symmetrical and effects legs more than arms)
-Progressive weakness, ataxia, paresthesias
- Memory loss, poor concentration, confusion, depression and irritability.
- Glossitis
-lemon ctinge
What is the management of pernicious anaemia ?
Vitamin B12 injection given IM.
If the patient has no neurological features, 3 injections per week for 2 weeks followed by 3 monthly treatment of vitamin B12 injections.
If there are neurological features - more frequent
What are patients with pernicious anaemia at a higher risk of ?
gastric cancer.
What antibiotics are specific for pernicious anaemia ?
Anti-intrinsic factor antibodies.
What vitamin in high doses is tetarogenic ?
Vitamin A
What does INR indicate ?
Higher INR = takes the blood longer to clot.
What should occur to warfarin intake in patients with major bleeding (haemorrhage) ?
Stop warfarin, give IV vit K 5mg and PT complex concentrate
In terms of anaemia, what should pantycytopenia increase suspicion of (low WCC, RBC and platelets) ?
Aplastic anaemia
What are the symptoms of hypocalcaemia ?
Tingling, spasms and numbness around the mouth.
What are patients that undergo thyroid surgeries at a higher risk of ?
Post op hypocalcaemia due to permenant loss of PTH production/
What are the main causes of microcytic anaemia ?
T- Thalassaemia
A - Anaemia of chronic disease
I - Iron deficiency anaemia
L - Lead poisoning
S - Sideroblastic anaemia
What are the main causes of normocytic anaemia ?
- A - Acute blood loss
- A - Anaemia of chronic disease
- A - Aplastic anaemia
- H - Haemolytic anaemia
- H - Hypothyroidism.
What is a common cause of normocytic anaemia (jaundice and low Hb) ?
G6PD deficiency.
What are the most common causes of macrocytic anaemia ?
B12/folate deficiency (Alcohol, reticulocytosis, hypothyroidism, liver disease and azathioprine)
What is pernicious anaemia ?
B12 deficiency with an auto-immune cause. Caused by defective intrinsic factor secretion.
