Haematology Flashcards
Which blood product causes transfusion transmitting bacterial infection?
Platelet transfusion
Neonate with unconjugated hyperbilirubinaemia on phototherapy, does not improve. What is the next step of management?
Do exchange transfusion and find pathological causes like RH incompatibility and G6PD deficiency
Middle-aged woman with generalised pruritus and tender hepatosplenomegaly. Elevated haemoglobin, haematocrit and leucocytes elevated liver enzymes. What is the best next step to evaluate this patient?
Abdominal Doppler ultrasonography for reduced hepatic vein flow, suspecting for myeloproliferative disorders. Next do JAK2 testing
Triad of Wiskott Aldrich syndrome. How do you treat?
Microthrombocytopenia, eczema, recurrent infections. Hematopoietic stem cell transplantation.
Drugs causing peripheral neuropathy
VIncristine, cisplatin, taxanes, phenytoin, isoniazid, amiodarone, hydralazine
SLE with B symptoms with generalised lymphadenopathy. Elevated LDH. Diagnosis? Confirmatory test?
Non Hodgkin lymphoma, excisional lymph-node biopsy
Which childhood lymphoproliferative disorder causes a bone pain?
ALL- neutropenia, thrombocytopenia, wbc- decreased or markedly increased
Young girl adopted from Nigeria presents with sudden onset weakness, hypotonia, hyper reflexia of right arm and leg, which additional test is done to diagnose after neuro imaging?
Haemoglobin electrophoresis. Confirm stroke with MRI
Von willebrand factor disease lab values.
All normal, elevated PTT
Work up in 60 yr males with firm fixed breast mass ?
Mammogram then core biopsy. Same as a female
60yr old female with blurred vision, headache, tingling, elevated protein, ESR. Dilated segmental tortuous retinal veins. No jaw tenderness, calcium normal? Next step?
Diagnosis- waldenstrom macroglobulinemia. Do serum protein electrophoresis
Massive transfusion protocols requirement. Blood products transfused?
More than 2 of the following-
1. Penetrating mechanism of injury.
2. Positive fast.
3. SBP less than 90.
4. Pulse more than 120
Blood products- 1:1:1- PRBC, FFP, platelets
Anaemia in diamond blackfan anaemia. Clinical findings and treatment.
Macrocytic, reticulopenia
CF- craniofacial abnormalities, triphalangeal thumbs, increase risk of malignancy
Rx- corticosteroids, RBC transfusions
Therapy given when standard treatment fails
Salvage therapy
Cells and associated diseases- target cells, bite cells, Heinz body, Howell jolly body, schistocyte, burr cell, spherocyte, basophilic stippling?
Target- thalassemia, bite Heinz - g6pd, Howell - asplenia, schistocyte- HUS, DIC, TTP, burr- EPO deficiency, spherocyte- AIHA, basophilic stippling- lead poisoning
Most common complication of sickle cell trait carrier
Hematuria
Hereditary haemorrhagic telengiectasia
Osler Weber rendu syndrome- epistaxis, AV shunts, telengiectasias
TTP Rx
Plasma exchange, high dose glucocorticoids, rituximab, caplacizumab
4M bruising, gum oozing, buccal hematomas, b/l ant cervical LNpathy, hepatosplenomegaly
ALL- platelet deficiency
15M CF- epistaxis
Vit K deficiency- absent coag factor act
Dyspnea, fatigue, splenomegaly, hemolytic anemia labs+, PBS- spherocytes. Direct coombs test +
AIHA
Haptoglobin levels in hemolysis
Decreased more in intravascular >extravascular
Rx of AIHA
warm- corticosteroids, splenectomy
cold- avoid cold temp, rituximab +fludarabine
3M fatigue, pallor, icterus, ecchymoses, thrombocytopenia, took med for diarr. PBS- shictocytes
HUS- MAHA
Painless right neck lump, wgt loss, smokes, LN- firm, close to right submandibular. FNA- SCC. Source?
H&N carcinoma- laryngoscopy
Hemolytic anemia labs+ dark urine, MRI- hepatic vein thrombosis
PNH- Rx- iron, folate supple, eculizumab
ADR of hydroxyurea
myelosuppression
Headache, confusion, icterus, anemia, thrombocytopenia. PBS- frag RBC. NBS
TTP- plasma exchange, glucocorticoids, rituximab, caplacizumab
CF of TTP
fever, low platelets, AMS, renal insuff, MAHA
