Haematology Flashcards
What are the symptoms of iron deficiency anaemia?
Dyspnoea
Fatigue
Headaches
Restless legs
Cognitive impairment
What is classed as severe anaemia?
haemoglobin less than 70g/L
What is the definition of anaemia?
In men aged over 15 years — Hb below 130 g/L.
In non-pregnant women aged over 15 years — Hb below 120 g/L.
In children aged 12–14 years of age — Hb below 120 g/L.
What are some tests to identify a source for IDA?
FIT
Coeliac testing
Urine in blood
What are the signs of DVT?
Unilateral localised pain
Tenderness.
Skin changes, which include oedema, redness, and warmth.
Vein distension.
How should a suspected DVT be initially investigated?
Assess leg and thigh swelling — measure the circumference of the leg 10 cm below the tibial tuberosity and compare with the asymptomatic leg. A difference of more than 3 cm between the extremities increases the probability of DVT.
Well’s score
How should most people with DVT be managed?
Anticoagulation therapy
How should a pregnant woman with DVT be managed?
Refer immediately for same-day assessment and management if deep vein thrombosis (DVT) is suspected in a woman who is pregnant or has given birth within the past 6 weeks.
What are some risk factors or associated factors for DVT?
Active cancer (treatment ongoing, within the last 6 months, or palliative).
Paralysis, paresis, or recent plaster immobilization of the legs.
Recently bedridden for 3 days or more, or major surgery within the last 12 weeks requiring general or regional anaesthesia.
Localized tenderness along the distribution of the deep venous system (such as the back of the calf).
Entire leg is swollen.
Calf swelling by more than 3 cm compared with the asymptomatic leg.
Pitting oedema confined to the symptomatic leg.
Collateral superficial veins (non-varicose).
Previously documented DVT.
Explain how DIC is managed
What are the risk factors for DIC?
What are some questions to ask in a patient with epitaxis?
When the bleeding started and from which nostril.
How much blood has been lost.
Whether a temporary pack (such as cotton wool) has been used
About any previous episodes of epistaxis and how they were treated.
What should be avoided after a nosebleed has occured?
Blowing or picking the nose.
Heavy lifting.
Strenuous exercise.
Lying flat.
Drinking alcohol or hot drinks.
What are some risk factors to consider for epistaxis?>
Trauma
Cancer
Allergies
What are some symptoms of polycythaemia?
What are some underlying causes of secondary polycythaemia?
Cardiac and respiratory symptoms or disease, smoking, and potential exposure to carbon monoxide.
Excessive daytime sleepiness, snoring, sleep disturbances, and observed night-time episodes of apnoea (particularly in people who are obese or with other respiratory conditions).
Previous renal transplantation.
Performance enhancing drug use (testosterone, anabolic steroids or erythropoietin).
What are some clinical findings of polycythaemia vera?
Ruddy complexion
Conjunctival plethora (indicative of erythrocytosis) is present.
Splenomegaly, which can be indicative of polycythaemia vera
Abdominal masses. Benign and malignant uterine, renal, and hepatic tumours, which may be palpable, can secrete erythropoietin, leading to secondary erythrocytosis.
How is polycythaemia vera managed?
An explanation of the risks and implications of the condition. A patient information leaflet, such as that provided by MacMillan Cancer Support, may be helpful.
Venesection to maintain the haematocrit at less than 0.45.
The volume of blood removed and frequency of venesection are adjusted depending on the person’s size and tolerability to venesection.
Prescription of aspirin 75 mg daily (unless this is contraindicated)
High risk or >60 = + The first-line drug is usually hydroxycarbamide
What might lead to further investigation for polycythaemia?
One-off values of elevated Hct (>0.6 in males and >0.56 in females) indicate an absolute erythrocytosis and require additional investigations.
What are the features of multiple myeloma?
The median age at presentation is 70 years old.
Use the mnemonic CRABBI + HANC:
Calcium
Renal
Anaemia
Bleeding
Bones
Infection
hyperviscosity
amyloidosis e.g. macroglossia
neuropathy
carpal tunnel syndrome
What are the features of acute haemolytic reaction?
Fever, abdominal pain, hypotension
How is acute haemolytic reaction managed?
Stop transfusion
Confirm diagnosis
check the identity of patient/name on blood product
send blood for direct Coombs test, repeat typing and cross-matching
Supportive care
fluid resuscitation
What are the features of TRALI?
Hypoxia, pulmonary infiltrates on chest x-ray, fever, hypotension
How is TRALI managed>
Stop the transfusion
Oxygen and supportive care
