Haematology

Question 1

secondary polycythaemia

Answer 1

high altitude (low oxygen)
hypoxamia (apnoea, COPD)
renal disease
hetaptoma, haemangioma, fibroids

Question 2

symptoms of polycythaemia

Answer 2

itchy
headache
plethora
hypertension
splenomegaly
gout (purines)
stroke
bleeding

Question 3

investigations for polycythamia

Answer 3

serum erythropoeitin
jak 2 mutation (90%)
bone marrow examination
abdo USS

Question 4

clinical features of myelofibrosis

Answer 4

bone marrow fibrosis
extramedullary haemopoeisis
splenomegaly
anaemia
weight loss
fatigue
bleeding

Question 5

intravascular haemolysis

Answer 5

red cells lyse in circulation

Hb to plasma

Question 6

extravascular haemolysis

Answer 6

eaten by spleen/liver

Question 7

elevated LDH in

Answer 7

haemolytic anaemia

Question 8

indirect coombs

Answer 8

agglutination identifies IgG mediated incompatibility between recipient plasma and test red cells.

Question 9

forwards grouping

Answer 9

add monoclonal anti A/B to blood to see if antigen on donor

Question 10

reverse grouping

Answer 10

add donor plasma to known red cells to see if they have IgM agglutinating ABO antibodies.

Question 11

antibody screening of recipient blood

Answer 11

IAT

should detect IgG that can cause delayed haemolytic transfusion

Question 12

rapid spin crossmatch

Answer 12

mix recpient serum with blood to be transfused

Question 13

electronic issue

Answer 13

if ABO has been determined 2x

can issue directly off of shelf.

Question 14

antigen identification

Answer 14

if antibodies foun

nature determined with an antigen identification panel

Question 15

group and save

Answer 15

40 mins
perform IAT screening and store sample
if no antibodies–> rapid issue

Question 16

crossmatch blood

Answer 16

assigning units to specific patient

Question 17

IAT crossmatch

Answer 17

if antibodies or no previous G+S

40 minute

Question 18

Emergency crossmatch

Answer 18

immediate spin
5 minutes
only ABO grouping

Question 19

extreme emergency

Answer 19

group O

Question 20

expiring of group and save

Answer 20

if recently transfused- send fresh sample

Question 21

commonest cause of actue reactions to transfusion

Answer 21

bacteria

usually from platelets because kept at room temp.

Question 22

management acute transfusion reaction

Answer 22

if allergy: IV chlorphenamine and paracetamol, monitor every 15 mins

if incorrect unit: IV saline to maintain urine output>1ml/kg/h
continuous monitoring
DISCONTINUE