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Treatments > Haematology > Flashcards

Haematology Flashcards

1
Q

Management of transfusion reactions

A
  • Stop transfusion
  • Check patient ID against component label
  • Consider anaphylaxis, Circulatory overload (TACO), acute haemolytic transfusion reaction (AHTR), lung injury (TRALI), bacterial infection, etc
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2
Q

Rx of transfusion associated circulatory overload (TACO)

A

Slow rate, IV diuretic + O2

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3
Q

Management of immediate haemolytic reactions

A
  • Notify blood services to investigate
  • O2
  • IV fluids
  • Diuretics
  • Ionotropes
  • Dialysis
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4
Q

Management of Transfusion Related Acute Lung Injury (TRALI)

A
  • O2
  • Resp. support
  • IV fluids
  • Notify blood services to investigate/intiate recalls
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5
Q

Management of bacterial infection related to transfusions

A
  • IV antibiotics
  • O2
  • IV fluids
  • Notify blood services to investigat/initiate recalls
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6
Q

RX of HDN

A

By careful monitoring

  • Antibody titres
  • Doppler US
  • Intrauterine transfusions
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7
Q

Management of severe allergic reaction (transfusion)

A
  • Return unit to blood bank
  • O2
  • Salbutamol nebuliser
  • IV Chlorophenamine (10mg slowly)
  • ?ADRENALINE?
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8
Q

Rx of hereditary spherocytosis

A
  • Folic acid
  • Transfusion
  • Splenectomy
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9
Q

Commonesnt disease causing enzymopathy in the world

A

G6PD Deficiency

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10
Q

Rx for an aplastic crisis

A
  • Ususally self limitting, <2wks

- MAY need a transfusion

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11
Q

Rx of a sequestration crisis

A

Urgent transfusion required

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12
Q

Rx of a “painful” crisis

A
  • Analgesia (severe = opiates)
  • Hyrdation
  • O2
  • Consider antibiotics

Give analgesia within 30mins of presentation + avoid pethidine (demerol)

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13
Q

Rx of a chest crisis

A
  • Resp. support
  • Antibiotics
  • IV fluids
  • Analgesia
  • Transfusion
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14
Q

Disease modifying drug for sickle cell disease

A

Hydroxycarbamide

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15
Q

Rx of thalassaemia major

A
  • Transfusions, 4-6 weekly
  • Careful of iron overloading
  • Iron chelation therapy
  • Bone marrow transplantaion = curative
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16
Q

What is used in iron chelation therapy

A

Oral Deferiprone + Subcutaneous Desferrioxamine

Ascorbic acid increases urinary excretion of iron

17
Q

Management of haemolytic anaemia

A

-Folic acid (support marrow function)
Correct cause
-Immunosupression if autoimmune (?Prednisolone?)(treat trigger CLL, lymphoma)
-Remove site of destruction (splenectomy)
-Treat sepsis, leaky prosthetic valce, malignancy etc

-Consider transfusion

18
Q

Rx for megaloblastic anaemia

A

Replace vitamin

  • B12 deficiency = B12 IM injection, loading dose then 3 monthly maintenance
  • Folate deficiency = Oral folate replacement
19
Q

Rx of acute presentation of arterial thrombosis

A
  • Thrombolysis (TPA, tissue plasminogen activator)

- Antiplatelet/anticoagulant drugs (Clopidogrel/warfarin)(asecondary prevention)

20
Q

Rx for Von Willebrand Disease

A
  • vWF concentrate or Desmopressin (DDAVP)

- Tranexamic acid

21
Q

Rx of ITP

A

Only if symptomatic

  • Prednisolone
  • Thrombopoietin analohues (Eltrombopag)
  • IV IgG
  • Splenectomy (cures =80%)
  • Immnosuppression if splenectomy fails (azathioprine)
22
Q

Rx of AML

A

-Support care
-Anti-leukaemic chemotherapy
-Stem cell transplantation (allogenic)
-Targeted antibodies (midostaurin + Myelotarg anti-CD3 with Calicheomycin)
(Tretinoin in APL (acute promyelocytic leukemia) )

23
Q

Rx of chronic myeloid leukaemia

A

Direct inhibitors of BCR-ABL first line in all patients nowadays

Tyrosine kinase inhibitors

  • Imatinib
  • Dasatinib
  • Nilotinib
  • Busitinib
  • Ponatinib

Allogenic transplant (few now) (only in TKI failures)

24
Q

Rx for polycythaemia vera

A
  • Venesection to keep haematocrit below 0.45 in men + 0.43 in women
  • Aspirin
  • Hydroxcarbamide
25
Q

Rx for essential thrombocythaemia

A
  • Aspirin

- Hydroxyurea

26
Q

What antibiotic + anti-fungal prophylaxis is given to reduce the risk of sepsis in haematological malignancy

A
  • Ciprofloxacin (antibiotic)

- Fluconazole (anti-fungal)

27
Q

What anti-viral+ PJP prophylaxis is given to reduce the risk of sepsis in haematological malignancy

A
  • Aciclovir (anti-viral)

- Co-trimoxazole

28
Q

5 supportive measures that reduce the risk of sepsis in haematological malignancy (not prophylactic therapy)

A
  • Stem cell rescure/transplant
  • Protective enviroment (laminar flow rooms)
  • IV immunoglobulin replacement
  • Vaccination
  • Growth factors (G-CSF)

(and prophylactic therapy)

29
Q

Management of neutropenic sepsis

A
  • Broad spectrum IV antibiotics (Gentamicin + Tazocin)
  • If no response in 72hrs add IV antifungal (Caspofungin)
  • CT chest/abdo/pelvis to find source
  • Modify Rx based on culture results
30
Q

In neutropenic sepsis, if a gram +ve organism is identified what should be added to the Rx

A

Vancomycin or Teicoplanin

31
Q

Rx of type I hypersensitivity

A
  • Antihistamines
  • Corticosteroids
  • Adrenaline
  • Allergen avoidance
32
Q

Rx for contact dermatitis

A
  • Topical steroid

- Allergen avoidance

33
Q

Rx of rejection

A
  • Corticosteroids
  • Anti-thymocyte globulin
  • Plasma exchange

Treatments (12 decks)

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