Haematology Flashcards
low platelets, abnormal clotting obvious septic person
DIC
Headache seizure abdo pain high bp high bili low haptoglobin high LDH schistocytes low platelets
TTP
Massive splenomeg
Myelofibrosis
Pelger Huet Cells
Myelofibrosis
Recurrent miscarriages
Anti-phospholipid Syndrome
Platelets of 150 in pregnant woman
Gestation thrombocythaemia. Think something else if less than 100
Someone who is 10w pregnant, sister had DVT last year at age 33, father on long-term anticoagulant
Anti-thrombin III deficiency
Smear cells
CLL
Auer Rods
AML
Kid with cancer
ALL
Dry tap on BM aspirate
myelofibrosis
High fever after transfusion
bacterial contamination
Pregnant woman who is iron deficient and does not want to take iron supplement had a transfusion in her first pregnancy and now she is pregnancy again and has another transfusion. Nurse set up transfusion, 30mins later returns and find her unconscious, cyanosis and faced puffed up
IgA deficiency because previous transfusion sensitised her
Patient who had recently been stabbed in LUQ and had been transfused with O negative blood. He lost consciousness or something a few minutes after the transfusion
Haemorrhage with splenic haemorrhage due to stab wound
Patient who has had several transfusions in the past now develops abdo pain, haemoglobinuria within 10 mins of starting transfusion
ABO Incompatibility
Patient had RTA which required a trasfusion. After few days of transfusion patient comes back jaundiced and slightly anaemic
Delayed haemolytic transfusion reaction
Patient becomes increasingly short of breath very soon after transfusion O2 sats low
TRALI
thalassaemia patient looks tanned and has diabetes
Transfusion haemosiderosis
Little old lady, with Hb of 68, complete well, 4 units of blood ordered, frothy pink sputum
Fluid overload
Normal INR
AF/DVT Target INR
Recurrent DVT/PE/Prosthetic valve INR
0.8-1.2
2-2.5
2.5-3.5
Prosthetic heart valve INR 2.0
Increase warfarin
INR 3.5-5
Decrease dose
INR 5-8 without bleed
Stop and start when in therapeutic range
INR 5-8 with a bleed
Stop and give Vit K
INR >8 with or without bleed
Stop and give Vit K monitor INR
INR >8 with major bleed
Stop, prothrombin complex given or FFP or recombinant factor 8 with Vit K
Monitoring anticoagulant state Pt on aspirin and clopidogrel
None needed
Monitoring anticoagulant state Pt on warfarin for AF
PT
Monitoring anticoagulant state Pt taking warfarin after mitral valve insertion
PT
Monitoring anticoagulant state of Pt on LMWH who was unstable after surgery
APTT
Monitoring anticoagulant state of Pt on LMWH who had surgery but is stable
None needed
Fibrinogen levels in liver disease and DIC
Low
normal Hb with positive sickle solubility test
Sickle cell trait
Low Hb with positive sickle test
Sickle cell disease
African man with haemolysis after anti-malarials
GPDDD
older man with polychromasia and spherocytes TEST
Hereditary Spherocytosis, do osmotic fragility test
Thalassaemia intermedia test
HbA2 levels
Autoimmune HA Test
Combs Test
Temporal Arteritis Blood measurement
ESR
HIV Measurements to monitor control
CD4 levels and viral load
Patient has prolonged APTT, normal PT and normal bleeding time
Haemophilia A
patient has menorrhagia, prolonged APTT, normal PT and prolonged bleeding time. Her mother had similar problems
vWD
patient has alcoholic liver cirrhosis
Vit K def or decreased synthesis of clotting factors
Elderly Patient is asymptomatic and has generalised lymphadenopathy, with abnormal bloods
CLL
Smear Cells
CLL
CML Management
Imatinib TK inhibitor. If not dasanitib
EBV causes
Infectious mononucleosis
Elderly patient presents with MASSIVE splenomegaly with low platelets, red cells and normal white cells
Myelofibrosis
Patient comes in with DIC and has a leukaemia
Acute Promyelocytic Leukaemia
20% blasts in BM, aeur rods, sudan black stain
AML
Bone pain, bence jone proteins, high calcium, kidney failure,
Multiple Myeloma
Patient with back pain, high IgG, plasma cells>20%
Multiple Myeloma
Patient with no signs or symptoms and just raised IgG
MGUS
Patient with collapsed vertebrae, no other lytic lesions, normal calcium, no anaemia
Osteoporosis
Patient with lump on clavicle and you see a lytic lesion on the Xray. There is also a raised IgA but no other lesions/abnormal calium/anaemia. No other symptoms.
Solitary Plasmacytoma. If other symptoms present, then multiple myeloma
Post Transplant Uncontrolled proliferation of B cells following infection
EBV reactivation
Cold AIHA
IgM antibody, EBV, mycoplasma stuff
Essentially AIHA at lower body temepratures which means there’s probably some kind of trigger for it such as infection, lymphoproliferative disorders or idiopathic
Warm AIHA
IgG antibody is present and Warm AIHI is associated with, lymphoma, CLL, SLE, Drugs
