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Surgery > Haematology in Peri-Op Care > Flashcards

Haematology in Peri-Op Care Flashcards

1
Q

What is anaemia?

A

A reduction in Hb concentration below normal

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2
Q

What is the normal range for Hb for men and women respectively?

A

13-16g/dL

11.5-15g/dL

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3
Q

How can anaemia be classified?

A

By MCV of red cells i.e. macrocytic, normocytic, and microcytic

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4
Q

What is the most common type of anaemia (according to cause)?

A

Iron deficiency

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5
Q

What are some of the causes of microcytic anaemia?

A 
TAILS:
Thallasaemia
Anaemia of chronic disease
Iron deficiency
Lead poisoning
Ssss(something blastic) anaemia
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6
Q

What are some of the causes of macrocytic anaemia?

A 
FAT RBC:
Folate deficiency
Alcohol
Thyroid, hypothyroidism
Reticulocytosis
B12 deficiency
Cirrhosis
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7
Q

Which of the causes of macrocytic anaemia are the most common?

A

Folate and B12 deficiencies

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8
Q

What are some of the causes of normocytic anaemia?

A 
KARMA:
Kidney - CKD
Acute blood loss
Rrrrrr (find something)
Mixed cause
Anaemia of chronic anaemia
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9
Q

Which operations are high risk for bleeding?

A 
Cardiothoracic
Urological
Polypectomy
Liver/spleen surgery
Vascular surgery
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10
Q

When are pts assessed haematologically?

A

In pre-op clinic for elective surgery

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11
Q

Apart from assessment for anaemia, what else is assessed in pre-op clinic wrt haematology?

A

Haemostatic competence
VTE risk assessment
Cellular immune competence
Oxygen carrying capacity

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12
Q

When assessing haemostatic competence, what aspects of blood workup, hx etc do we look at?

A

Platelets
Hx of bleeding
FHx of bleeding disorders
DHx - antithrombotic agents

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13
Q

In an elective situation and an acute situation, how is anaemia treated?

A

Elective - treat the cause e.g. iron suppliments, erythropoeitin injections etc according to cause

Emergency - G&S/crossmatch -> transfusion of blood

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14
Q

Haemastatic assessment - important aspects in the Hx?

A

Previous operations - did they bleed lots?
Any previous injuries involving blood loss?
Known anaemia, clotting disorders, hx of thrombotic events, antithrombotic therapies
Heavy bleeds with periods, nose bleeds, assoc with giving birth?
FHx

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15
Q

What studies are involved in a clotting screen?

A

Prothrombin time
APTT
TT/TC
Fibrinogen

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16
Q

Do surgical pts on anticoagulation have to stop them before surgery?

A

Yeep.

Only don’t have to if for minor surgery, dental procedures, or cataracts.

17
Q

What can cause low platelets?

A

Bone marrow suppression
Haematinic deficiency
DIC
Immune or splenic destruction

Surgery (11 decks)

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