Hematology Flashcards
Transfusions reactions
Major blood group
Back pain , hypotension shortness of breath, fever , tachycardia, dark urine during transfusion
Anaphylactic reaction: rapid onset (seconds) respiratory distress and shock ( IGa deficiency)
Minor blood group ( Delayed
Fever, jaundice 14 days after, failure of the expected rise in hematocrit
No therapy
Transfusion related acute lung injury (leukoagglutination
Antibodies in the donor plasma attack neutrophils in the recipient which causes precipitation of wbc in the lung
Less than 6 hours
Supportive care resolution within 4 days
Febrile nonhemolytic transfusion
Mild elevation in temperature
Leukocytes debris release cytokines
No therapy except antipyretic
Urticarial reaction
Antihistamine
To prevent: washed red cells
Heparin induced thrombocytopenia
5-10 days
IgG auto antibody coats the surface of platelets
Thrombocytopenia
Arterial and venous thrombosis
Dx : elisa
Administer direct thrombin inhibitors: argatroban
Factor V Leiden
Dominat mutation unable to activate protein C
Testing should be considered for an unprovoked first Time thrombus in young patients or unusual site
Immune thrombocytopenia purpuRA
IgG antibodies against GPIII/IIIa
Isolated thrombocytopenia, Normal sized spleen
Diagnosis of exclusion
Bone marrow: megakaryocytes
Peripheral smear and creatinine Normal
Vitamin k deficiency
Mimic haemophilia
Dx both pt and PTT are elevated
Correction of pt and ptt in response to giving vit k
Von willebrand disease
Dominant
Related to platelets with a normal platelet count and markedly worsened after the use of aspirin
Trt: desmopressin
Disseminated intravascular coagulation
Bleeding from any site
Pt and pttt elevated
Low platelets
D dimer
Decreased fibrinogen
Schistocytes
Plasma cell disorders ( dyscrasis)
Multiple myeloma
Monoclonal gammopathy of unknown significance
Waldenstrom macroglobulinemia
Multiple myeloma primary malignancy of bone
Bone pain (pathological fracture)
Hypercalcemia
Infection because of abnormal plasma cells
Presenting hyperuricemia turn over
Anemia Infiltration of bone marrow
Renal failure immunoglobulin and bence jones
Dx x ray : lytic lesion (punched out )
Electrophoresis M spike
Bone marrow >10% clonal plasma confirms
Blood smear: rouleaux ig Stick to RBC
Monoclonal gammopathy
Over production of IG but without systemic manifestation
Bone marrow biopsy to rule out myeloma
But may progress to myeloma
Waldenstrom macroglobulinemia
IGm antibodies, hyper viscosity syndrome like blurry vision, vertigo neuropathy ,neoplastic infiltration of tissues
Lytic bone lesions are absent
Spike IGM
Plasmapher
