Hematology Flashcards
do we give platelets transfusion in patient with upper GIT bleeding and if platelet is 80
Patient is hemodynamically stable
Do not offer platelet transfusion to patients who are not actively bleeding and are hemodynamically stable. Platelets may be given to those actively bleeding and have a platelet count of less than 50 × 109/L.
Offer fresh frozen plasma to bleeding patients who have either a prothrombin time or activated partial thromboplastin time greater than 1.5 times normal
cryoprecipitate or fibrinogen concentrate to those with a fibrinogen level of less than 1 g/L.
prothrombin complex concentrate to patients who are taking warfarin and actively bleeding
Tumour lysis syndrome (TLS) is a potentially deadly condition related to the treatment of high-grade lymphomas and leukaemias. It can occur in the absence of chemotherapy but is usually triggered by the introduction of combination chemotherapy. On occasion, it can occur with steroid treatment alone.
Management
Clinically recognize factors of increased risk:
- High tumor burden
- High grade tumors with rapid cell turnover
- Pre-existing renal impairment
- Increased age
- Treatment with highly active, cell-cycle specific
- Concomitant use of drugs that increase uric acid levels
Low: IV fluids
Intermediate: IV fluids + Allopurinol (7 days)
High: IV fluids + Rasburicase ± Allopurinol
