Introduction to Haematology

Question 1

What is haematinics?

Answer 1

Investigation of vitamins and minerals important for normal haematopoiesis

• Iron studies
• B12
• Folate

Question 2

What are the two broad mechanisms of haemolysis?

Answer 2

Intrinsic to red cells

Extrinsic to red cells

Question 3

What does the activated partial prothrombin time measure (APTT)?

Answer 3

Intrinsic
- XII
- XI
- IX
- VIII
Common
- X
- V
- II (thrombin)
- Fibrinogen

Question 4

What does the prothrombin time (PT)/international normalised ratio (INR) measure?

Answer 4

Extrinsic
- VII
Common
- X
- V
- II (thrombin)
- Fibrinogen

Question 5

What are the investigations of haemostasis or bleeding disorders?

Answer 5

Routine coags
- APTT
- PT/INR
- Fibrinogen
- Platelet count and morphology
Specialised testing
- Factor assays
- Inhibitor assays
- Von Willebrand Disease testing
- Platelet aggregometry

Question 6

What is the measurement used to monitor heparin therapy?

Answer 6

APTT

Question 7

What is the measurement used to monitor warfarin therapy?

Answer 7

INR

Question 8

What is measurement used to monitor clexane therapy?

Answer 8

Anti Xa
Doesn't need routine monitoring except in
- Bleeding patient
- Pre-operatively
- Renal impairment

Question 9

How are haemoglobinopathies tested for?

Answer 9

Film/red cell indices
HPLC = measures proportions of different types of Hb
Hb electrophoresis = separates different Hb
Genetic testing - only reliable way to confirm alpha and beta thalassemias

Question 10

What does blood grouping for transfusions involve?

Answer 10

ABO and D testing

Red cell Ab screening