JB-Haematology Flashcards
treatment for a DVT in patients with anti-phospholipid syndrome
Lifelong warfarin
Diagnostic test for hereditary spherocytosis
EMA bind test
(None if clear dx)
Who gets G6PD
Men (x linked recessive)
African and Mediterranean
Treatment for hereditary spherocytosis
Acute haemolytic crisis -> transfuse/ supportive
Folate replacement
Splenectomy
Most common inherited bleeding disorder
Von Willibrans disease
How is VWF disease inherited
AD (most common in UK)
Rarely AR
VWF disease on clotting screen
Prolonged clotting time
APPT maybe prolonged (affects factor 8)
What disease can CLL transform to
High-grade lymphoma
NON HODGKINS
Richters transformation
What must be started when warfarin is commenced
Cover with LMWH
Prothrombotic first 2 -7 days as less protein C and S as much shorter half life (natural anti-coagulant)
How many days of LMWH cover on wafarin
At least 5
More if INR is less than 2
Why may skin necrosis occur on a patient starting warfarin
Hereditary protein C/S deficiency
Warfarin drops C and S levels further
Micro clots in skin -> necrosis
Treatment of Venus sinus thrombosis
LMWH (warfarin longer term)
Cannot used DOACs!
Difference between using prothrombin concentrate (octeplex) in warfarin vs DOAC
Warfarin reverses as provides clotting factors which warfarin stopped body making
Does not reverse DOAC. Used provides extra so hopefully some Xa is made.
Can a patient on a DOAC have surgery if PT and APTT is normal
No - not a reliable measure
Need anti X-a level (same as LMWH)
