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HAEMATOLOGY > [leukaemia] > Flashcards

[leukaemia] Flashcards

1
Q

[leukaemia][basic]: 3 complications of leukaemia?

A

hyperviscosity
infection
bleeding

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2
Q

[leukaemia][basic]: patients report what non-specific symptom?

A

drowsiness/tired

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3
Q

[leukaemia][basic]: what is the cut off for neutropenia?

A

<=0.5 x10^9/L

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4
Q

[leukaemia][basic]: in neutropenic patients … as a route for drug administration should be avoided

A

IM injections

check IVI sites

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5
Q

[leukaemia][basic]: Septicaemia is assumes in neutropenic patients whose temperature is > … on one occasion

A

38

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6
Q

[leukaemia][basic]:Septicaemia is assumed in neutropenic patients if their temperature is > .. on 2 seperate occasions

A

37.5

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7
Q

[leukaemia][basic]: what is empirical treatment for septicaemia with neutropenia

A

Tazocin (pipercacillin + tazobactam)
+
Gentamicin

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8
Q

[leukaemia][basic]: when would you add in gentamicin to treat septicaemia in a neutropenic patient?

A

Gram + suspected

or
infection source found e.g. hickmans line

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9
Q

[leukaemia][basic]: if septicaemia with neutropenia persists post Abx Tx; where might the infection come from?

A

Central Line infection

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10
Q

[leukaemia][basic]: If septicaemia + neutropenia persists post Abx Tx, what organisms might be suspected (2)

A

Fungi (aspergillus/ candida)

CMV

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11
Q

[leukaemia][basic]:for how long is the course of Abx in septicaemis +neutropenia

A

5 days

or afebrile for 72

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12
Q

[leukaemia][basic]: speticaemia+neutropenia: what WCC are you aiming for with Abx Tx?

A

> 0.5x10^9/L

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13
Q

[leukaemia][basic]:what score indicates the risk of septic complications?

A

MASCC (multinational association for supportive care in cancer)

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14
Q

[leukaemia][basic]: what 2 things are released in high concentrations in tumour lysis syndrome?

A

K+

Urate

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15
Q

[leukaemia][basic]: what happens to cancer cells in tumour lysis syndrome

A

breakdown of cells after Tx

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16
Q

[leukaemia][basic]: what organ is most affected in tumour lysis sydnrome

A

renal (renal injury)

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17
Q

[leukaemia][basic]: which 2 cancers does tumour lysis syndrome usually affect

A

lymphomas

leukaemias

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18
Q

[leukaemia][basic]: how can you prevent tumour lysis syndrome (drug Tx) in normal risk pts.

A

allopurinol pre-cytotoxics

+advise high fluid intake

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19
Q

[leukaemia][basic]: what advice other than drug Tx for tumour lysis syndrome would you give before giving cytotoxics

A

high fluid intake

20
Q

[leukaemia][basic]: in patients at high risk of tumour lysis syndrome what pre-cytotoxic drug may be given?

A 
recombinant uricase
(rasburicase)
21
Q

[leukaemia][basic]: > what WCC would manifest as hyperviscosity?

A

> 100 x10^9/L

22
Q

[leukaemia][basic]: describe leukostasis?

A

WBC thrombi formation

23
Q

[leukaemia][basic]: DIC: widespread coagualtion activation causes fibrin strand depostion: how can this affect RBCs

A

haemolysis of RBCs

24
Q

[leukaemia][basic]: DIC: what happens to blood concentrations of clotting factors and platelets

25
Q

[leukaemia][basic]: DIC: why is there a widespread activation of coagulation?

A

Release of pro-coagulants

26
Q

[leukaemia][basic]: DIC: clinical signs? (3)

A

Bleeding
Bruising
Renal failure

27
Q

[leukaemia][basic]: DIC: What organ may be affected by DIC

A

Kidney - renal failure

28
Q

[leukaemia][basic]: DIC: on Ix: platelet count?

29
Q

[leukaemia][basic]: DIC: on Ix: fibrinogen?

A

Down (correlates with severity)

30
Q

[leukaemia][basic]: DIC: what are D-Dimers?

A

fibrinogen degradation products

31
Q

[leukaemia][basic]: DIC: D-Dimer count

32
Q

[leukaemia][basic]: DIC: PT?

33
Q

[leukaemia][basic]: DIC: APTT

34
Q

[leukaemia][basic]: DIC: what would be seen on blood film

A

schistocytes (broken RBCs)

35
Q

[leukaemia][basic]: DIC: Tx is to treat the cause; how could you increase coagulation factors?

36
Q

[leukaemia][basic]: DIC: what is the cut off for tranfusion of platelets?

A

<50 x10^9/L

37
Q

[leukaemia][basic]: DIC: If there is severe sepsis or multiorgan failure what Tx option is available?

A

Activated protein C

38
Q

[leukaemia][basic]: DIC: what is activated protein c

A

anti-coagulant

inactivates factor 5 and 8

39
Q

[leukaemia][basic]: what Tx is available to give a septic patient to prevent progression to severe sepsis?

A

Ciprofloxacin

40
Q

[leukaemia][basic]: why would a fluoroquinolone (e.g. ciprofloxacin) be given to a patient in sepsis?

A

prevent progression to severe sepsis

41
Q

[leukaemia][basic]: leukaemia time course is acute/sub-acute/chronic timecourse?

42
Q

[leukaemia][basic]: In a patient with neutropenic sepsis what organism is most likely to cause lung pneumonia?

A

Pneumocystis Jirovecii

fungus) (immunocompromised

43
Q

[leukaemia][basic]: what is empirical Tx for pneumocystis jirovecii?

A

Co-trimoxazole 120mg/kg/day IVI for 3 weeks

44
Q

[leukaemia][basic]: what may you see on CXR in pneumocystis jirovicii

A

normal CXR possible!

45
Q

[leukaemia][basic]: What is co-trimoxazole?

A

trimethoprim +sulfamethoxazole

46
Q

[leukaemia][basic]: DIC: what would you give to replace consumed fibrinogen?

A

Cryoprecipitate

HAEMATOLOGY (25 decks)

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