Leukaemia and the on-call junior doctor Flashcards
How are the types of leukaemia divided?
Due to the subtypes, they originate from
Lymphoid and myeloid
The patients with acute leukaemia fall ill suddenly. What do they fall ill with?
Infection
Bleeding
Hyperviscosity
Neutropenic regimen:
Why must infection control be strictly adhered to?
Why are IM injections avoided?
A Hickman line is put in place. What is it and why is this used?
Why is chlorhexidine used on moist skin?
What can be done regularly to look for infections?
What type of mouthwash can be used to prevent oral infection?
As they are immunocompromised
The danger of infected haematoma
A Hickman line is a soft, small, long, hollow tube that is placed into a vein in the chest and ends in a larger vein just above your heart. A Hickman line is used long-term to access your veins and can be used to give chemotherapy, intravenous medications, nutrition, and to draw blood for labs. - for this, it is to be able to take blood
Chlorhexidine (commonly known by the salt forms chlorhexidine gluconate (CHG) or chlorhexidine acetate), is a disinfectant and antiseptic that is used for skin disinfection before surgery and to sterilize surgical instruments.
Swabs
Hydrogen peroxide
Use of antibiotics in neutropenia:
What should be looked at for guidance when prescribing?
If antibiotics are given and the fever doesn’t resolve, what should you be thinking about?
Local guidelines
Viruses and fungi
Other dangers:
Hyperviscosity:
- What is leukostasis?
Leukostasis (also called symptomatic hyperleukocytosis) is a medical emergency most commonly seen in patients with acute myeloid leukaemia. It is characterized by an extremely elevated blast cell count and symptoms of decreased tissue perfusion.
Basically WBC thrombi
Other dangers:
DIC:
- What is it?
- What can cause it?
- What will blood tests show?
- How is it Rx?
The release of procoagulants into the circulation causes widespread activation of coagulation consuming clotting factors and platelets increasing the risk of a bleed.
Malignancy
Sepsis
Trauma
Low platelets
Raised PT and aPTT
Treat the cause
Replace platelets
