MCQ haem/ immuneology/ allergy Flashcards
(40 cards)
risk of replacing folate before b12?
subacute combined degeneration
most common inherited bleeding disorer?
VWD: deficiency of abnormal function of VWF (responsible for platelet plug forming and factor 8)
nose bleeds, menhorragia, raised APTT, blood group O woman. tx?
VWD. test family.
Ix: VWF antigen assay detects quantitative deficiency. there is also qualitative
TX: desmopressin (temporarily increases factor 8/ vwf)(intranasal/ parerntal), TXa
drugs that cause low platelets?
CARDS Not Very High Quality
Carbemazepine
Abciximab
Rifampicin
Diuretics (furosemide)
Ssulphonamides
NSAIDs
Heparin
Quinine
Standard for detecting malaria?
fever pattern?
most serious cx?
thick and thin blood films, gram stain.
diurnal variation of fever
serious/ splenic rupture: P. falciparum
APTT measured?
intrinsic pathway - factors 12, 11, 9, 8,, 5, 2, 1, VWF. and the common pathway (factor 10 to 2 to fibrinogen to fibrin)
PT measures?
extrinsic pathway and common pathway, 1, 2, 5 ,7 10 and warfarin.
how do coagulation factor defects normally present?
large bruises, small bleed from cut, haematuria, bleeding after a day of truama/ surgery/ dental extraction, haemoarthrosis (in severe cases of haemophilia)
How are platelet/ vWF deficiencies liekly to present?
small bruises, lot sof bleeding form cuts, immediately bleeding post surgery/ dental work, nosebleeds and gI bleeds common
post transfusion: fever, chills, burnign at site of transfusion, red urine, pain, restless, chest tightness. cx?
acute haemolytic reaciton (ABO incompatibility/ direct antibodies in recipients blood)
post transfusion: 2 hrs after/ SOB, fever, chills, malaise
non haemolytic (due to cytokine production from leukocytes. delayed reaction could be days/ weeks later.
post transfusion: high fever, shock, no clear cx for infection?
bacterial contamination
TRALI is?
antibodies in donor’s blood attacking recipient, recipient releases mediators that cause pulmonary oedema
G6PD?
x linked causes haemolyitc crisis after exposure to fava beans, quinine, sulfa drugs, infections, heinz bodies, normocytic normochromic anaemia
pruritus, ehadache, sweating, ruddy complexion, splenomegaly, turning red in hot bath. HTN
dx criteria?
myeloproliferative neoplasm: Polycythaemia vera AF: dysfunction of JAK 1 and 2,
Dx: 2 major+1 minor or 2 minor and 1st major
major: HB 185+men/165+women / JAK2/ haematocrit 0.6+men/ 0.56 women
minor: EPO <normal, bone marrow changes
risk: vTE/ tx: control cardio rf
Down’s syndrom associated conditions?
hypothyroid, AD, duodenal atresia, t1dm, hirschprungs, acute leukaemia, LD, endocardial cusion defects, seizures
apparent polycythaemia?
increased haemtrocrit, normal red cell mass caused by reduced plasma volume. obese men, stress, diuretics, smoking, HTN, alchjol dehydration
secondary PCV?
caused by EPO production due to chronic hypoxia eg copd, CLD. renal disorders - inappropraite EPO, sleep apnoea, obesity,
microcytic cx?
TAILS (thallassaemia, anaemia of chronic disease, iron (ferritin <15, lead, sideroblastic).
thalassaemia - common in ethnic, MCV more reduced
Riskiest blood product?
platelets (@stored at room temp)
cough, sob, hypoxia, pulmonary infiltrates new on CXR.
B/G: anaemia, jaundice, vaso-occlusive crisis?
sickle cell crisis
cryoprecipitate contains?
factor 8, 13, vwf, fibrinogen,
VTE in cancer patients tx?
6 monts
coag disorder older women?
young boy?
VWF
Haemophilia A (x linked)
