Medicine - Haematology Flashcards
What tests should you order when querying IDA in a sick vs healthy patient?
No illness: Ferritin
Illness: TIBC, TF, iron
Why? Ferritin is an acute phase protein
What markers will be raised in iron deficiency anaemia?
LDH, haptoglobins, uBR
Differentiate the class of immunoglobulin associated with warm vs cold AIHA?
Warm: IgG
Cold: IgM
How is warm AIHA managed?
Steroids, splenectomy
Recall some causes of warm AIHA
Lymphoma
CLL
Drug allergy
SLE
Recall some causes of cold AIHA
Myclopasma pneumoniae
EBV
CMV
What abnormality would be seen on blood film in warm AIHA?
Spherocytes
What test is used to identify paroxysmal nocturnal haemoglobinuria?
Ham’s test
If warm AIHA and hereditory spherocytosis both have spherocytes, what test can be used to differentiate them?
Coomb’s/DAT test
Positive in AIHA
Neg in HS
Recall 3 possible causes of MAHA
HUS
TTP
Adenocarcinoma
Recall 3 electrolyte abnormalities seen in tumour lysis syndrome
Hyperkalaemia
Hyperphosphataemia
Hypocalcaemia
How should tumour lysis syndrome be managed?
Allopurinol
IV if high risk
PO if low risk
What Hb level indicates packed RBC transfusion?
No ACS: <70g/L
ACS: <80g/L
Recall 4 contraindications for platelet transfusion
Chronic BM failure
Heparin-induced thrombocytopaenia
ITP
TTP
Which inherited thrombophilia increases the relative risk of DVT the most?
Antithrombin III deficiency
What is the prevalence of Factor V Leiden?
5%
What is the most common inherited bleeding disorder?
Von Willebrand
What is the aetiology (broadly) of heparin-induced thrombocytopaenia?
Antibodies form against heparin and platelet factor 4 –> platelet activation via various mechanisms –> PROTHROMBOTIC state (even though it’s a thrombocytopaenia)
Which blood group antigens are most likely to cause a delayed transfusion reaction?
Duffy
Kidd
What % of the population are Rh pos?
85%
What sort of transfusion reaction does Rhesus incompatability cause?
Delayed haemolytic
Recall the storage conditions for RBCs, platelets and FFP
RBCs: 4C for 35 days
Platelets: 22C for 7 days
FFP: frozen
How long does FFP need to thaw?
20-30 mins
How long can RBCs be out of the fridge?
4 hours
