Passmed Haematology - Pharmacological Managements

Question 1

Antiphospholipid syndrome in pregnancy

Answer 1

Low-dose aspirin once pregnancy confirmed
LMWH once foetal heart seen on US (stop at 34 wks)

Question 2

Non-haemolytic febrile transfusion reaction

Answer 2

Slow/stop transfusion
Paracetamol

Question 3

Minor allergic transfusion reaction

Answer 3

Temporarily stop transfusion
Antihistamine

Question 4

Anaphylactic transfusion reaction

Answer 4

Stop transfusion
IM adrenaline 0.5mg 1 in 1000
O2 + fluids

Question 5

Acute haemolytic transfusion reaction

Answer 5

Stop transfusion
Check diagnosis (send blood for direct Coombs test, repeat typing/cross-match) + patient details

Question 6

Transfusion-associated circulatory overload

Answer 6

Slow/stop transfusion
Consider IV furosemide
O2

Question 7

Transfusion-related acute lung injury

Answer 7

Stop transfusion
O2 + supportive

Question 8

Blood product to give for surgery patients to correct clotting deficiencies with hepatic synthetic failure

Answer 8

Fresh frozen plasma

Question 9

Drugs that can cause haemolysis in G6PD?

Answer 9

Primaquine
Ciprofloxacin
Sulph- drugs (sulphonamides, sulphasalazine, sulfonylureas)

Question 10

Acute graft-versus-host-disease

Answer 10

IV steroids

Question 11

Hodgkin’s lymphoma

Answer 11

ABVD treatment (doxorubicin, bleomycin, vinblastine, dacarbazine)

Question 12

Neutropenic sepsis

Answer 12

Piperacillin with tazobactam (tazocin)

Question 13

Polycythaemia vera

Answer 13

Aspirin

Question 14

Sickle cell anaemia

Answer 14

Hydroxyurea

Question 15

Tranexamic acid use in major haemorrhage

Answer 15

IV bolus then infusion

Question 16

B12 deficiency

Answer 16

1mg IM hydroxycobalamin 3 times per week for 2 weeks, then once every 3 months