PBL 7 Flashcards
What is the name of surgical removal of the spleen?
Splenectomy
What is the long term risk associated with spenectomy What can be prescribed for this? (3)
After spleen removal, you’re more likely to contract serious or even life-threatening infections. Following splenectomy, your doctor may recommend you receive a pneumonia vaccine and yearly flu vaccines. In some cases, preventive antibiotics may be recommended as well, especially if you have other conditions that increase your risk of serious infections.
What do you need before surgery to remove the spleen?
To prepare for splenectomy, you may need to: Receive blood transfusions before surgery to ensure you have enough blood cells following removal of your spleen
What different types of blood donation are there? (4) How do the methods of collection differ?
Whole blood. This is the most common type of blood donation, during which approximately a pint of whole blood is given. The blood is then separated into its components — red cells, plasma, platelets. Platelets. This type of donation uses a process called apheresis. During apheresis, the donor is hooked up to a machine that collects the platelets and some of the plasma, and then returns the rest of the blood to the donor. Plasma. Plasma may be collected simultaneously with a platelet donation or it may be collected without collecting platelets during an apheresis donation. Double red cells. Double red cell donation is also done using apheresis. In this case, only the red cells are collected.
How often can you donate blood, and what are the age and weight restrictions?
You should be able to donate blood every four months without any adverse effects if you are: - healthy - weigh over 50kg, 110lbs, 7st 12 - between 17 and 65 years old (or 60 for first-time donors).
In what situations could giving blood be dangerous to donor, and is therefore not allowed by the NHS? (4)
You’re a male donor with less than 12 weeks’ interval between donations You’re a female donor who had given blood in the last 12 weeks (normally, you must wait 16 weeks). You do not weigh over 50kgs (7st 12). Please note, if you are female, aged under 20 years old and weigh under 65kg (10st 3lbs) and are under 168cm (5’ 6”) in height, we need to confirm your estimated your blood volume is over 3500ml. You should not give blood if you are pregnant or you are a woman who has had a baby in the last 6 months.
In what situations could giving blood be dangerous to recipient, and is therefore not allowed by the NHS? (excluding sexual reasons) (12)
You have a chesty cough, sore throat or active cold sore You’re currently taking antibiotics or you have just finished a course within the last seven days or have had any infection in that last two weeks. You’ve had hepatitis or jaundice in the last 12 months. You’ve had a tattoo, semi-permanent make up or any cosmetic treatments that involves skin piercing in the last 4 months. You have had acupuncture in the last 4 months, unless this was done within the NHS or by a qualified Healthcare Professional. A member of your family (parent, brother, sister or child) has suffered with CJD (Creutzfeld-Jakob Disease). You’ve ever received human pituitary extract (which was used in some growth hormone or fertility treatments before 1985). You have received blood or think you may have received blood during the course of any medical treatment or procedure anywhere in the world since 1st January 1980. You may not be able to donate if you’ve had complicated dental work. Simple fillings are OK after 24 hours, as are simple extractions after 7 days You’ve been in contact with an infectious disease or have been given certain immunisations in the last four weeks. You’re presently on a hospital waiting list or undergoing medical tests You may not be able to give blood if you’ve had a serious illness or major surgery in the past.
How does travel abroad affect your eligibility to give blood?
Please wait 6 months after returning from a malarial area before giving blood. Please also tell us if you have visited Central/South America at any time. (Those who’ve had Malaria, or an undiagnosed illness associated with travel, may not however be able to give blood.)
What is donated blood always tested for? Why? Is this foolproof?
Every single blood donation is tested for HIV (the virus that causes AIDS) and hepatitis B and C. Infected blood isn’t used in transfusions but our test may not always detect the early stages of viral infection. The chance of infected blood getting past our screening tests is very small, but we rely on your help and co-operation. People who carry these viruses may feel healthy for many years.
You should never give blood if: (6)
You have ever had syphilis, HTLV (Human T - lymphotropic virus), HIV or hepatitis C. You’ve ever worked as a prostitute. You’ve ever injected yourself with drugs - even once.
What are the eligibility criteria for giving blood with regards to the sex life of the donor? (7)
- A prostitute is asked not to give blood. You should not give blood for 12 months after sex with: A man (if you’re a male). Men who have had anal or oral sex with another man (with or without a condom) are deferred from blood donation for 12 months. A man who has had sex with another man (if you’re a female). A prostitute. Anyone who has ever injected themselves with drugs. Anyone with haemophilia or a related blood clotting disorder who has received clotting factor concentrates. Anyone of any race who has been sexually active in parts of the world where AIDS/HIV is very common. This includes countries in Africa.
What are the guideline normal values of monocytes in the blood? When might they be raised? (3)
Guideline normal values: 0.2–0.8 x 10^9/L. comprising 2–10% of WBCs. Raised in: - Acute and chronic infections (especially TB, brucellosis, protozoan disease) - Malignant disease (especially M4 & M5 acute myeloid leukaemia and Hodgkin’s disease) Myelodisplastic syndrome - a diverse collection of haematological conditions that involve ineffective production (or dysplasia) of the myeloid class of blood cells.
What is glandular fever? What Microbe is it caused by? What is it characterised by? (4) Who is most likely to contract it? What is the treatment?
Infectious mononucleosis, commonly known as glandular fever, is a viral infection that’s caused by the Epstein-Barr virus. Anaemia is a rare side effect. The disease is characterised by a sore throat, swollen lymph nodes (usually in the neck) and extreme fatigue. Young people aged between 10 and 25 years are most vulnerable to this infection. The treatment is to ease the symptoms, and the illness usually passes without serious problems.
How is glandular fever contracted? How long is the incubation period? What are the specific symptoms: in the first two weeks? After the first two weeks? (12)
the Epstein-Barr virus is transferred from one person to another in saliva. Kissing is one obvious way by which the disease can be transmitted. But the infection is also spread via airborne droplets. The incubation period from infection to when the symptoms first appear is between 30 and 50 days. It’s possible to become infected with this virus and to develop no symptoms. This is referred to as a subclinical infection. Before the disease breaks out, one to two weeks may pass with symptoms that are similar to those of flu. Then: - A sore throat, - swollen tonsils that are heavily covered by a white coating. - Fever. - Severe fatigue. - Muscle pains. - In 20% cases: swelling and puffiness around the eyes - Headache. - Tendency to sweat. - spleen can become swollen. If this occurs, it can sometimes be felt below the ribs on the left-hand side of the abdomen and may occasionally cause mild pain. - Swollen, sore lymph nodes in the neck, armpits and groin. - The liver may become enlarged; yellow jaundice non-itchy widespread, red rash that quickly disappears.
How do you diagnose glandular fever?
The diagnosis is made on the grounds of the symptoms, blood samples and a throat swab
Good advice to give someone with Glandular Fever (6)
Hot drinks can relieve the sore throat Drink plenty of fluids when you run a fever. Rest when you’re tired or are running a fever. Resume physical activities slowly. Wait at least eight weeks before resuming activities involving heavy physical strain. It’s sensible to avoid drinking alcohol for 6 weeks
How long does glandular fever last? What are the long term effects of the illness? What are some rare complications? (7) How is glandular fever treated ?
Glandular fever usually takes two to four weeks and resolves itself without complications. In about 3 per cent of all cases, it goes on longer. After having the disease, a person will have lifelong immunity to it – so will not catch it again. Possible, but rare, complications: - The respiratory passages may become partially blocked and require a short course of oral steroid therapy to help to reduce the inflammation. - Pneumonia requiring antibiotic therapy. - The spleen may rupture – this happens in 0.1 to 0.2 per cent of all cases. - Anaemia. - blood platelets may decrease (thrombocytopenia). - Rarely, the disease may lead on to chronic fatigue. - Very rarely, the central nervous system may be infected by the virus and can cause complications like meningitis or encephalitis. There’s no efficient treatment of infections caused by the Epstein-Barr virus other than to ease the symptoms.
What are the normal values of haemoglobin concentration in the blood? What is the Hb conc test used for? What is it ordered as a part of? What is it not normally used to screen for? Why?
Normal values Hb conc in an adult are approximately 120 to 180 grams per litre (12 to 18 g/dL) of blood. The test is used to: - detect and measure the severity of anaemia (too few red blood cells) or polycythaemia (too many red blood cells), - monitor the response to treatment of anaemia - help make decisions about blood transfusions. - It is often requested before operations to make sure you are fit for surgery and do not require a transfusion. Haemoglobin measurement is part of the full blood count (FBC) (which is requested for many different reasons), especially when your doctor suspects anaemia, and sometimes as part of a general health screen). It is not usually used to screen for polycythaemia (too many red blood cells), as the haematocrit - another routine part of a full blood count - is a more accurate test for this.
