year 5 Flashcards
Thrombotic crises
also known as painful crises or vaso-occlusive crises
precipitated by
by infection, dehydration, deoxygenation (e.g. high altitude)
painful vaso-occlusive crises should be diagnosed clinically
acute chest syndrome features
dyspnoea, chest pain, pulmonary infiltrates on chest x-ray, low pO2
pulmonary infilitatres
transfusion will improve oxygenation
Aplastic crises
caused by infection with parvovirus does what to hb and reticulocye count
fall in Hb
bone marrow suppression causes a reduced reticulocye count
Sequestration crises
sickling within organs such as the spleen or lungs causes pooling of blood with worsening of the anaemia
what does reticulocyte count do
increased reticulocytes due to pooling of blood
what is post thrombic sndrome
problems post dvt associated with venous outflow obstruction, venous insuffiecny resulting in chronic venous hypertension - painful calves, puritits, swellign, varicoe veins and venous ulceration.
tx of post thrombotic syndrome
Compression stockings have in the past been offered to patients with deep vein thrombosis to help reduce the risk of post-thrombotic syndrome. This is now not recommended.
However, once post-thrombotic syndrome has developed compression stockings are a recommended treatment. Other recommendations including keeping the leg elevated.
transfusion of two units of blood or more can result in fluid overload.
what should be prescribed through units if hx of hf
Therefore, furosemide should be prescribed to be given between every other unit, if two or more units are given.
Paracetamol can be used if there is a non-haemolytic febrile reaction to the transfusion.
Cetirizine and hydrocortisone are used in cases of an anaphylactic reaction to the transfusion.
Platelets may be given in cases of major haemorrhage, alongside packed red cells.
Renal impairment in myeloma has 4 causes
AL type amyloidosis, Bence Jones nephropathy, nephrocalcinosis, nephrolithiasis
3 things on blood film seen post splenectomy
Howell-Jolly bodies are nuclear remnants seen in red blood cells, and their presence suggests a lack of splenic function because the spleen normally removes these bodies from circulating red blood cells.
Target cells can be seen in various conditions including liver disease, thalassaemia, and post-splenectomy.
Pappenheimer bodies are siderotic granules that can also be seen after splenectomy. Hence, the combination of Howell-Jolly bodies, target cells, and occasional Pappenheimer bodies is most suggestive of a post-splenectomy state.
spherocytes found in what two conditions
he FBCs reveal severe anaemia, and the LFTs together with the examination findings demonstrate a pre-hepatic jaundice (only bilirubin is deranged). The most likely cause is therefore haemolysis. The peripheral blood smear narrows the differentials, as it shows spherocytes which are found in hereditary spherocytosis and autoimmune haemolytic anaemia. In hereditary spherocytosis, the anaemia is usually mild to moderate, more chronic, and may have a family history. Autoimmune haemolytic anaemia is therefore more likely.
High uric acid + renal impairment following chemotherapy
nausea, reduced urine output, and deranged blood results. Of note, her blood results show hyperkalaemia, an AKI, hypocalcaemia, hyperphosphataemia and an increased uric acid
tumour lysis syndrome
IV rasburicase
ITP should be considered in the presence of symptoms that suggest isolated thrombocytopenia e.g.
epistaxis, menorrhagia
rare for females to have haemophillia
small mature lymphocytes.
CLL
asx
It is characterised by peripheral blood lymphocytosis (many of which are precursors, but not blasts), and an uncontrolled proliferation of small, mature lymphocytes in the bone marrow, lymph nodes (resulting in lymphadenopathy) and spleen (resulting in splenomegaly)
in hodgkins what b symtpoms indicate worse prognosis
weight loss > 10% in last 6 months
fever > 38ºC
night sweats
managment of acute chest crisis in sickle cell
pain relief
oxygen therapy
antibiotics
transfusion
myeloma bone aspirate you would see
increased number of palsma cells
