Haematology

Question 1

Anticoagulant reversal

Answer 1

Thrombolysis: TXA 1g, cryoprecipitate 10u and consider FFP 2u q6h
Platelet agents: DDAVP, platelets
Dabigatran: idaracizumab 5g IV
Apixaban: prothrombinex 50u/kg, TXA 1g (andnexenet alpha)
Warfarin: vitamin K 10mg, prothrombinex 50u/kg, FFP
Heparin: protamine 1mg for every 100u of heparin given

Question 2

Pancytopenia causes

Answer 2

Bone marrow failure
- Aplastic anaemia
- radiation
- viral illnesses: parvovirus, EBV
- cytotoxic drugs
- acute leukaemia
Overwhelming sepsis
Bone marrow infiltration
- haem malignancies: multiple myeloma, lymphoma
- myelofibrosis
Myelodysplasias
Hypersplenism
Vit B12 or folate deficiency

Question 3

Post splenectomy infection

Answer 3

Howell jolly bodies and Heinz bodies
Target cells
Thrombocytosis

Strep pneumonia
HiB
Neisseria meningitides
Salmonella
Malaria

Need rescue abx if febrile and pre procedure.