8/5

Question 1

How is haemochromatosis monitored?

What seperates it from other causes of high ferritin
(remember it is an acute phase reactant)?

Answer 1

Ferritin and transferritin levels

The high transferritin - shows that there is a lot of iron in the blood not just in stores

Question 2

How is bence jones protein illicted in myeloma?

Answer 2

Urine sample

Question 3

What antibiotic can not be used with methotrexate?

Answer 3

Trimethoprim

Don’t mix your meths

Question 4

High INR in warfarin management

Answer 4

Important points to remember:
- Remember 5 and 8
- Aim for INR <5
- If bleeding give IV vit K
- >8 stop warfarin and only start when <5
- if major bleeding give FFP regardless of INR

Between 5-8 with no bleeding
- withold 1/2 doses and reduce maintenance

5-8 with minor bleeding
stop warfarin
IV vit K and restart when INR <5

> 8
Stop warfarin
Vit K oral/IV dependant on bleeding

Question 5

What is the reversal agent for DOAC

Answer 5

AndeXAnet alfa

Question 6

What cardiovascular meds should be stopped pre-surgery?

Answer 6

Clopidogrel - stop 7 days before
Warfarin - normally 5 days before - replace with LWMH
ACEi - the day before