Hx Taking/ Practical

Question 1

What q’s for anaemia?

Answer 1

Tiredness, SOB, chest pain

Question 2

General q’s for haematology?

Answer 2

Anaemia - tiredness, infections, bleeding problems

Question 3

If pt has bleeding disorder - what q’s?

Answer 3

Easy bruising - size, last, spontaneous, location
Bleeding after cuts
Nose bleeds
Bleeding with dental tx

Question 4

What family history should you ask?

Answer 4

Important as many genetic

Sickle cell, haemophilia

Question 5

Social hx of important?

Answer 5

Alcohol - if excessive poss liver disease and bleeding problems

Question 6

What causes sickle cell disease?

Answer 6

Mutation in haemoglobin - instead GAG glutamic acid have GTG = valine
S shaped haemoglobin

Question 7

What do you see in sickle cell?

Answer 7

Vaso-occlusive crisis - very painful and due to hypoxia

Can be precipitated cold, infection, hypoxia, stress

Question 8

Tx sickle cell

Answer 8

Analgesia, keeping warm, IV fluid, folic acid, antibiotics if infection

Question 9

Management chronic sickle cell?

Answer 9

Blood transfusion in childhood

Ab and vaccination due to hyposplenism

Question 10

What is haemophilia and explain the severity?

Answer 10

X-linked disorder (dominant)
Severe <1% factor activity = spontaneous bleeds
Moderate 1-5% = may have spontaneous bleeds
Mild >5% = bleed trauma/ surgery

Question 11

Tx haemophilia?

Answer 11

Clotting factor replacement

DDAVP - for mild haemophilia