Anaemias/Coagulation

Question 0

G6PD Precipitants?

Answer 0

Drugs - aspirin, dapsone, vit K, primaquine, sulphonamides

Broad beans
Moth balls

Question 1

Hereditary Spherocytosis

Enzyme deficiency?
Susceptible to …?

Answer 1

Spectrin deficiency

Parvovirus B19

Question 2

Sickle Cell Disease

Treatment?

Answer 2

Analgesia for painful crises
Folic acid
Hydroxycarbamide
Penicillin V
Pneumovax
HiB vaccine

Question 3

B Thalassemia

Diagnosis?

Treatment?

Answer 3

Hb Electrophoresis

Blood transfusions and desferroxiamine (prevent Fe overload)

Question 4

Paroxysmal Cold Haemoglobinuria

Describe.
Ab?

Answer 4

Hb in the urine caused by viral infection e.g measles

Donath- Landsteiner Ab (stick to RBC in cold, haemolysis on rewarming)

Question 5

Micro angiopathic HA

Causes?

Answer 5

HUS
TTP
DIC
preeclampsia 
Intravascular devices e.g heart valves

Question 6

APTT

Measures which pathyway?
Which drug?

Answer 6

Intrinsic

Heparin

Question 7

Prothrombin time

Which pathway?
Which drug?

Answer 7

Extrinsic

Warfarin

Question 8

Acute and Chronic ITP

treatment?

Answer 8

A : spontaneous remission common

C: IVIG, steroids, splenectomy

Question 10

Haemophilia A

Treatment?

Answer 10

Avoid NSAIDS and IM injections

Desmopressin, factor VIII concentrates lifelong

Question 11

DVT Prophylaxis

Answer 11

Daily subcutaneous LMWH e.g tinzaparin, clexane

Question 12

1st episode DVT / PE or AF

Target INR?

Answer 12

2.5

Question 13

Recurrent DVT or PE, mechanical prosthetic valve

Target INR?

Answer 13

3.5

Question 14

INR Protocol

4.5-6
6-8
>8 no/minor bleed
Major bleed

Answer 14

1) reduce warfarin / omit. restart when INR>5
2) stop warfarin. restart when INR >5
3) stop warfarin oral vit K
4) stop warfarin. Prothrombin complex concentrate (2nd line is FFP). IV Vit K

Question 15

Heparin

MofA?
Antidote?

Answer 15

potentiates antithrombin III (which inactivates thrombin and factors 9,10,11)

Protamine sulphate

Question 16

DVT/ PE

Treatment?

Answer 16

LMWH + WARFARIN
Stop LMWH once INR is 2.5
Continue warfarin for 3-6 months

Question 17

Rivaroxiban

Answer 17

Direct inhibitor of Xa

Question 18

Sideroblastic Anaemia

Blood film?

Answer 18

Ring sideroblasts

Treat with pyridoxine

Question 19

Direct Autoimmune test +ve ?

Answer 19

AI HA

(Warm is most common).

Question 20

Donath-Landsteiner Ab

Answer 20

Paroxysmal Cold Haemoglobinuria