Blood Flashcards
Ix if ? Fe deficiency anaemia
FBC (microcytic, hypochromic)
- MCV <80
Serum ferritin (<30 micrograms/L)
Transferrin saturation (<16%)
Reticulocytes (low)
Blood film (pencil cells)
Coeliac serology
when is 2ww gastric referral needed for Fe deficiency anaemia?
> 60 years old
<50 years old + persistent rectal bleeding
When is a non-cancer gastro referral needed for Fe deficient anaemia
ALL men + post-menopausal women (unless overt non-GI bleeding)
> 50 + anaemia or FH of colorectal cancer
Pre-menopausal women <50 with persistent Fe deficient anaemia despite treatment.
Treatment of Fe deficient anaemia
200mg PO ferrous sulphate, 2-3x per day.
Hb should rise by 10g/L/week.
Continue for 3 months after iron stores normalise.
Take with food (SE: nausea, GI upset)
When is IV iron indicated?
Oral route contraindicated
Oral route ineffective (e.g. inadequate mobilisation of Fe stores in CKD).
Febrile non-haemolytic transfusion reaction + management
Fever
Rigors/chills
Headache + anxiety
Tachypnoea
STOP transfusion
paracetamol
restart transfusion slowly
Anaphylaxis transfusion reaction + management
angioedema hypotension tachycardia pruritis hypotension
STOP transfusion
0.5mg adrenaline IM
100mg chlorphenamine
200mg hydrocortisone
5mg salbutamol nebs
Bacterial contamination of blood transfusion + management
fever/rigors
hypotension
STOP transfusion
call haem
blood cultures
broad spectrum antibiotics
TRALI + management
Sudden onset SOB
tachycardia
fever
hypotension
STOP transfusion
Oxygen
Treat ARDS (O2, CPAP, NIV)
Remove donor from pool
TACO + management
Fluid overload
Pulmonary oedema
hypertension
STOP transfusion
Sit up
oxygen
diuretics