Haem Flashcards
(24 cards)
Polycythaemia management
Venesection/phlebotomy (1st line)
Aspirin
Chemotherapy
Management for autoimmune haemolytic anaemias?
Steroids +/- rituximab
Management for hereditary spherocytosis/elliptocytosis
Folic acid supplement
Splenectomy before 5 is curative
Acute:
Transfusion
What is seen on the blood film for autoimmune haemolytic anaemia?
Spherocytes
Reticulocytes
Normocytic
Investigations, including blood film for G6PD deficiency
G6PD enzyme assay dignostic
Heinz bodies
Bite and blister cells
Investigations for hereditary spherocytosis/elliptocytosis
Spherocytes on blood film
Mean corpuscular haemoglobin concentration high
EMA binding
What are the laboratory investigations for DIC?
Decreased platelet
Prolonged PT (APTT sometimes)
Decreased fibrinogen
Increased fibrin degradation products
Decreased factors 5, 8, 10, 13
What is seen on a blood film for a DIC patient and why
Schistocytes due to microangiopathic haemolytic anaemia
Auer rod cells are associated with what?
Acute myeloid leukaemia
What is associated with smear/smudge cells
Chronic lymphoid leukaemia
Which leukaemia can progress to lymphoma
CLL
Which cancer causes symmetrical painless lymphadenopathy?
CLL
What is associated with tear drop poikilocytes?
Myelofibrosis
Which sickle cell crisis causes a decrease in reticulocytes
Aplastic crisis
Which sickle cell crisis causes increased reticulocytes
Splenic sequestrian
Difference between CML and AML in terms of WBCs?
WBC count in CML is massively raised (if >100 it’s cml)
AML has a somewhat raised WBC
CML has granulocytosis with all stages of maturation seen whilst AML has low % granulocytes and high -blasts
Management for CML
Imatinib (tyrosine kinase inhibitor)
What is seen on blood film in alpha thalassemia?
Heinz bodies
Target cells in HbH disease too
What are the 3 types of alpha thalassemia and how do they present
1/2 alpha globulin affected:
- hypochromic microcytic RBCs
- normal Hb and usually asymptomatic
3 alpha globulins (HbH DISEASE):
- hypochromic microcytic anaemia with splenomegaly
- jaundice, fatigue, SOB, facial bone deformities
4 alpha globulins:
- death in utero
Anaemia of chronic disease compared to IDA:
Serum iron, TIBC, ferritin
Serum iron: low
Ferritin: high/normal
TIBC: low/normal
IDA
Serum iron: low
Ferritin: low
TIBC: high
Which blood cancer is massive splenomegaly associated with?
CML
What blood cancer causes swollen gums and mild splenomegaly
AML
Management for vaso-occlusive crisis (including acute chest syndrome) of sickle cell
Analgesia (paracetamol, ibuprofen)
O2 if hypoxic
IV fluids
Transfusion if life-threatening or symptomatic anaemia
In acute chest syndrome:
- O2 is first with incentive spirometry
- paracetamol
- Broad spec AB (pneumonia never ruled out)
- Transfusion
DIC management
Treat underlying
FFP if high bleeding risk/active bleeding
Chronic:
- heparin for thrombosis signs
- anti fibrinolytic agents (tranexamic acid) for hyperfibrinolysis
