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spin the wheel notes > haem > Flashcards

haem Flashcards

1
Q

myelodysplastic syndromes

A

< 20 blasts in plasma
30% leads to AML
more susceptible to infection

give antibiotics
blood transfusion w iron chelation

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2
Q

AML

A

> 20 blasts
bone failure- anaemia, thrombocytopenia, infections
FBC, bone marrow aspirate- blast cells, blood film- auer rods
supportive care
chemo
remission- <5% blasts

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3
Q

haemolytic disease of newborn

A

anti D prophylaxis at 28 weeks and 34 weeks
jaundice
neg mum pos baby
indirect coombs test
Positive Direct Antiglobulin Test (DAT)
Anaemia, Jaundice

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4
Q

hyposplenism

A

howell jolly bodies
pitted erythrocytes
antibiotic prophylaxis
vaccinations

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5
Q

G6PD defic

A

normocytic, intravascular haemolytic anaemia

low haptoglobin
high retic
raised

antimalarials
fava beans
infection

spherocytes
heinz bodies
bite/ blister cells

negtaive coombs

treat folic acid

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6
Q

haemorrhagic disease newborn

A

vit K deficient
bulging fontanelle
prolonged PT AND APTT
caused by drugs in pregnancy
give vit K
Intracranial bleeding
Gastrointestinal bleeding
Post-circumcision bleeding
Umbilical stump bleeding

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7
Q

thalassemia

A

most common- beta 1
autosomal recessive
hair on end appearance on CT

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8
Q

clotting cascade

A

Xa they join
subendothelial contact is intrinsic
cellular damage is extrinsic
APTT is intrinsic
PT is extrinsic
Xa turns prothrombin into thrombin

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9
Q

anaemia of chronic disease

A

normocytic or microcytic
cancers
COPD
infection
RA

low ferritin
high total binding iron

give iron 3 months- doesnt work then anaemia of chronic disease

treat underlying cause
EPO

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10
Q

folate or B 12

A

IM B12 and folate
first B12 because paraesthesia gets worse if u give folate first

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11
Q

MGUS

A

<9% of bone marrow is plasma one cell
>9% is myeloma

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12
Q

haemophilia

A

bleeding after trauma
haemarthroma
big bulges

A- vonwillebronjames associated. 8. more common and more severe
B- 9

drainage

IV recombinant factor
give fresh frozen plasma
tranexamic acid

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13
Q

lemon yellow tinge

A

b12 and folate
macrocytic
megaloblastic

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14
Q

ALL

A

tumour marker CD19
blast cells on blood film
blast cells >20% of bm
neuropathic symptoms more than CML

chemo 4-6 weeks
methotrexate 18 months

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15
Q

CLL

A

lymphocytes >5
B cells
smudge and smear cells
binet
watch and wait
chemo
rituximab- monoclonal

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16
Q

treatment ET

A

aspirin
hydroxycarbamide

17
Q

PRV

A

extra cells
itchy in shower
venesection weekly
aspirin

18
Q

primary myelofibrosis

A

everything decreased
tear drop poikolyctes
dry tap aspirate

give epo
give platelets
give hydroxycarbamide

cure w allogeneic stem cells

19
Q

hereditary spherocytosis

A

normocytic haemolytic
spherocytes
anaemia
pigment gallstone
DAT/ coombes - pos. extravascular
autoimmune
autosomal recessive

folic acid
transfusion

aplastic
parvovirus B19

20
Q

treatment von willedbrand

A

Type 1: Tranexamic acid or Desmopressin (DDAVP) more please. stimulation

Type 2 and 3: Factor VIII and von Willebrand factor (vWF). theres is useless or they have none

type 1 quantitative
2 qualitative
3 none

OCP for menorrhagia

21
Q

sickle cell

A

autosomal recessive
HbS trait
HbSS is the disease
manage crisis conservatively
prophylaxis for malaria- proguanil
vaccines
hydroxycarbamide- get rid of bad cells
bone marrow transplant

but protective for malaria weirdly

22
Q

aplastic crisis

A

breathlessness
fatigue
unwell and random

23
Q

factor V leiden

A

autosomal dominant
too much clotting
protein C is like no stop but he doesnt listen to C he keeps clotting
recurrent miscarriage
shortened APTT

preventation anti coags
doacs

24
Q

heparin induced thrombocytopenia

A

lose 30% within 5-10 days

25
Q

TTP

A

hereditary or aquired anti adam

fatigue
purpura
organ damage

too many thrombi
when u actually need it u dont have enough platelets
stops the inactivation of VWD
antibodies against adam ts 13

plasma
aspirin
heparin

26
Q

HUS

A

haemolysis
thrombocytopenia
AKI

bloody diarrhoea
abdo pain

caused by gastroenteritis

treat- monitor kidneys
give saline
avoid toxic drugs

27
Q

DIC

A

prolonged PT and APTT
increased D dimer
decreased fibrinogen
thrombocytopenia
schistocytes

Microvascular thrombosis leading to tissue ischaemia
Mucosal bleeding, poor healing and bleeding from wounds
ulceration and gangrene formation

fresh frozen plasma
supportive
treat underlying cause

28
Q

APLS

A

miscarriages recurrent ≥3 recurrent miscarriages

Coagulation Screen (Partial Thromboplastin Time: aPTT)

Anticardiolipin antibodies

Control cardiovascular risk
if had venous event lifelong Warfarin (INR 2-3) and consider a higher INR if its inadequate
History of Recurrent miscarriage: Active Monitoring along with Low Molecular Weight Heparin (LMWH) and Aspirin throughout pregnancy
Systemic Lupus and APLS: Hydroxychloroquine (thromboprotective)

29
Q

universal donor of platelets

A

AB
universal recipient of other stuff

30
Q

myeloma is normally paraproteins for what

A

IgG and IgA

waldenstrom IgM

31
Q

myeloma

A

chemo, steroids, bisphosphonates

serum electrophoresis
bone aspirate

bence jones protein in urine

32
Q

neutropenic sepsis

A

rigor
fever
source of infection
neutropenia

33
Q

ITP

A

caused by vaccinations
children
chicken pox
CLL
sick
FBC low platelets
purpura
coagulopathy screen
steroids first line
IV immunoglobulins

34
Q

non hodgkins

A

not got reed sternberg
not painful lymphoma
mid life

chemo and CD20 straight away

burkitts- starry nighst sky on aspiration

35
Q

lymphoma risk factors

A

EBV
HIV
immunosuppression
smoking

ann arbour

36
Q

hodgkins

A

hurts when drinking alcohol
reed sternberg

chemo first
then CD30

37
Q

haemochromatosis

A

recessive
accumulation of iron in the body
bronze pigmentation of the skin
pearls prussian blue positive in liver

defective hepcidin (he usually says im done in give me no iron)

stop eating iron
venesection
iron chelation

spin the wheel notes (4 decks)

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