Haematological pathologies 💉 Flashcards
(25 cards)
What is deep vein thrombosis? (DVT)
- It is a thrombos in the deep (large) veins
- Can cause complete or partial occlusion
- Presents as:
- Unilateral swelling/oedema
- Pain
- Redness
- Warmth
How do you diagnose DVT?
- Well’s score (measures the risk)
- D-dimer test (negative = no; positive = undetermined)
- Doppler ultrasound
What are the risk factors for DVT?
- Virchow’s triad
- Surgery
- Cancer
- COCP, pregnancy
- Genetic
How can you limit your risk of DVT?
- Heparin
- Warfarin
- Both only if indicated
- Weight management
- Compression stockings
What is a pulmonary embolism?
- Thrombus lodged in pulmonary artery
- Presentation:
- Sudden, sharp chest pain (worse on deep breathing)
- Dyspnoea
- Cough (pink, foamy mucous, blood)
- Tachycardia, tachypnoea
- Sweating/anxiety
- Syncope
Long and short term treatment for pulmonary emboli?
- Short-term:
- O2 support
- Heparing/LMWH
- Thrombolysis if it is massive
- Long-term:
- Warfarin
What are haemophilia A and B?
- Deficiencies of clotting factor - X linked recessive
- Factor 8 = A
- Factor 9 = B
- Presentation:
- Deep haemorrhage
- Post-traumatic and post-operative bleeding
- Mucocutaneous bleeding (gums, nosebleeds)
- Haematomas, ecchymosis (skin discolouration)
How do you diagnose haemophilia A and B?
- Genetic tests
- APTT will be prolonged
- Factor 8 will be decreased
- vWF will be normal
What is disseminated intravascular coagulation? (DIC)
- It is an acquired syndrome characterised by activation of coagulation pathways - causes more clotting and more bleeding
- Due to intravascular thrombi causing a depletion of platelets and coagulation factors
How does DIC present?
- Bleeding (epistaxis, gingival bleeding, GI bleeding, petechiae, ecchymosis, haematuria)
- Oliguria
- Cough, dyspnoea
- Fever, hypoxia, hypertension
- Mental disorientation, delirium, coma
How do you diagnose DIC?
- APTT, INR, TT are all prolonged
- D-dimer is elevated
- Platelet count is normal or decreased
- Fibrinogen is decreased
What is von Willebrand’s disease?
- Common genetic disorder (autosomal dominant)
- Causes a decrease in vWF which is required for platelet adhesion and activation - also a carrier for factor 8
- Presentation:
- Mild-moderate bleeding disorder
How do you diagnose von Willebrand’s disease?
- APTT is mildly prolonged
- vWF assays
- Factor 8 will be decreased
What is thrombocytopenia?
- Low platelet count
- Classifications:
- Mild: 100-150
- Moderate: 30-100
- Severe: <30
Describe the aetiology of thrombocytopenia
- Increased destruction:
- Immune causes
- Non-immune causes (e.g. DIC, thrombotic thrombocytopenia)
- Decreased production:
- Congenital (rare)
- Acquired (e.g. drugs, infection, liver disease)
- Platelet pooling (splenomegaly)
- B12 and folate deficiency
What is thrombocytosis?
A high platelet count
What are primary causes of thrombocytosis?
- Essential thrombocytosis
- Idiopathic myelofibrosis
- Polycythaemia vera
- Chronic myeloid leukemia
What are secondary causes of thrombocytosis?
- Acute/Chronic inflammation
- Infections
- Malignancy
- Splenectomy
- Acute/Chronic bleeding
- Haemolysis
Distinguish between leucocytosis and leucopenia
- Leucocytosis:
- Increased leukocyte number
- Leucopenia:
- Decreased leukocyte number
What are some causes of leucocytosis?
- Reactive:
- Infection
- Bordetella pertussis
- Inflammation
- Tissue damage
- Post splenectomy
- Clonal:
- Acute/Chronic leukemia
- Lymphoma
What are some causes of leucopenia?
- Congenital
- Acquired:
- Autoimmune
- Drugs
- Infection
- Malignant (aplastic anaemia, myelodysplasia, marrow infiltration and malignancy)
Eosinophilia
- Increased eosinophil number
- Causes:
- Allergy
- Parasites
- Drug hypersensitivity
Eosinopenia
- Decreased eosinophil number
- Can be caused by steroid therapy
Basophilia
- Increased basophils
- Causes:
- Myeloproliferative disorders
- Allergic/Inflammatory conditions
