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Icm > Haematology > Flashcards

Haematology Flashcards

1
Q

What are the types of HITT

A

Type 1 is non immune mediated - occur g at 3 days

Type 2 is immune mediated at 5-10 iGg

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2
Q

Pathophysiology of HITT

A

Heparin bind to platelet factor 4
The complex is immunogenic and activates iGG hit antibodies
This causes platelet activation and thrombosis

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3
Q

What is included in the Warkentin hit score

A

Thrombocytopenia
Timing
Thrombosis
Other potential cause a

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4
Q

What lab tests confirm hit

A

Immunoassay for hit antibodies

Functional platelet assays

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5
Q

What is haemolytic uraemic syndrome

A

Micro angioplasty is haemolytic anaemia
Thrombocytopenia
Renal failure

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6
Q

What causes haemolytic uraemic syndrome

A

Epidemic or atypical
Epidemic - prodromal bloody diarrhoea and E. coli
Atypical rare and worse - strep, hiv, bmt, cancer

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7
Q

Pathophysiology of Haemolytic uraemic syndrome

A

Exposure to toxin
Bloody diarrhoea due to haemorrhaging colitis
aki secondary to toxin mediated vascular endothelial damage
Platelet aggregation- > thrombi -> compliment

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8
Q

Treatment of haemolytic uraemic syndrome

A

Cipro for e.coli

Plasma exchange - Mainly for atypical

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9
Q

What is thrombotic thrombocytopenic purpura

A 
Maha
Thrombocytopenia 
Aki
Fluctuating consciousness 
Fever
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10
Q

Pathophysiology of ttp

A

Deficiency in ADaMTS 13
vWF not cleaved
Large multimers and no cleaving therefore uncontrolled platelet activation
Fibrin deposited forming a mesh that shreads red cells

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11
Q

Management of ttp

A

Plasma exchange continue 2 days after plts >150
Methyl pred
Retuximab if relapse
Aspirin and thromboprophalycis once plts > 50

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12
Q

Definition of Anaemia

A

Men 130

Women 120

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13
Q

Define sickle cell disease

A

Chromosome 11
Autosomal recessive
Hb S is less soluble and more viscous and tends to polymerise - distorts it’s contour

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14
Q

Presentations of sickle cell

A

Vaso- occlusive

  • acute chest syndrome
  • Stoke
  • long bone ischaemia
  • aki

Sequestration
- anaemia, hypotension and enlarged spleen

Aplastic

  • red cell aplasia
  • parvo B19 / folate
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15
Q

define thalasaemia

A

2 types- alpha and beta
Alpha - deletion of 1-4 alpha chains

Beta- reduced beta and increased alpha and gamma
Minor or major

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16
Q

Define factor 5 Leiden

A

Autosomal dominant
Mutates factor 5 therefore activated protein c cannot bind to it resulting in ongoing clot formation

Present with venous thrombus

17
Q

Define anti phospholipid syndrome

A

Autoimmune hypercoaguloable state due to excess antiphospholipid antibodies

Arterial and venous thrombosis

18
Q

Define haemophilia

A

X linked recessive
A - factor 8
B -factor 9

19
Q

Define von willrbrands disease

A

Autosomal dominant

VWF needed for platelet adhesion to the endothelium and to bind to factor 8 to prevent its breakdown

20
Q

Define DIC

A

Acquired syndrome characterised by a dyregulated host response to a trigger resulting in intravascular coagulation, damaged microcasculature and organ dysfunction

21
Q

Triggers for DIC

A

Sepsis
Trauma
Obstetric emergencies

22
Q

Pathophysiology of DIC

A

Excessive thrombin production
Excessive fibrinolysis
Thrombosis and bleeding
Loss of localisation

23
Q

What is cross matching

A

Mixing donor cells with recipient serum and observing for signs of agglutination

24
Q

Which blood group is the universal donor

A

O-

25
Q

Which is the universal recipient

A

AB +

26
Q

What is donor blood tested for

A

HIV antibodies
HCV antibodies
Hep b surface antigen
Syphilis serology

27
Q

How is blood stored

A

Citrate
Phosphate
Dextrose
Adenine

Shelf life 35 days

28
Q

How are platelets stored

A

Pooled from 4-6 ffp
Stored at 20-24 degrees
Agitated to prevent clumping

Shelf life 3-5 days

29
Q

What is the storage lesions

A

Changes that occur is stored blood

Hyperkalaemia
Acidosis 
Reduced 2,3 dpg (left shift)
Low platelet
Factor 5 and 8 decrease activity
30
Q

Define massive transfusion

A

Whole circulating volumes in 24 hours
50% circulating volume in 3 hours
10 unit transfusion

31
Q

Complications of transfusion

A 
Immediate haemolytic reaction 
Delayed haemolytic reaction (3-10/7) 
Febrile
Allergic
Hyperkalaemia
Hyperkalaemia 
Iron overload 
Transfusion related infection 
Taco (lvf or ccf in 6-24hours)
Trali (ards in 6hours)
32
Q

Transfusion threshold

A

70 -90

Tricc restrictive vs liberal

33
Q

What is needed to check blood and give blood

A 
2 trained members of staff
Patient ID
- surname
- dob
- gender
- hospital number

Check all match with medical notes, patient band, transfusion form and compatibility label

  • blood group and pack number
  • return the tag
34
Q

What is rhesus on blood

A

If you are rh D negative you have antibodies to Rh D and therefore destroy any rd D positive cells

35
Q

What can a patient with AB blood recieve

A

Everything

36
Q

What can a patient with A blood recieve

A

A and O

37
Q

What can a patient with O blood recieve

A

O

Icm (16 decks)

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