Haematology

Question 1

what is thrombotic crisis in sickle cell anaemia?

Answer 1

multiple infarcts in various organs which can be precipitated by infection, dehydration or low oxygen. It is a clinical diagnosis and management includes IV fluids, oxygen

Question 2

what is sequestration crisis in sickle cell anaemia?

Answer 2

sickling within organs such as spleen and lungs which causes pooling of blood and worsening anaemia.

Slow bleed so have high retic count

Question 3

What is acute chest syndrome in sickle cell anaemia?

Answer 3

infarcts within the lung parenchyma. Get PE type symptoms (dypsnoea, low O2) and also lung infiltrates are seen on x ray.

Manage with pain relief, O2, Ab if needed, tranfusion

Question 4

What is aplastic crisis in sickle cell anaemia?

Answer 4

Bone marrow suppression caused by parovirus. Leads to low haemoglobin (and low retic count), low WCC, low platelets

Question 5

What is haemolytic crisis in sickle cell anaemia?

Answer 5

Excessive haemolysis leading to anaemia. Rare

Question 6

Auer rods

Answer 6

Acute myeloid leukaemia

Question 7

Philadelphia chromosome

Answer 7

Chronic myeloid leukaemia

Question 8

Most common leukaemia in children

Answer 8

Acute lymphocytic leukaemia

Question 9

Which leukaemia is most associated with Reichters transformation

Answer 9

Chronic lymphocytic leukaemia to non-hodgkins lymphoma

Question 10

which leukaemia is most likely to present with insidious fatigue, mild anaemia and splenomegaly?

Answer 10

chronic myeloid leukaemia

Question 11

blast cells

Answer 11

Acute leukaemias

Question 12

band cells

Answer 12

chronic leukaemias

Question 13

Which marker is associated with Hodgkins lymphoma

Answer 13

Reed Sternberg cells

Question 14

how does non-hodgkins lymphoma typically present?

Answer 14

non tender symmetrical and widespread lymphadenopathy + B symptoms (night sweats, fever, weight loss)

Question 15

how does Hodgkins lymphoma typically present?

Answer 15

non tender asymmetrical lymphadenopathy

Question 16

what are risk factors for lymphomas?

Answer 16

viruses: EBV, HIV
smoking
immunosuppresion

Question 17

how long for and at what temperature can red cells be stored?

Answer 17

35 days at 4 degrees

Question 18

how long for and at what temperature can platelets be stored?

Answer 18

22 degrees for 7 days

Question 19

how long for and at what temperature can FFP be stored?

Answer 19

-30 degrees for 3 years

Question 20

which is the most common blood group?

Answer 20

O

Question 21

which is the least common blood group?

Answer 21

AB

Question 22

which blood group is the universal donar?

Answer 22

O

Question 23

Which blood group is the universal recipient?

Answer 23

AB

Question 24

What are the indications for red cell transfusion?

Answer 24

• symptomatic anaemia with Hb less than 70

- major bleed

Question 25

What are the indications for platelet tranfusion?

Answer 25

- bleed and platelet less than 30 - thrombocytopenia - platelet less than 10 - prophylaxis in transplant/chemo/bone marrow failure

Question 26

what are the indications for FFP transfusion?

Answer 26

- bleeding patient with coagulopathy - clinically significant bleed + PT/APTT >1.5 - prophylaxis prior to surgery or procedure in patient with coagulopathy

Question 27

who do you need to give CMV-ve blood to?

Answer 27

pregnant women and neonates

Question 28

which tranfusion product is most associated with bacterial contamination?

Answer 28

platelets

Question 29

why would you use irradiated blood products?

Answer 29

to avoid tranfusion related graft versus host disease

Question 30

tiredness, breathlessness, high bilirubin and reticulocytes, coombs test +ve

Answer 30

autoimmune haemolysis

Question 31

what are the indications for cryoprecipitate

Answer 31

- clinically significant bleed + fibrinogen <1.5 such as DIC

Question 32

what are the indications for prothrombin complex

Answer 32

- major bleed + on anticoagulant (used to reverse the anticoagulant effect)

Question 33

what is non-haemolytic febrile transfusion reaction and how is it managed?

Answer 33

get fever following transfusions with no other systemic signs slow the transfusion + paracetamol + monitor

Question 34

what is minor allergic transfusion reaction and how is it managed?

Answer 34

histamine reaction to transfusion leading to itching and rash temporarily stop the transfusion + antihistamine + monitor

Question 35

what is acute haemolytic transfusion reaction and how is it managed?

Answer 35

get ABO incompatibility. Fever, abdo pain, hypotension stop transfusion. Check patients ID and name, re do coombs test and cross match IV fluid resus

Question 36

what is transfusion associated circulatory overload (TACO) reaction and how is it managed?

Answer 36

transfusion went too fast leading to fluid overload and subsequently pulmonary oedema and hypertension stop/slow transfusion and consider IV loop diuretic and O2

Question 37

what is transfusion related acute lung injury (TRALI) and how is it managed?

Answer 37

non cardiogenic pulmonary oedema caused by molecules in blood leads to hypoxia, pulmonary infiltrates on CXR, fever, hypotension stop transfusion + O2 + supportive care