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Flashcards in Haematology Deck (15)
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1

How to diagnosAdde myelofibrosis?

2

vWD presentation

bleeding tendency in face of normal PT and APTT

 

AD inheritance

 

Desmopressin can be used before surgery

3

Most likely infection in platelet transfusion

Staph epidermidis

4

Indication platelet tranfusion

platelets below 20

5

Indication blood transfusion

R1 Acute blood loss Objective: to maintain circulating blood volume and haemoglobin (Hb) concentration > 7 g/dl in otherwise fit patients, and 8 - 9g/dl in older patients and those with known cardiovascular disease. 15-30% loss of blood volume (800-1500 in an adult) red cell transfusion is unlikely to be necessary, transfuse crystalloids or synthetic colloids. In obstetrics transfusion should commence when blood loss approaches 1000ml and is continuing. 30 -40% loss of blood volume (1500-2000 in an adult) Rapid volume replacement is required with crystalloids or synthetic colloids and red cell transfusion probably required to maintain Hb levels. >40% loss of blood volume (>2000ml in an adult) Rapid volume replacement is required including red cell transfusion. R2 Hb concentration < 7g/dl R3 Hb concentration < 8 or 9g/dl in patients with known cardiovascular disease or those with significant risk factors of such disease ( e.g. elderly patients, those with hypotension, diabetes mellitus PVD. For Chronic renal failure transfuse to maintain Hb > 10g/dl ) R4 In critical care transfuse to maintain Hb > 7 g/dl. or >9 g/dl if cardiac or respiratory disease present. R5 Post-chemotherapy / radiotherapy: There is no evidence based guide to practice Most hospitals use a threshold of Hb 8 or 9 g/dl for chemotherapy and 11 – 12 for radiotherapy R6 Chronic anaemia; Transfuse to maintain the Hb concentration just above the lowest concentration which is not associated with symptoms of anaemia. Many patients may be asymptomatic with an Hb >8g/dl. Do not transfuse when effective alternatives exist.

6

Indication cryoprecipitate

Low fibrinogen <1.5 and ongoing bleeding where blood transfusion did not help

7

Fresh frozen plasma

Where fibrinogen above 1.5 and PT/APTT prolonged

8

PCC indication

Warfarin reversal where there is bleeding or when urgent surgical treatment indicated or head injury with significant bleeding on warfarin

9

AIHA tx

1st line prednisolone

2nd line rituximab

10

CLL tx 

1st line: fludarabine 

OR 

Chlorambucil

2nd line: rituximab

11

Most common transfusion related morbidity

TACO

12

polycythaemia association

gout (increased serum urate)

13

Coagulation cascade

14

Late consequence of chemo and radio for Hodgkins

15

Felty's syndrome triad

rheumatoid arthritis

splenomegaly

neutropenia