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Principles of surgical patient care > Haemtology > Flashcards

Haemtology Flashcards

1
Q

PRBC storage

A

42d at 1-6deg

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2
Q

FFP’s/cryo storage

A

Frozen - 1y

Thawed - 5d at 1-6deg

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3
Q

Platelets storage

A

5d at 22-24deg

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4
Q

What changes occur in stored blood

A 
Inc K
Inc lactate
Increased haemolysis - RC’s swell, spherical
Dec 2,3 DPG
Dec viable plt 
Dec factor 7,8,9
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5
Q

Types of reactions post transfusion

A

Acute haemolytic - ABO incompatibility. SIRS type response
Febrile non-haemolytic - anti-leukocyte antibodies against donor blood
Hypersensitivity - plasma protein sensitisation from previous transfusion
TRALI - antileukocyte antibodies against recipient blood
Nosocomial infection

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6
Q

Define massive transfusion

A

Entire blood volume <24h
30% blood volume in 4h
4u in 1h with continued blood loss

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7
Q

Transfusion triggers - platelets

A

<10
<50 and massive bleed or pre-op
<100 and microscopic bleed or TBI

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8
Q

Transfusion triggers FFP

A

INR >1.5

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9
Q

Transfusion triggers cryo

A

Fibrinogen <1

VWD

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10
Q

TXA indication

A

<3h post injury with significant bleed

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11
Q

Normal R-time, what to give if abnormal

A

4-8 min

FFP’s - clotting factors

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12
Q

Normal K- time, what to give if abnormal

A

1-3min

Cryo

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13
Q

Normal alpha angle, what to give if abnormal

A

34-47

Cryo

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14
Q

Normal MA, what to give if abnormal

A

50-70mm

Platelets

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15
Q

Normal Ly30, what to give if abnormal

A

<3%

TXA

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16
Q

Exceptions to restrictive transfusion strategy

A

TBI
Septic shock with CVO2 <70%
AMI, unstable angina, ACS

17
Q

HIIT diagnosis and treatment

A

Platelet factor 4 Eliza

Argatroban

18
Q

DIC inticing event

A

Tissue factor release

19
Q

TTP mechanism

A

Platelets bind to abnormal VWF

Clotting factors not depleted

20
Q

TTP pentad

A 
Fever
AMS
ARF
low plt
Microangiopathic haemolytic anaemia
21
Q

HELLP vs DIC

A

INR and PTT are normal

22
Q

Haemophilia inheritance pattern

A

A, B - X-linked

C - AR

23
Q

VWD inheritance pattern

A

AD

24
Q

Heparin reversal

A

Protamine sulphate

25
Q

UFH works on

A

2a (via AT3)

10a

26
Q

Oral 10a inhibitors

A

Rivaroxaban
Abixaban
Endoxaban

27
Q

Oral thrombin inhibitors

A

Dabigatran

Argatraban

28
Q

Prerequisits before administration of recombinant factor 7

A 
PH >7.2
Plt >50 (?100)
T normal - at least >35
Fibrinogen >1
Hct >24%

Also
- massive transfusion received

29
Q

What increases PT

A

Warfarin, liver dysfunction, DIC

Normal 10-12s

30
Q

What increases PTT

A

Heparin, haemophillia, DIC

Normal 30-40s

31
Q

What decreases fibrinogen

A

DIC, envenomation

Normal 200-400

Principles of surgical patient care (10 decks)

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