Sickle Cell Disease

Question 1

Follow up during pregnancy in sickle cell disease

Answer 1

Every 4 weeks until 24 and then every 1-2 weeks until delivery

Question 2

What pain relief in sickle cell

Answer 2

paracetamol and codeine. not take ibuprofen before 12 weeks and after 28 weeks.

Question 3

What pain relief contraindicated in sickle cell

Answer 3

Pethidine

Question 4

What are the Clinical features of sickle cell disease

Answer 4

1- painful sickle cell crisis
2- acute chest pain syndrome
3- Pulmonary hypertension
4- retinal damage
5- Kidney disorder
6- Leg ulcer
7- Avascular necrosis of the head of femour and hip joint
8- Stroke

Question 5

What is the Chronic disease assessment ?

Answer 5

preconceptually & annually)
▪ Pulmonary HTN – ECHO( TR jet velocity >2.5 m/s a/w high risk of pulm HTN)
▪ HTN – BP, urine analysis.
▪ Sickle nephropathy/ liver – RFT , LFT
▪ Proliferative retinopathy- retinal screening.(more common in HbSC) . can cause loss of vision.
▪ Iron overload – T2 cardiac MR. ( aggressive chelation before conception if overload)
▪ Screening for RBC antibody. ( increased risk of haemolytic disesase of newborn)

Question 6

Risk of sickle disease in pregnancy

Answer 6

1- miscarriage
2- DVT
3- PTL
4- wording anaemia
5UTI
6- PET
7- GDM
8- CS
9- acute painful crisis
10 eye retenopathy
11- recurrent hospital admission
12-

Question 7

What is the aim of preconception clinic

Answer 7

To optimise and manage and screen for end organ damage
Discussa also contraception
Assessment of chronic disease complication

Question 8

Sickle cell complication

Answer 8

Acute chest syndrome
Sickle cell crisis
Retinopathy

Question 9

Blood transfusion when it’s recommended

Answer 9

In sickle cell crisis
Acute exchange transition