haem

Question 1

symptomatici anemia

Answer 1

s.o.b
chest pain
syncope - esp standing up
pale
lethargic
pica
koilinhcyia
cold extrmeities !
restless leg syndrome

Question 2

at what level would we usually transfuse

Answer 2

less than 70
and if not then patient is symptomatic +

Question 3

what is Glasgow Blatchford score

Answer 3

it is used in upper gi bleed and if more than zero it means high risk of GI bleed, and some medical intervention is necessary like endoscopy or transfuison its a sense of urgency thats the whole point of the score, how urgent do they need the intervention

Question 4

score for lower gi bleed

Answer 4

oakland

Question 5

a patient comes in with really low levels of hb really low what will you do

Answer 5

1. want to see if he is bleeding from anywhere, any hemoptysis or melaena, hematochezia
2. physical exam PR, any fresh blood coming out? even if patient says they dont see blood in their poo you should never take the word for it
3. ask about cancer symptoms
4. you would think about blood transfusion to replace the blood
5. DO GBS score?
6. do a group and save incase its a surgical issue?

Question 6

causes of panctyopenia

Answer 6

1. drugs - chloramphenicol , TMP
2. chemo + radio
3. infections- viral, EBV, CMV, parovirus
4. b12/b9 deficieny (because essential for dna synthesis which all cell lines need, so if none, then you cant produce the cells, also on top of that you get dodgey cells which are immatures and crowd the bone marrows as they are non functional )
5. cancers like leukemia

Question 7

an example of inherited panctyopenia

Answer 7

fanconis anemia - recessive

Question 8

how do CS affect blood cells

Answer 8

increase neutrophil counts but makes them less functional hence infection risk

decrease lymphocytes

increase plt and rbc

Question 9

feltys syndrome

Answer 9

isorder that includes rheumatoid arthritis, a swollen spleen, decreased white blood cell count, and repeated infections.

Question 10

agranuloctyosis

cause

Answer 10

Agranulocytosis is a severe reduction in granulocytes, especially neutrophils, leading to a high risk of infections. It is a life-threatening condition where the absolute neutrophil count

drugs
inherited - kostmann
feltys syndrome

Question 11

lymphocytosis

Answer 11

Acute viral infection (especially EBV and CMV)
Chronic atypical infection (tuberculosis, brucella, toxoplasmosis)
Lymphoproliferative disorders (chronic lymphocytic leukaemia and lymphoma).

Question 12

itp vs ttp

Answer 12

1. both low plt counts
2. itp has anitbodies against plt (immune response)
3. itp not as clinically unwell but ttp clinically unwell
4. itp usually a dignosi of exclusion, no abnormal cells on a smear
5. cause of itp usually recent infection
6. TTP - not just ptl affcted rbc too hence you get shistocytes as they are getting detsroyed, pt looks unwell, fever, neurologic signs
7. ttp deificency in adams 13
8. ttp - the terible pentad 1. fever, 2. neuoloigc symptoms 3. kidney 4. anemia 5. plt

Question 13

HUS FINDINGS AND HISTORY

Answer 13

rcent bbq or eaten something
e. coli 157, h7

anemia
plt
kindey failure (increased creatine )

bloody diarrhea

shistiocytes

Question 14

neutrohilia

Answer 14

steroids
infection
stress
inflammtion
smoking

Question 15

causes of thrmobocytopenia

Answer 15

1. ITP
2. TTP
3. Heparin induced (typically 1- 2 weeks after startinh )

Question 16

what steps to take if you pt has very low plt and you need to see if they are actively bleeing or not

Answer 16

HISTORY
1. signs of upper gi bleed, cofee ground vomit, black tarry stools
2. any nose bleeds
3. any bruises on your skin
4. any fresh blood from back passage
5. any feeling dizzy, dificulty breathing (signs of shock ) feeling clammy

physical exam

1. look for purpra, petechiae
2. pulse (fast if shock and bleeding )
3. look at nose and gums signs of bleeing
4. resp exam - standard
5. abdo - if tender could mean inernal bleeding
6. PR exam

Question 17

cut off for heparin induced thrombocytopneia

Answer 17

a drop by more than 30 %

Question 18

how does temporal arteritis affect bloods?

Answer 18

the esr (most important indicator)
commonly also raises the plateletf