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Haematology (Warfarin (1972 (1=10) - factors affected by warfarin, Major…
Haematology
Warfarin
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Major Bleed - Stop warfarin, give IV vit K 5mg and Proth C
INR >8 + minor bleed: Stop warfarin, IV vit K (1-3), repeat vit K if INR still high after 24 hrs
INR > 8 + no bleeding: Stop warfarin, give vit K 1-5 mg, repeat if INR still high after 24 hrs
If INR 5-8 + bleed: Stop warfarin give vit K 1-3, restart when INR <5
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Sickle cell
Salmonella, lethargic + microcytic anaemia - parvovirus B19
Splenectomy patients are at risk from encapsulated bacteria - see howell-jolly and pappenheimer bodies on peripheral blood film
Sickle cell crisis - analgesia , IV fluids, O2, consider exchange transfusion
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Non-Hodgkins
More common, B cell more than T cell
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Polycythaemia Vera
Raised RBC, haemoglobin and packed cell volume
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Megaloblastic Anaemia
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Drugs: Megaloblastic, phenytoin + any antifolate
Myeloma
Malignancy of plasma cells (2/3 - IgG, 1/3 - IgA)
Sx: Older, increase calcium, renal failure, anaemia, bony lytic lesions
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Hereditary Spherocytosis
Spherical RBCs due to molecular defect in one of the proteins in the cytoskeleton of the RBC membrane
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Hodgkin's lymphoma
Sx: Non-tender lymphadenopathy, B symptoms, chronic pruritus
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CML
Adults, massive splenomegaly
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AML
Auer rods, myeloblast cells
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CLL
Commonest, few symptoms, smude cells, can transform into lymphoma