key concepts

• Chronic myeloid leukaemia - imatinib = tyrosine kinase inhibitor
• Transfusion Associated Circulatory Overload: Hypertension, raised jugular venous pulse, afebrile, S3 present.

  Transfusion Related Acute Lung Injury: Hypotension, pyrexia, normal/unchanged JVP
• Hodgkin's Lymphoma may present with asymmetrical spreading lymphadenopathy
• In acute intermittent porphyria, the urine classically turns deep red on standing
• Excisional node biopsy is the diagnostic investigation of choice for suspected Non-Hodgkin's lymphoma
• Hypotension, dyspnoea, wheezing, angioedema during a blood transfusion → anaphylaxis
• Aplastic crisis has reduced reticulocytes, whereas sequestration crisis has increased reticulocytes
• TTP presents with a pentad of fever, neuro signs, thrombocytopenia, haemolytic anaemia and renal failure
• In a non-urgent scenario, a unit of RBC is usually transfused over 90-120 minutes
• DVT investigation: if the scan is negative, but the D-dimer is positive → stop anticoagulation and repeat scan in 1 week
• Abdominal pain, constipation, neuropsychiatric features, basophilic stippling → lead poisoning
• TRALI is differentiated from TACO by the presence of hypotension in TRALI vs hypertension in TACO
• Acute haemolytic transfusion reactions are usually the result of RBC destruction by IgM-type antibodies
• Irradiated blood products are used to avoid transfusion-associated graft versus host disease
• G6PD enzyme assays should be repeated around 3 months after acute haemolytic episodes to avoid false negatives
• Venous thromoboembolism - length of anticoagulation

  • provoked (e.g. recent surgery): 3 months
  • unprovoked: 6 months
• 'B' symptoms in Hodgkin's lymphoma are associated with a poor prognosis

  • weight loss > 10% in last 6 months
  • fever > 38ºC
  • night sweats
• Hydroxyurea increases the HbF levels and is used in the prophylactic management of sickle cell anemia to prevent painful episodes
• Piperacillin with tazobactam (Tazocin) is the empirical antibiotic of choice for neutropenic sepsis
• Benign ethnic neutropaenia is common in people of black African and Afro-Caribbean ethnicity
• Anaphylactic reaction to blood transfusion should be immediately treated with IM adrenaline and the transfusion terminated.
• High potassium, high phosphate, and low calcium are the metabolic abnormalities in tumour lysis syndrome
• HbA2 is raised in patients with beta thalassaemia major
• Irradiated blood products are used to avoid transfusion-associated graft versus host disease
• Rosacea: topical ivermectin is first-line for patients mild papules and/or pustules
• Idarucizumab is a reversal agent for dabigatran
• Myelofibrosis is associated with ’tear drop' poikilocytes on blood film
• Piperacillin with tazobactam (Tazocin) is the empirical antibiotic of choice for neutropenic sepsis
• Thrombotic crises in sickle cell can be precipitated by infection, dehydration or deoxygenation
• If investigating a suspected DVT, and either the D-dimer or scan cannot be done within 4 hours, then start a DOAC
• Coagulase-negative, Gram-positive bacteria such as Staphylococcus epidermidis are the most common cause of neutropenic sepsis
• SLE commonly causes neutropaenia
• Excisional node biopsy is the diagnostic investigation of choice is the investigation of choice for suspected Non-Hodgkin's lymphoma
• Thrombocytopenia is a common finding in alcoholic liver disease
• Polycythaemia vera usually causes an isolated rise in haemoglobin
• Myelodysplasia may progress to acute myeloid leukaemia
• Dabigatran is a direct thrombin inhibitor
• IV iron should be used in patients who are found to have iron deficiency anaemia prior to surgery where oral iron either can't be tolerated or the time interval is too short
• If investigating a suspected DVT, and either the D-dimer or scan cannot be done within 4 hours, then start a DOAC
• Platelet transfusion threshold: 10 x 109 for patients not bleeding or having an invasive procedure- except where CI or alternative treatments for their condition