Tag Archives: blood transfusion

Case 50 part 2 – the beginning

A 21 year old female presents with chest pain. You are asked to authorise a blood transfusion as she is anaemic. Hb 69g/L (115-160) MCV 111fL (79-98) WCC 12.6×10*9/L (4-11) Neuts 10.6×10*9/L (2-7) PLT 578×10*9/L (150-400) Here is her blood … Continue reading

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Case 49 – summary

Thanks to everyone who  tweeted for our case! The learning points are summarised below.   The case was based around a nulliparous 27 yr old women with sickle cell disease.  She wished to seek prior to conception.  Ideally pregnancy’s should … Continue reading

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Case 49 – update 2

The patient presents to a&e with shortness of breath at 22weeks gestation.   how would you assess this patient? management? differential?

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Case 49 – update 1

Partner testing reveals beta- thal trait.  How would you council this lady? The patient was commenced on hydroxycarbamide two years ago due to recurrent acute chest crisis.   As suggested by one of our followers – advice would be to … Continue reading

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Case 49 – the beginning

Our case this week focuses around a 27 year old lady who is know to have sickle cell disease.  She attends the joint haematology/obstetric clinic for preconceptual counselling.   As the junior haematology registrar in this clinic, consider how you … Continue reading

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Case 40 – summary

In this case we were able to interpret blood grouping cards, to allow us to determine further management for this pregnant lady. The first sample to interpret was the blood group of the pregnant lady which identified that she was … Continue reading

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Case 40 – update 3

The patient continues her pregnancy with no further complications. The baby’s blood group is shown below: what can you deduce from this blood card grouping? any further management for mum? any information regarding the fathers blood group? What other clinical … Continue reading

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Case 40 – update 2

Thankfully bleeding has eased, mum and baby are well. What dose of anti-D is required? How is this calculated? Any further tests to help with dosing? Of note she had an antibody screening with booking in bloods which was negative. … Continue reading

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Case 40 – update 1

At 26 weeks this patient presents with an antepartum haemorrhage. How would you manage this lady?

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Case 40 – the beginning

The first blood sample is taken from a 23 year old lady at her antenatal booking appointment. How do you interpret this blood grouping card? What is the patients blood group? Are there any other considerations for this patient? Answers … Continue reading

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Case 34 – summary

This was a varied case centered around an unwell patient with sickle cell anaemia post surgery. There were a number of themes to cover in this case reminding us that patients with sickle cell anaemia can be complex and require … Continue reading

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Case 34 – update 4

Our patient with sickle cell anaemia has been investigated for a delayed haemolytic transfusion reaction. However, the reticulocyte count was not elevated and the direct antiglobulin test was not positive as would be expected. Similarly there was no new antibody … Continue reading

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Case 34 – update 3

Lots of great suggestions via #teamhaem. Patients with sickling disorders need careful attention when operations are being planned. They should be carefully pre-assesed with involvement of haematologists and anaesthetists.  Important points include: Respiratory function post op – high risk of … Continue reading

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Case 34 – update 2

We have a patient with sickle cell anaemia post op who is now more anaemic. She also has a sickle cell crisis with abdominal pain. She has a rather elevated CRP which may be post op or due to the … Continue reading

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Case 34 – update 1

Thanks for all of the great contributions on Twitter via #teamhaem We have initiated basic treatment for patients with a potential sickle cell crisis: Oxygen if hypoxic Hydration Analgesia Keep warm Low threshold for antibiotics Septic screen Our patients investigations show: … Continue reading

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Case 24 – the beginning

This case is aimed in the first instance at medical students and foundation doctors/medical trainees. Please join in to develop your ability to investigate and manage common haematological issues in the context of general medicine. SCENARIO:          You are the medical … Continue reading

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Case 21 – summary

This case highlighted a number of important issues: 1) The differential diagnosis of thrombocytopenia associated with pregnancy Working out why a pregnant or post partum patient is thrombocytopenic can be difficult.  A number of conditions can cause thrombocytopenia to a … Continue reading

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Case 19 – summary

There are a number of important points to this case. 1) The patient is known to be chronically neutropenic because of myelodysplasia.  Myelodysplasia results in varying degrees of pancytopenia due to a clonal bone marrow malignancy.  Patients are at risk … Continue reading

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Case 19 – update 6

For the start of the case scroll below… or click https://teamhaem.wordpress.com/2014/01/26/case-19-the-beginning/ The team have correctly identified that the patient is having a delayed transfusion reaction.  The fevers she complained of initially may have been due to this but concurrent infection may … Continue reading

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Case 19 – update 5

For the start of the case scroll below… or click https://teamhaem.wordpress.com/2014/01/26/case-19-the-beginning/ So far our patient with chronic neutropenia due to myelodysplasia has been admitted with fevers and anaemia.  She only had a transfusion a matter of days ago, so her anaemia … Continue reading

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