Rheumatology & Haematology — Flashcards

Flashcard 21: INR 5.0-8.0 + Minor Bleeding management?

Answer: • Stop Warfarin • Give IV Vitamin K 1–3 mg • Restart Warfarin when INR < 5.0 (at a lower dose)

Extra: Management of Warfarin Overdose (based on INR & Bleeding): 1. **INR > 5.0, no bleeding:** Omit 1-2 doses, reduce maintenance dose. 2. **INR 5.0–8.0, minor bleeding:** Stop warfarin, give IV Vitamin K 1–3 mg, restart when INR < 5.0. 3. **INR > 8.0, minor bleeding:** Stop warfarin, give IV Vitamin K 1–5 mg, restart when INR < 5.0. 4. **Major bleeding (any INR):** Stop warfarin, give IV Vitamin K 5–10 mg + Prothrombin Complex Concentrate (PCC) or FFP.

Flashcard 22: What are the classic signs of a Hip Fracture?

Answer: • Shortened and externally rotated leg

Flashcard 23: Haemoglobin of 18.4 g/dl?

Answer: • Raised haemoglobin • suggests secondary polycythaemia

Flashcard 24: What is the management for Sjögren's Syndrome?

Answer: • Artificial tears (Eye drops) • Artificial Saliva • Vaginal lubricants • Muscarinic agonists (e.g., Pilocarpine, Cevimeline) for dryness • Hydroxychloroquine (for arthralgia/skin involvement)

Extra: Sjögren's Syndrome management focuses on symptomatic relief of sicca symptoms (dry eyes, dry mouth). - Dry Eyes: Artificial tears, cyclosporine drops. - Dry Mouth: Frequent sips of water, sugar-free gum, muscarinic agonists (pilocarpine). - Systemic involvement: Hydroxychloroquine or immunosuppressants. Note: "Vignal" in the original card was a typo for "Vaginal".

Flashcard 25: What are the skin features of Sarcoidosis?

Answer: • Erythema Nodosum -> on shins • Lupus Pernio -> cheeks and nose

Flashcard 26: What are the blood test findings to remember for Sarcoidosis?

Answer: • Raised ACE • Hypercalcaemia

Flashcard 27: Would a Haemoglobin of 10.1 g/dL indicate LTOT?

Answer: No. Secondary polycythemia (Hematocrit > 55%) is an indication for LTOT, not anemia.

Extra: LTOT Indication in COPD (Stable patients, non-smokers): 1. PaO2 < 7.3 kPa (regardless of other factors). 2. PaO2 7.3 – 8.0 kPa AND one of: - Secondary polycythemia (Hct > 55%) - Peripheral edema (cor pulmonale) - Pulmonary hypertension

Flashcard 28: What laboratory parameters are used to diagnose Iron Deficiency Anaemia (IDA)?

Answer: • Serum Ferritin (most specific) • Serum Iron • Total Iron Binding Capacity (TIBC) • Transferrin Saturation (TSat)

Extra: In Iron Deficiency Anaemia (IDA): • Low Ferritin (<30 ng/mL) • Low Serum Iron • High TIBC • Low Transferrin Saturation (<15-20%)

Flashcard 29: What are the antibodies associated with Sjogren's syndrome?

Answer: • Anti-Ro • Anti-La

Flashcard 30: What is the imaging of choice for suspected Osteomyelitis?

Answer: • MRI