Basics to Brilliance: Haematology Podcast
Welcome to Basics to Brilliance, the podcast created to supplement & bolster your knowledge of Haematology.
Featuring a two way, non-didactic conversational-style Q&A between the SpR and SHO, this podcast will be your pocket companion no matter where you are.
We aim to cover:
- Malignant and non-malignant topics
- Science/lab detail
- UK guidelines, hallmark trials and how these translate into clinical practice
- Future research directions
- The whole syllabus for FRCPath part 1
All readily accessible and completely free of charge!
For every budding haematologist out there, we hope this podcast aids you in your endeavours and fills you with interest and excitement for the brilliant world of Haematology.
Warmest Regards,
Dr. Everden
Dr. Fasey
Dr. Jafri
Disclaimer: This podcast is intended as a revision aid and should not be used for the medical management of patients. Guidelines in the initial episodes span 2023/2024. We aim to update our content in accordance with the most recent available guidelines when possible.
This podcast is CPD accredited by the Royal College of Pathologists UK
Basics to Brilliance: Haematology Podcast
Acquired Haemophilia A
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00:52 Intro and chuckles
01:40 Case study: 75M, left calf swelling, put on DOAC, 24 hrs later haematoma and deep bleed on CT
06:00 General information
- Elderly (>65), Mortality 8-40%
- Common presentations: GI and UG bleeding, Retroperitoneal and muscle bleeds (compartment syndrome)
- Ptegnancy, TTP, Malignancy (15%), Autoimmune disease (17%)
08:56 Pathogenesis and diagnosis: AutoAb against F8
- *Bethesda units do not correlate with bleeding phenotype in Acquired HA- second orfer kinetics*
- History
- APTT, PT (isolated raised APTT)
- Mixing studies: 50/50 or 80/20 mix
- Factor Assays (**Intrinsic**)
- Decreased Factor VIII + Non-paralellism -> Bethesday Assay
20:20 Non-clotting investigations
22:05 Treatment
- MDT + Comprehensive Care Center escalation
- RICE., TXA, Bypassing agents
- Limit iatrogenic bleeding
- Review medications
- Pregnancy: birth plan!!! inhibitor can cross palcenta
- Steroid +/- Cyclophosphamide
27:10 Bypassing Agents in Acquired Haemophilia A
- FENOC + EACH2 study: FEIBA vs NovoSeven = No difference in bleeding/thrombosis rates- more info at 33:25 for EACH2
- Obizor can be titrated according to response whereas FEIBA and NovoSeven cannot
- Emicizimab +/- Immunosuppression = Not currently licesnsed in the UK
32:25 Inhibitor eradication
- Mean time to remission: 5 weeks
- Good prognostic markers: FVIII 1 or more, Inhibitor titre < 20
- EACH 2 Study: Steroids -> Steroids + Cyclophosphamide -> Steroids + Cyclo + Rituximab
- Biggest cause of death: infection
36:45 Follow up
- Weekly FVIII levels and inhibitor monitoring till remission then monthly for 6 months then 2-3 monthly for a year
- Planned procedure; FVIII level
38:45 Golden Nuggets
'Basics to Brilliance: Haematology Podcast' has been accredited for CPD credit by the Royal College of Pathologists UK.
Medical professionals and clinical scientists holding career-grade positions, who are registered with any of the Royal Colleges for CPD, will be eligible to earn 1 credit for every hour of learning.
Email: basicstobrilliancehaem@gmail.com
Insta: BasicstoBrilliance
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