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WorksheetsPost-test PBM
Total questions: 25
Worksheet time: 14mins
Madam N, 35 years old, G2P1 at 18 weeks POG with Hb of 10.7 g/dL. MCV and MCH were normal. Is she anemic?
YES
NO
NOT SURE
Below are primary haemostasis bleeding disorders except:
Immune thrombocytopenia
Von willebrand disease
Storage pool disease
Acquired Haemophilia A
Aspirin related platelet dysfunction
The most common cause of anemia in pregnancy is iron deficiency. True or false?
FALSE
TRUE
What are the indications for parenteral iron therapy?
Noncompliance with oral iron therapy
Inadequate time prior to delivery for oral iron to be effective.
Poor response to oral iron therapy (Hb increment of less than 1g in 2 weeks or 2g in 4 weeks)
Intolerance to oral iron therapy
These are the Preoperative measures in minimizing blood loss and bleeding ( 2nd Pillar of PBM) except:
Minimizing iatrogenic blood loss
Identify and manage bleeding risk
Screen for and manage anaemia
Consider preoperative autologous blood donation
In the context of postpartum haemorrhage (PPH), what is the primary rationale for using tranexamic acid (TXA)?
To improve platelet function
To promote vasoconstriction
To increase red cell production
To reduce fibrinolysis and bleeding
To activate the coagulation cascade
Choose an example of Haemostatic agent to minimize bleeding intraoperatively
Adrenaline
Cell Salvage
Fibrin / Collagen matrix
Desmopressin
All are Indications for Cell Salvage except:
Anticipated Intraoperative blood loss >1L
Rare blood disorders
Jehovah’s witness
Preop anaemia/high risk of bleeding
According to recent consensus, what hemoglobin level is considered the threshold to screen for iron deficiency and enhanced patient blood management (PBM) before surgery?
<130 g/L for all
120 g/L for women and <130 g/L for men
<100 g/L for women and <120 g/L for men
<110 g/L for all
What is the most common cause of preoperative anemia?
Vitamin B12 deficiency
Chronic kidney disease
Iron deficiency anemia (IDA)
Hemoglobinopathies
Which serum ferritin level is considered indicative of absolute iron deficiency in the preoperative setting?
<70 μg/L
<30 μg/L
<25 μg/L
<15 μg/L
A woman with thalassaemia trait is found to have Hb 96 g/L and ferritin 85 µg/L at 26 weeks. She feels well. What is the most appropriate action?
Start oral iron
Start folic acid 5 mg daily
Transfuse 1 unit PRBCs
Repeat full blood count in 2 weeks
Refer for haematology review
What is the first-line treatment for iron deficiency anemia in the preoperative setting?
Intravenous iron
Blood transfusion
Oral iron therapy
Erythropoiesis-stimulating agents (ESA)
When is intravenous iron therapy indicated preoperatively?
For all anemic patients
Only for functional iron deficiency
For patients intolerant to oral iron or when there is insufficient time for oral iron response
When ferritin is >100 μg/L
What is the recommended management regarding preoperative blood transfusions?
Recommended at hemoglobin 8-9 g/dL
Routinely used for all anemic patients before surgery
Reserved for moderate anemic patients scheduled for elective surgery surgery
Reserved for very anemic patients where urgent surgery precludes other treatments
Organs susceptible for iron over load:
LIVER
RENAL
PITUITARY
GUT
CARDIAC
Indication for platelet transfusion in paediatric:
ITP when platelet <10k
As a first line in neonate with NAIT and bleeding symptoms
In leukaemia patients with febrile neutropenia when platelet < 20k
In thrombotic thrombocytopenic purpura (TTP)
For patient going for invasive surgery, the threshold is >100k
True in complication of transfusion in Paediatric compared to adults
Higher in allergic reaction
More likely to develop hypotensive reaction
Less likely to develop febrile non haemolytic reaction
Higher incidence of TACO
Higher in TRALI
Which one of below belongs to primary haemostasis?
Factor V
Platelet
Calcium
Thrombin
Fibrinogen
Strategies to minimise phlebotomy losses in paediatric, except:
laboratory equipment uses the smallest possible sample volumes
optimal sampling and sample handling to avoid sample rejection
Avoid blood overdraw
All blood taking should be done senior health care professional to avoid wastage
Massive bleeding can also be defined as:
Loss of 20% of total blood volume within 48 hours
Loss of 50% of blood volume within 3 hours
Replacement of the total blood volume within 48 hours
Platelet count <50,000/µL in a bleeding patient
What is the primary reason for giving calcium during a massive transfusion?
To improve oxygen delivery
To stabilize platelet membranes
To prevent hypocalcemia from citrate toxicity
To prevent hyperkalemia
What is the most appropriate action when MTP is no longer clinically indicated?
Discontinue all blood products immediately
Continue transfusion until labs normalize
Deactivate the MTP and switch to targeted component therapy
Notify the blood bank after 24 hours
A 40 year old man planned for elective arthroscopy meniscus repair and accidental finding of PT 12 seconds APTT 84 seconds. What is the next step of plan?
Transfuse Fresh frozen plasma
Cancel the procedure
Ask for bleeding history
Infuse factor VIII concentrate
Which component of the TEG tracing reflects the clot strength, integrating fibrin and platelet contribution?
K-time
R-time
α-angle
Maximum Amplitude (MA)
