Haem: Sickle Cell Crises: Free MSRA Podcast

🎧Deep Dive: SickleCell Crises – MSRA High-Yield HaematologyIn this episode, webreak down sickle cell crises – whatthey are, why they happen, and how to recognise and manage them. Whether you’rerevising for the MSRA or sharpening yourclinical understanding, this fast-track session covers everything you need to recall the essentials with confidence. 🧬What is a Sickle CellCrisis?A sickle cell crisisis an acute complication of sickle cell diseasecaused by sickling of red blood cells → vascular blockage → tissue ischaemia and pain. It’s a clinicalemergency that requires rapid recognition and targeted management. 🧠Types of Crises (5Main Types)Thrombotic / Vaso-occlusive – most common, severe pain due to vessel blockageSequestration – pooling of blood in spleen/lungs → sudden anaemiaAcute Chest Syndrome – occlusion in pulmonary vessels → chest pain, hypoxia, infiltratesAplastic Crisis – triggered by parvovirus B19 → ↓ RBC productionHaemolytic Crisis – sudden ↑ RBC breakdown → worsening anaemia🧠Mnemonic: “The Sickle Crises Are Horrid”→ T-S-C-A-H 🔥Key Triggers – DITSH• Dehydration• Infection• Temperature extremes• Stress• Hypoxia🧠Mnemonic: DITSH triggers sickling! 🧪PathophysiologySnapshot• Mutation → HbS → polymerises when deoxygenated• RBCs → sickleshape = rigid + sticky• Vaso-occlusion → ischaemia + pain + inflammation• Recurrent crises →long-term organ damage 👩‍⚕️Who’s Affected?• Highest inindividuals of African, Caribbean, MiddleEastern, or South Asian descent• ~15,000 peopleaffected in the UK• Most crises seenin those with sickle cell anaemia (HbSS) 🩺Clinical Presentation• Severe pain – long bones, back, joints, abdomen• Acute chest syndrome – chest pain, SOB,infiltrate• Splenic sequestration – enlarged spleen +sudden anaemia• Other clues – fever, priapism, neuro signs(stroke), jaundice 🔍Differentials toConsider• Bone fracture•Appendicitis/gallstones• Renal colic• Vasculitis• Acute abdomen• Infection/sepsis 🧪Investigations✔️FBC – anaemia, ↑ WCC, reticulocyte count✔️Retics – high in sequestration, low in aplastic✔️Blood smear – sickled cells✔️CXR – check for acute chest syndrome✔️Other – infection screen, renal/liver function, imagingif needed 💊Management (UKPractice)🎯Goals:Control painTreat triggersPrevent complications🩹Stepwise Pain ReliefParacetamol → NSAIDs→ Opioids/PCA💧Fluids – oral/IV🦠Antibiotics – if infection suspected💉Oxygen – if SpO₂ low💉Transfusion – in severe anaemia, acute chest, pregnancy💊Hydroxyurea – long-term to prevent recurrent crises🧠Mnemonic: HOT-FATHydration, Oxygen,Treat cause, Fluids, Analgesia, Transfusion (when needed) ⚠️Complications•Stroke 🧠•Acute chest syndrome 💨• Chronic pain• Renal/liverdysfunction• Gallstones• Splenic infarction→ ↑ infection risk• Priapism• Leg ulcers• Osteonecrosis• Recurrentinfections• Early mortality ifpoorly managed 📚Sickle Cell Crisis –MSRA Revision Resources📖Revision Noteshttps://www.passthemsra.com/topic/sickle-cell-crises-revision-notes/🧠Flashcardshttps://www.passthemsra.com/topic/sickle-cell-crises-flashcards/❓Accordion Q&ANoteshttps://www.passthemsra.com/topic/sickle-cell-crises-accordion-qa-notes/🔥Rapid Fire Quizhttps://www.passthemsra.com/topic/sickle-cell-crises-rapid-quiz/🧪Practice Quizhttps://www.passthemsra.com/quizzes/sickle-cell-crises/ 🎓Key TakeawaySickle cell crisesare painful, potentially life-threatening events in sickle cell disease.Recognition of crisis type, triggers, and prompt, effective multidisciplinary care is critical. Preventionthrough education, hydroxyurea, and avoiding DITSH triggers saves lives. #MSRA#SickleCellCrises #Haematology #MSRARevisionNotes #MSRAQuiz #MSRAQuestionBank#MSRAFlashcards #VasoOcclusiveCrisis #Hydroxyurea #AcuteChestSyndrome#PasstheMSRA #FreeMSRAResources