Fatigue Flashcards
causes of dyspnea w/ fatigue
- pleural effusion
- pericardial effusion
- anemia
- constrictive pericardial dz
- LAD
compare petechiae and purpura
petechiae - pinpoint hemorrhages
purpura - confluent petechiae
**both caused by thrombocytopenia
compare ecchymoses and hematoma
ecchymoses - confluent purpura (bruise)
hematoma - collection of blood in soft tissues
what is hemarthroses
bleeding into a joint
can be from trauma or sever hemophilia
telangiectasias suggest what kinds of dz
connective tissue dz or hereditary hemorrhagic telangiectasia
if you have a case of anemia, what is the most helpful test to order
reticulocyte count (tells you how the bone marrow is working)
in an anemic patient with decreased RBC production, what is on the ddx
- aplastic anemia
- chronic kidney dz
- B12/folate deficiency
- iron deficiency/hemoglobinopathy
- chronic dz/marrow infiltration
list the histologic and lab results in a patient with iron deficiency anemia
microcytic hypochromic anemia (may be normocytic)
decreased serum iron and ferritin, increased TIBC
is iron supplementation effective in anemia of chronic dz?
nope
what is lasthenie de ferjol syndrome
factitious anemia due to autophlebotomy
- underlying psychiatric disorder
in an anemic patient with increased RBC production, what is on the ddx for INTRINSIC disorders
- hereditary spherocytosis
- G6PD deficiency
in an anemic patient with increased RBC production, what is on the ddx for EXTRINSIC disorders
- march hemoglobinuria
- lead or copper toxicity
- malaria, babesia, bartonella
- autoimmune hemolysis
- portan HTN
what is cardiac anemia
pts w/ severe aortic stenosis and prosthetic valves can have ongoing lysis of RBCs –> mild anemia
heinz bodies and bite cells are characteristic of what dz process
G6PD deficiency
histological manifestations of G6PD def.
normochromic normocytic anemia
how does lead cause anemia
interferes w/ cation pump –> shortened RBC survival times
slows production of RBCs in the marrow
treatment of warm antibody hemolysis
high doses of steroids
immunosuppressives (cyclophosphamide and azothioprine)
splenectomy
clinical presentation of polycythemia vera
- facial rubor (red face)
- hyperviscocity signs (HA, dizziness, blurred vision, heaviness in extremities)
- pruritis w/ hot shower or bath
- splenomegaly
what is the usual cause of death in polycythemia vera patients
progressive marrow fibrosis w/ pancytopenia (spent phase)
what dz process is associated with budd chiari syndrome
polycythemia vera
what causes polycythemia vera
JAK mutations (JAK2/V617F)
treatment of polycythemia vera
phlebotomy ever 1-2 weeks
also hydroxyurea
