G6PD Deficiency Anemia Flashcards
How does this patient present?
Sudden onset of 1) Jaundice and dark urine along with 2) back pain and fatigue. Patient may have a history of 3)Bactrim for diarrhea and possible 4) family history
What are the positive review of systems?
Pallor, icterus, itch, dark urine, no dysuria
For patient with jaundice due to hemolytic cause, what a physical examination Should be done?
The usual including lymph nodes and Neuro, skin
Jaundice can be the result of what?
Hemolytic causes, disorders involving liver or a biliary tract
What are the routine orders for this patient?
CBC with differential, basic metabolic panel, LFT, prothrombin time
What points to intravascular hemolytic jaundice?
Dark colored urine, pallor, exposure to sulfa drugs
What are the pertinent negatives in physical examination that precludes liver or biliary tract pathology? Pertinent negative labs?
Normal abdominal examination, no abdominal tenderness, normal LFTs
What suggests hemolysis on Initial labs?
Anemia and CBC, bite cells on peripheral smear. Increased indirect bilirubin
What test can be used to confirm hemolytic activity? How does this change if patient has anemia, what should be done?
Reticulocyte count being elevated; Calculate reticulocyte production index to correct for degree of anemia
What labs will confirm intravascular hemolyses?
Serum haptoglobin and LDH (increases)
What should ordered and done for this patient with hemoglobin nine?
Type and cross match for two units of blood, PRBC packed red blood cell transfusion, repeat H & H in 12 hours
After the CBC comes in for this patient was should be ordered next?
Reticulocyte count with index calculation, LDH, and haptoglobin, UA, T&T, PRBC, check HH every 12
Heterozygous female for G6PD deficiency should avoid exposure to what? When?
Exposure to drugs would accident potential during pregnancy and lactation because may trigger hemolyses in fetus or neonate
When is transfusion necessary for this anemia?
If anemia is severe due to impaired compensatory Erythropoiesis
What are the other types of hereditary hemolytic anemia? How are they diagnosed?
Sickle cell anemia, hereditary spherocytosis, thalassemias; hemoglobin electrophoresis all except HS
