Hematology Flashcards
ADAMTS13
It’s VWF cleaving enzyme and associated with TTP
TTP Symptoms
Fever AKI Neuro ( seizure , Stroke , delirium ) Low platelets Hemolytic anemia
HUS
Fever ( diarrhea before due to E.coli ) AKI Hemolytic anemia Low platelets NO NURO
TTP Vs HUS
HUS : diarrhea , No Neuro , AKI with higher creatinine
TTP : ADAMTS13 , With neuro , less AKI
Schistocytes seen in
DIC
TTP
HUS
Waldenstrom Macroglobulinemia
Disorder of the B-cell ( IgM )
Waldenstrom Macroglobulinemia presentation
Hyperviscosity ( High IgM )
Cryoglobulunemia ( Raynaud phenomenon )
Cold agglutinins disease
Waldenstrom Macroglobulinemia Dx
Bone marrow biopsy
Dutcher bodies +IgM
MUGS
Monoclonal gammopathy of undetermined significance
This is the precursor of two diseases
1. Multiple Myeloma ( IgG + IgA )
2. Walden storm macroglobulenemia
Amyloidosis Major sites of clinically important dispositions
Kidney
Heart
Liver
Amyloidosis DX
Tissue biopsy with Congo red staining.
Esophageal cancer
Barret - Adenocarcinoma
Plummer Vinson - Sqamous cell carcinoma
Prussian blue
It’s spider oblast is anemia
Bite cells + Hence bodies
G6PD
Coombs +
Autoimmune heamolysis
Reedstenberg
Hodgkin disease
High RDW
It’s only Iron deficiency Anemia
Aur rods
AML
Iron deficiency Anemia 2 only’s
- High RDW.
- Low ferritin. ( ferritin t store t )
hypersegmented neutrophils
Folate + B12 deficiency
Target Cell
Thalassemia
All RBC production problems give you
Low retic count .. Either Folate + B12 or Thlasemia and iron def etc
No contents of the retic how we gonna make the retics
The only Low MCV and High retic Count is
3 gene deletion
Hypothyroidism Anemia is
Macrocytic Anemia
This Big MCV one
Also liver disease Macrocytic
Very Well known medication that cause Folate deficiency
Phenytoin
Reticulocytes
Larger Cells than RBs
They are retained placenta BIG ones
Very low Hematocrit
Very low Hgb
25-30
8-10
1 unit of Packed RBC
Raise the hematocrit (3 points)
Raise the Hgb ( 1 point )
Warfarin Overdose reversed by
PCC
Prothrombin complex concentrate 2 7 9 10
NOT FFP
Tx.
Hemophilia A&B
VWD
Factor 8 or 9 / Desmopressin DDVAP
Factor 8 or / Desmopressin DDVAP
NOAC Overdose
Idarusizumab
FFP Replaces
Clotting Factors
It’s need blood type
Hepcidin
Keep in the iron Trapped in the Store so you can’t use it
Anisocytosis
Unequal RBC sizes
HIT
IgG AB Against PF4
4-10 days after heparin
More than 50% drop in platelets count
TX is stop heparin + foundaparinux / argatroban / lipirudin
Complications: Arterial and venous thrombosis
Wells score
Risk assessment for DVT
Thalassemia minor labs
RBC count normal
Hgb normal
RDW normal
EXCEPT Low MCV
Only thing change in the lab of thalassemia minors patient is
Low MCV .. It’s microcytic anemia
Thalassemia Chromosomes
A thalassemia
B thalassemia
Chr.16
Chr.11
Most Accurate test for Thalasemia diagnosis
Genetic testing
It’s autosomal recessive disease so
A thalassemia Chr.16
B thalassemia Chr.11
Normal Adult Hemoglobin component
A :97%
A2 : 2 %
F: 1%
Disorder in the heme part of the Hgb is two
Heme - Iron def / Chronic disease
Protoporphyrin- Sideroblastic
Tumor lysis syndrome
Associated with hematologic malignancies After initiation of cytotoxic
Chemotherapy
1. High P ( phosphate and Potassium ) + Uric acid
2.Low Calcium ( the phosphate bind the calcium so more phosphate with bind more Ca making it low )
Manage with:
Fluids
Allopurinol + Rasburcase “ lowers uric acid “
Monitor the Arrhythmia’s ( because of Ca + K abnormality )
