Nicole Shared "Heme Part 2" - 31 Picmonics
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Heme Part 2
Acute Myelogenous Leukemia (AML)
- Myeloblasts Increase on Peripheral Smear
- Median Onset 60 Years
- T 15;17 M3 Subtype
- Auer Rods
- Disseminated Intravascular Coagulation (DIC) is a Common Presentation
- M5 Gum Infiltration
- Responds to Vitamin A
3 mins
Chronic Myelogenous Leukemia (CML)
- Pathophysiology
- BCR-ABL
- 9;22 Translocation
- Philadelphia Chromosome
- Signs & Symptoms
- Tyrosine Kinase
- Low Alkaline Phosphatase
- Splenomegaly
- Considerations
- Blast Crisis
- Age 30 to 90 Years
- Responds to Imatinib
3 mins
Acute Lymphoblastic Leukemia (ALL)
- Ages < 15
- May Present with Bone Marrow Involvement in Children
- Mediastinal Mass in Adolescents
- TdT Positive
- CALLA Positive
- t(12;21) Better Prognosis
- Spread to CNS and Testes
- Most Responsive to Chemotherapy
2 mins
Chronic Lymphocytic Leukemia (CLL)
- Signs and Symptoms
- Age > 60 Years
- B Cell Neoplasm
- Smudge Cells
- Often Asymptomatic
- Cold IgM Autoimmune Hemolytic Anemia
- Warm IgG Autoimmune Hemolytic Anemia
- Richter's Transformation
3 mins
Auer Rods
- Azurophilic granular needles in leukemic blasts
- Disseminated Intravascular Coagulation (DIC)
- Acute Myelogenous Leukemia (AML)
- All-trans Retinoic Acid (Vitamin A)
1 min
Hodgkin Lymphoma Signs & Symptoms
- Signs and Symptoms
- Localized Single Group of Lymph Nodes
- Contiguous Spread
- Constitutional B Symptoms
- Low-Grade Fever
- Night Sweats
- Weight Loss
2 mins
Hodgkin Lymphoma Pathophysiology
- Pathophysiology
- Reed-Sternberg Cells
- Binucleate
- Owl's Eyes Appearance
- CD 15 and CD 30
- B Cell Origin
- Bimodal Age Distribution
2 mins
Hodgkin's Lymphoma Interventions
- Diagnosis
- Biopsy
- Staging
- Interventions
- Radiation
- Chemotherapy
- Treat Side Effects of Therapy
- Considerations
- Secondary Cancer Screening
2 mins
Non-Hodgkin's Lymphoma Assessment
- Cause
- Lymphatic Cancer
- Non-Contiguous Spread
- B or T Cells
- Assessment
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Mediastinal or Abdominal Mass
- Considerations
- Older Adults
- > 60 Subtypes
2 mins
Diffuse Large B Cell Lymphoma
- Epidemiology
- Most Common Non-Hodgkin’s Lymphoma
- Usually in Older Adults
- 20% in Children
- Features
- May be Mature T Cell in Origin
- Derives from Germinal Center
- GI Tract and Brain
2 mins
Multiple Myeloma Pathophysiology
- Pathophysiology
- Monoclonal Plasma Cell Cancer
- Clock Face Chromatin
- Diagnosis
- M Spike on Protein Electrophoresis
- Increased IgG and IgA
- Fried Egg Appearance (BM Biopsy)
- Rouleaux Formation
- Stacked RBC's
- Bence Jones Protein
2 mins
Multiple Myeloma Signs and Symptoms
- Signs and Symptoms
- Increased Susceptibility to Infection
- Back/Bone Pain
- Punched Out Lytic Bone Lesions
- Hypercalcemia
- Primary Amyloidosis
- Renal Insufficiency
- Anemia
2 mins
Types of Blood Products
- Types
- Whole Blood
- Packed Red Blood Cells
- Fresh Frozen Plasma
- Immunoglobulins
- Clotting Factors
- Albumin
- Platelets
- Considerations
- Use within 24 Hours
- Washing Removes Antibodies
- Irradiation Destroys WBCs
2 mins
Transfusion Reactions
- Acute Hemolytic
- Febrile, Non-Hemolytic
- Mild Allergic
- Anaphylactic
- Circulatory Overload
- Sepsis Reaction
- Transfusion-Related Acute Lung Injury (TRALI)
- Massive Blood Transfusion
2 mins
Selective IgA Deficiency
- Pathophysiology
- Defect in Class Switching
- Decreased IgA
- Signs and Symptoms
- Often Asymptomatic
- Increase in Atopic & Autoimmune Diseases
- Sinopulmonary Infections
- Increased Risk Giardia Lamblia Infections
- Inflammatory Bowel Disease
- Celiac Disease
- Considerations
- Anaphylaxis From IgA Containing Blood Products
2 mins
Warm Agglutinin Autoimmune Hemolytic Anemia (W-AIHA)
- Pathophysiology
- Most Common Autoimmune Hemolytic Anemia
- IgG Coats RBCs at Warm Temperatures
- Fc Portion of IgG Recognized By Macrophages
- Extravascular Hemolysis
- Medications
- Alpha Methyldopa
- Chronic Lymphocytic Leukemia (CLL)
- Systemic Lupus Erythematosus (SLE)
- Diagnosis
- Positive Coombs Test
- Treatment
- Corticosteroids
- Splenectomy
- Intravenous Immunoglobulin (IVIG)
- Rituximab
3 mins
Cold Agglutinin Autoimmune Hemolytic Anemia (C-AIHA)
- Pathophysiology
- IgM Binds to RBCs at Cold Temperatures (28-31C)
- Extravascular Hemolysis
- Waldenstrom's Macroglobulinemia
- Mycoplasma Pneumoniae
- Infectious Mononucleosis
- Lymphomas and CLL
- Symptoms
- Acrocyanosis with Cold Exposure
- Blue Fingers and Toes
- Diagnosis
- Positive Coombs Test
- Treatment
- Avoid Cold
- Rituximab
- +/- Fludarabine
4 mins
Leukemia Interventions
- Diagnosis
- Bone Marrow Aspiration
- X-Rays
- Interventions
- Chemotherapy
- Bleeding Precautions
- Neutropenic Precautions
- Strict Asepsis
- Bone Marrow Transplant
- Blood Transfusions
- Monitor Temperature Elevations
- Adequate Nutrition
- Imatinib (Gleevec) for Chronic Myelogenous Leukemia (CML)
3 mins
HIV CD4+ 500
- Signs and Symptoms
- Candida albicans (Oral Thrush)
- Kaposi's Sarcoma (HHV-8)
- Human Papillomavirus (HPV)
- Epstein-Barr Virus (Oral Hairy Leukoplakia)
3 mins
HIV CD4+ 200
- Signs and Symptoms
- Herpes Simplex Virus (HSV)
- JC Virus
- Progressive Multifocal Leukoencephalopathy (PML)
- Pneumocystis Pneumonia
- (HIV) Dementia
- Histoplasmosis
3 mins
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