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Dehra Shared "BHL" - 32 Picmonics

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BHL

Coagulation Cascade Overview
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
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2 mins
Von Willebrand Disease
Mixed platelet and coagulation disorder
Mechanism
Autosomal Dominant Condition Leading to Reduced vWF
Defect in platelet plug formation
Labs
Increased Bleeding Time
PTT increased
Factor VIII decreased
Normal platelet count
Treatment
DDAVP (synthetic vasopressin)
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1 min
Disseminated Intravascular Coagulation (DIC)
Pathophysiology
Bleeding State
Activation of Clotting Factors
Deficiency of Clotting Factors
Causes
Sepsis
Trauma
Obstetric Complications
Acute Pancreatitis
Malignancy
Nephrotic Syndrome
Transfusion
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2 mins
Heparin Indications
Indications
Acute Coronary Syndrome (ACS)
Prophylaxis
Pulmonary Embolism
Atrial Fibrillation
Used during Pregnancy
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1 min
Warfarin
Mechanism of Action
Interferes with Vitamin K-dependent Clotting Factors
Extrinsic Pathway
Bridge with Heparin
Indications
Chronic Anticoagulation
Side Effects
Bleeding
Necrosis
Cytochrome P450
Contraindications
Pregnancy
Antidote
FFP + Vitamin K
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2 mins
Heparin Mechanisms
Mechanism of Action
Short Half-life
Antithrombin Activation Cofactor
Decrease Thrombin, Factor Xa
Side Effects
Bleeding
Heparin Induced Thrombocytopenia (HIT)
Antidote
Protamine Sulfate
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2 mins
Hemolytic Uremic Syndrome (HUS)
Children
Pathophysiology
Preceded by Acute Diarrheal Illness
Endothelial Damage
Classic Triad of Symptoms
Microangiopathic Hemolytic Anemia (MAHA)
Thrombocytopenia
Renal Failure
Labs
Helmet cells
LDH
Treatment
Dialysis
Supportive
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2 mins
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
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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
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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
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2 mins
Adult T Cell Lymphoma
Caused by HTLV 1
Japan, West Africa, Caribbean
Present with cutaneous lesions
Aggressive
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1 min
Burkitt's Lymphoma
Adolescents or young adults
C-myc gene moves next to heavy chain Ig gene
T 8;14
Starry sky appearance
Sheets of lymphocytes with interspersed macrophages
Jaw lesion in endemic (African) form
Pelvis or abdomen in non endemic form (American form)
Associated with EBV
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2 mins
Follicular Lymphoma
Derives from Germinal Center
Occurs in adults
T14;18
BCL 2 overexpression
BCL 2 inhibits apoptosis
Indolent
Generalized lymphadenopathy
Bone marrow involvement
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2 mins
Mantle Cell Lymphoma
Older Males
Activation of Cyclin D Gene
T 11;14
CD5
Poor Prognosis
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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
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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
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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
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3 mins
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
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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
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2 mins
Hairy Cell Leukemia
Pathophysiology
Mature B Cell Tumor
Signs and Symptoms
Splenomegaly
Diagnosis
Flow Cytometry
Cells Have Filamentous Hair-Like Projections
Stains TRAP Positive
Dry Tap on Bone Marrow Aspiration
Treatment
Cladribine
Pentostatin
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2 mins

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