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Hemat & Onco 2
Hereditary Spherocytosis Disease
Northern Europeans
Mechanisms
Autosomal Dominant
Spectrin/Ankyrin Deficiency
Spherocyte Formation
Hemolytic Anemia
Symptoms
Bilirubin Gallstones
Jaundice
Splenomegaly
3 mins
Hereditary Spherocytosis Diagnosis & Treatment
Labs
Increased MCHC
Spherocytes
Normocytic Anemia
Diagnosis
Eosin-5-Maleimide (EMA) Binding Test
Osmotic Fragility Test
Glycerol Lysis Test
Treatment
Folic Acid
Splenectomy
2 mins
G6PD Deficiency
X-linked Recessive
Hemolytic Anemia
Inflammatory Response
Fava Beans
Sulfonamides
Primaquine
Anti TB Drugs
Heinz Bodies
Bite Cells
Prevalent Among African Americans due to Increased Malarial Resistance
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)
1 min
Clopidogrel (Plavix)
Mechanism
ADP Receptor Antagonist
Prevent Platelet Aggregation
Indications
Acute Coronary Syndrome (ACS)
Prevention of Thrombotic Events
Side Effects
Bleeding
Thrombotic Thrombocytopenic Purpura (TTP)
Pancytopenia
Abdominal Pain
Considerations
Withhold Before Surgery
2 mins
Enoxaparin (Lovenox)
Mechanism of Action
Inhibits Clotting Factors
Factor Xa
Indications
Clot Formation Prevention
Side Effects
Heparin Induced Thrombocytopenia (HIT)
Bleeding
Considerations
Medication Education
Subcutaneous Injection
2 Inches from Umbilicus or Incisions
Antidote
Protamine Sulfate
2 mins
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
2 mins
Thrombotic Thrombocytopenic Purpura (TTP)
Inhibition or deficiency of ADAMTS 13
vWF Multimers are Not Degraded
Microthrombi (and Emboli)
Symptoms
FAT RN Pentad
Fever
Anemia
Thrombocytopenia
Renal Dysfunction
Neurologic Abnormalities (Altered Mental status)
Treatment
Plasmapheresis
Corticosteroids
Splenectomy
2 mins
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
2 mins
Sepsis Assessment
Signs and Symptoms
Systemic Infectious Process
Fever
Hypotension
Change in LOC
Increased WBC
Shift to the Left
Tachycardia
Tachypnea
Hyperglycemia
Edema
2 mins
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