Juan Shared "1. Heme-Onc Exam 1" - 82 Picmonics

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1. Heme-Onc Exam 1

Microcytic Anemia Causes
MCV < 80
Causes
Thalassemias
Chronic Disease or Illness
Lead Toxicity
Late Iron Deficiency
Sideroblastic Anemia
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1 min
Normocytic Nonhemolytic Anemia Causes
MCV 80-100
Nonhemolytic
Anemia of Chronic Disease/Inflammation
Aplastic Anemia
Chronic Kidney Disease
Early Iron Deficiency
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1 min
Normocytic Hemolytic Anemia Causes
Intrinsic Hemolytic
Hereditary Spherocytosis
RBC Enzyme Deficiency
Hemoglobin C Defect
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Sickle Cell Anemia
Extrinsic Hemolytic
Autoimmune
Microangiopathic
Mechanical Destruction
Prosthetic Cardiac Valves
Infection
Snake Venom
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2 mins
Macrocytic Anemia Causes
MCV > 100
Megaloblastic
B12 Deficiency
Folate Deficiency
Orotic Aciduria
Non Megaloblastic
Alcoholism
Liver Disease
Reticulocytosis
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2 mins
Anemia Lab Values
Iron Deficiency Anemia
Serum Iron Decreased
Transferrin Increased
Ferritin Decreased
% Transferrin Saturation Decreased
Pregnancy and OCP Use
Serum Iron Normal
Transferrin Increased
Ferritin Normal
% Transferrin Saturation Decreased
Anemia of Chronic Disease
Serum Iron Decreased
Transferrin Decreased
Ferritin Increased
% Transferrin Saturation Decreased or Normal
Hemochromatosis
Serum Iron Increased
Transferrin Decreased
Ferritin Increased
% Transferrin Saturation Increased
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3 mins
Iron Deficiency Anemia
Causes
Malnutrition/Malabsorption
Hemorrhage
Signs
Microcytic, Hypochromic Anemia
Decreased Heme Synthesis
Labs
Decreased Reticulocytes
Decreased Ferritin
Increased Red Cell Distribution Width (RDW)
Poikilocytosis
Anisocytosis
Increased Central Pallor
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2 mins
Hereditary Spherocytosis Disease
Northern Europeans
Mechanisms
Autosomal Dominant
Spectrin/Ankyrin Deficiency
Spherocyte Formation
Hemolytic Anemia
Symptoms
Bilirubin Gallstones
Jaundice
Splenomegaly
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3 mins
Hereditary Spherocytosis Diagnosis & Treatment
Labs
Increased MCHC
Spherocytes
Normocytic Anemia
Diagnosis
Osmotic Fragility Test
Treatment
Splenectomy
Folic Acid
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1 min
Sickle Cell Anemia (Mechanism)
Intrinsic Normocytic Hemolytic Anemia
Point Mutation
Autosomal Recessive
African-American
Dehydration or Decreased O2
Newborns Asymptomatic
Heterozygote Malarial Resistance
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2 mins
Sickle Cell Anemia (Signs and Complications)
Signs
Crew-cut on Skull X-ray
Complications
Auto-splenectomy
Painful Crisis
Aplastic Crisis
Splenic-sequestration Crisis
Hyper-hemolytic Syndrome
Renal Papillary Necrosis
Salmonella osteomyelitis
Pulmonary Hypertension
Hyposthenuria
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2 mins
Sickle Cell Anemia (Management)
Long Term Treatment
Hydroxyurea
Bone Marrow Transplant
Folate
Acute Treatment
Exchange Transfusion
Prophylaxis
Penicillin Prophylaxis
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1 min
Beta Thalassemia
Mechanism
Microcytic, Hypochromic Anemia
Mediterranean Populations
Decreased Beta-Globin
Beta-Thalassemia Minor
Increased HbA2
No Intervention
Beta-thalassemia Major
Blood Transfusions
Hemochromatosis
Crew-cut on Skull X-Ray
Diagnosis
Electrophoresis
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2 mins
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Pathophysiology
Defective PIG-A Gene
Deficiency of DAF (Decay Accelerating Factor CD55)
Symptoms
Dark Urine in the Morning
Intravascular Hemolysis
Thrombosis
Diagnosis
Decreased CD55 and CD59
Treatment
RBC Transfusion
Eculizumab
Bone Marrow Transplant is Curative
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3 mins
Pyruvate Kinase Deficiency
Pathophysiology
Autosomal Recessive
Defect in Pyruvate Kinase
Decreased ATP
Extravascular Hemolysis
Presentation / Symptoms
Hemolytic Anemia in a Newborn
Diagnosis
RBC Enzyme Assay
Echinocytes
Burr Cells
Small Uniform Projections
Normocytic Anemia
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2 mins
Cold Agglutinin Autoimmune Hemolytic Anemia (C-AIHA)
Pathophysiology
IgM Binds to RBCs at Cold Temperatures (28-31C)
Intravascular Hemolysis
Waldenstrom's Macroglobulinemia
Mycoplasma Pneumoniae
Infectious Mononucleosis
Lymphomas and CLL
Symptoms
Acral Cyanosis with Cold Exposure
Blue Fingers and Toes
Diagnosis
Positive Coombs Test
Treatment
Avoid Cold
Rituximab
+/- Fludarabine
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3 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
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3 mins
Acute Intermittent Porphyria (AIP)
Pathophysiology
Autosomal Dominant
Inhibited Porphobilinogen Deaminase
Increased Serum Porphobilinogen
Increased Serum Delta-ALA
Increased Urinary Porphyrin Precursors
Signs & Symptoms
Precipitated By P450 Inducers
Painful Abdomen
Polyneuropathy
Psychological Disturbances
Port Wine-Colored Urine
Treatment
Glucose and Hemin
Considerations
Avoid Triggers
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3 mins
Porphyria Cutanea Tarda (PCT)
Pathophysiology
Inhibited Uroporphyrinogen Decarboxylase (UROD)
Most Common Porphyria
20% Autosomal Dominant
80% Sporadic Type
Hepatitis C Association
Signs & Symptoms
Photosensitivity
Blistering of Skin
Tea Colored Urine
Diagnosis
Increased Uroporphyrins (Urinary & Serum)
Treatment
Avoid Sunlight
Phlebotomy
Hydroxychloroquine (Low Dose)
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3 mins
Hemoglobin (Hgb) Lab Values
Men: 13 - 17 g/dL
Women: 12 - 16 g/dL
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46 secs
WBC Differential Lab Value
White Blood Cells (WBC)
5-10 (5,000-10,000)
Leukocyte Differential
Neutrophils (50%-70%)
Bands (2%-5%)
Segs (50%-70%)
Lymphocytes (20%-40%)
Monocytes (4%-8%)
Eosinophils (2%-4%)
Basophils (0.5%-1.5%)
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2 mins

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