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Hematology Exam 1
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
3 mins
Folate Deficiency
Clinical Features
Macrocytic Anemia
Megaloblastic Anemia
Etiologies
Malabsorption
Dietary
Tea and Toast
Alcoholics
Medication-induced
Methotrexate
Trimethoprim
Increased Requirement
Hemolytic Anemia
Pregnancy
2 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
2 mins
Enterohemorrhagic E. Coli (EHEC)
Characteristics
O157:H7
Non-Sorbitol Fermenting
Hamburger Meat
Produces Shiga-like Toxin
Gram-negative
Lysogeny
Inactivates 60S Ribosome
Disease
Bloody Diarrhea
Hemolytic Uremic Syndrome (HUS)
Hemolytic Anemia
Acute Renal Failure
Thrombocytopenia
2 mins
Chronic Gastritis
Type A
Type A
Fundus and Body
Autoimmune
Autoantibodies to Parietal Cells
Pernicious Anemia
Achlorhydria
Type B
Type B
Most Common Type
Helicobacter pylori
Antrum
Increased Risk of MALT Lymphoma
Associations
HIV/AIDS
Crohn's Disease
3 mins
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
2 mins
Plummer-Vinson Syndrome
Triad of Symptoms
Dysphagia
Esophageal Webs
Glossitis
Iron Deficiency Anemia
Association
Squamous Cell Cancer of Esophagus
1 min
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
2 mins
Hereditary Spherocytosis Disease
Northern Europeans
Mechanisms
Autosomal Dominant
Spectrin/Ankyrin Deficiency
Spherocyte Formation
Hemolytic Anemia
Symptoms
Bilirubin Gallstones
Jaundice
Splenomegaly
3 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
Mycoplasma Pneumoniae
Characteristics
No Cell Wall and No Gram Stain
Cholesterol Membrane
Eaton's Agar
Mulberry Colonies
Disease
Atypical pneumonia
Military Recruits
Cold IgM Autoimmune Hemolytic Anemia
Erythema Multiforme
Treatment
Tetracycline
Erythromycin
2 mins
Iron (Ferrous Sulfate)
Mechanism
Ferrous Salts
Indications
Anemia
Side Effects
GI Distress
Nausea and Vomiting
Dark Stools
Considerations
Take Between Meals
Liquid can Stain Teeth
Keep out of Reach from Children
Caution with GI Disorders
Avoid Antacids
3 mins
Colorectal Cancer Assessment
3rd Most Common Cancer
Assessment
Change in Bowel Habits
Bowel Obstruction
Rectal Bleeding
Anemia
Weight Loss
Ascites
Considerations
Colonoscopy
FOBT and FIT
2 mins
Sickle Cell Anemia (Mechanism)
Intrinsic Normocytic Hemolytic Anemia
Point Mutation
Autosomal Recessive
African American
Dehydration or Decreased O2
Newborns Asymptomatic
Heterozygote Malarial Resistance
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
2 mins
Sickle Cell Anemia (Management)
Long Term Treatment
Hydroxyurea
Bone Marrow Transplant
Folate
Acute Treatment
Exchange Transfusion
Prophylaxis
Penicillin Prophylaxis
1 min
Shigella
Characteristics
Gram-Negative
Bacilli
Non Lactose Fermenting
White on Macconkey Agar
Oxidase Negative
Non H2S Producing
Day Care Centers
High Virulence
Replicates Intracellularly
Actin Rocket
Signs and Symptoms
Bloody Diarrhea
Shiga Toxin
Inhibits 60S Ribosome
Hemolytic Uremic Syndrome (HUS)
Hemolytic Anemia
Thrombocytopenia
Kidney Failure
3 mins
Vitamin B12 (Cobalamin) Deficiency Causes
Causes
Vegans
Pernicious Anemia
Gastric Bypass Surgery
Malabsorption
Sprue
Enteritis
Crohn's Disease
Diphyllobothrium latum
4 mins
Vitamin B12 (Cobalamin) Mechanism and Deficiency
Mechanism
Cobalamin
Large reserve pool in the liver
Homocysteine to methionine
Methylmalonyl CoA to succinyl CoA
Deficiency Signs and Symptoms
Macrocytic Megaloblastic Anemia
Hypersegmented Neutrophils
Neurologic defects
Posterior column
Lateral corticospinal tract
Spinocerebellar tract
5 mins
Fluorouracil (5-FU)
Mechanism
Antimetabolite
"Thymine-less Death"
Indications
Slow-growing Solid Tumors
Co-administered with Leucovorin for Stomach Cancer
Basal Cell Carcinoma (Topical)
Side Effects
Myelosuppression
Mucositis
Severe Diarrhea
3 mins
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