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HEME AND LYMPH
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
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
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
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
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
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
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
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
Heparin Indications
Indications
Acute Coronary Syndrome (ACS)
Prophylaxis
Pulmonary Embolism
Atrial Fibrillation
Used during Pregnancy
1 min
Tamoxifen
Mechanism of Action
Selective Estrogen Receptor Modulator (SERM)
Antagonist on Breast Tissue
Indications
ER-positive Breast Cancer
Side Effects
Decreased Risk of Osteoporosis
Increased Risk of Endometrial Cancer
Increased Risk of Venous Thromboembolism (VTE)
1 min
Aromatase Inhibitors
Indications
Estrogen Receptor-positive (ER+) Breast Tumors
Systemic Metastases
Drugs
Reversible, non-steroid
Letrozole
Anastrozole
Irreversible, steroid
Exemestane
Side Effects
Osteoporosis
Arthritis
1 min
Imatinib (Gleevec)
Indications
Chronic Myelogenous Leukemia (CML)
Inhibitor of BCR-ABL Tyrosine Kinase
Caused by Philadelphia Chromosome
GI Stromal Tumors
Inhibitor of C-kit Tyrosine Kinase
Toxicity
Fluid Retention
1 min
Bleomycin
Indications
Testicular Cancer
Hodgkin's Lymphoma
Mechanism of Action
Induces Free Radical Formation
Breaks in DNA Strands
Side Effects
Pulmonary Fibrosis
Skin Changes
Mucositis
1 min
Dactinomycin (Actinomycin D)
Indications
Wilms' Tumor
Rhabdomyosarcoma
Ewing's Sarcoma
Gestational Trophoblastic Malignancy
Mechanism
Intercalates DNA
Side Effect
Myelosuppression
1 min
Cisplatin
Indications
Carcinomas
Ovarian
Bladder
Lung
Testicular
Mechanism
Cross-Links DNA
Side Effects
Ototoxicity
Nephrotoxicity
Treat with Amifostine and Chloride Diuresis
2 mins
Trastuzumab
Indications
HER-2+ Breast Cancer
Stomach Cancer
Mechanism
Monoclonal Antibody Against HER-2
Inhibition of Cellular Signaling
Cytotoxicity
Side effects
Cardiotoxicity
1 min
Doxorubicin (Adriamycin)
Indications
Solid Tumors
Lymphomas and Leukemias
Mechanism
Free Radical Production
Intercalates DNA
Prevents Double Helix from Sealing
Side Effect
Cardiotoxicity
Dexrazoxane Decreases Toxicity
1 min
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