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Hematology PA

Clinical presentation

Reticulocyte count will be low (<2%) Hypoproliferative Anemia
Reticulocyte count will be high (>3%) Hyperproliferative Anemia
seen primarily in southeast Asian, Mediterranean or African descent Alpha Thalassemia
seen primarily in Mediterranean (Italian, Greek) and less often in Asians and Africans Beta Thalassemia
fatigue, dyspnea on exertion, tachycardia, nail changes, dysphagia, pica ; microcytic/hypochromic as iron stores depleted Iron Deficiency Anemia
mild to moderate anemia; initially normocytic and moves to mild microcytic hypochromic due to defect in moving iron into rbcs Anemia of Chronic Disease
may have enlarged spleen or liver; mild to moderate anemia Sideroblastic Anemia
glossitis, anorexia, diarrhea, peripheral neuropathy B12 Deficiency
malnourished appearing, diarrhea, cheilosis, glossitis, NO neurological symptoms; alcohol is most common precipitator due to impaired hepatic function Folate Deficiency
severe anemic symptoms Pure Red Cell Aplasia
any age; pancytopenia; fatigue, weakness, excess bleeding/bruising, petechiae, purpura, pallor Aplastic Anemia
anemia may not be apparent until rbc life span becomes shortened to approx 20 days Hemolytic Anemias
anemia, splenomegaly, jaundice; pogment type gallstones may be present; maybe chronic leg ulcers Hereditary Spherocytosis
episodic hemolytic anemia will cause Fe deficiency as well; venous thrombosis; deficient hematopoiesis causing pancytopenia; reddish-brown urine Paroxysmal Nocturnal Hemoglobinuria
episodic hemolysis often triggered by oxidative stress (infections, toxins or drugs); no splenomegaly; no chronic hemolytic anemia Glucose 6 Phosphate Dehydrogenase Deficiency
pallor, jaundice, splenomegaly, leg ulcers, pigment gallstones, priapism; vascular occlusion leading to infarction Sickle Cell Disorders
anemia can be rapid onset and severe Autoimmune Hemolytic Anemia
mottled or numb fingers/toes; anemia is rarely severe Cold Agglutinin Disease
stomatitis (ulcers in mouth); fever sometimes; severe infections such as septicemia, pneumonia and cellulitis may occur Neutropenia
dyspnea, headaches, visual disturbances, tinnitus, pruritis, thromboses; PE shows retinal-vein occlusion, ruddy cyanosis and splenomegaly Polycythemia Vera (PCV)
rare in children, slight female predominance; approx 1/3 or pts asymptomatic at diagnosis; 2/3 of pts report vasomotor symptoms or complications from thrombosis or bleeding Thrombocytosis
early stages asymptomatic; later stages: general malaise, weight loss, splenomegaly or splenic infarction (LUQ pain); hepatomegaly in 50% of pts Myelofibrosis
asymptomatic; abnormal blood counts during routine screening; if symptomatic: fatigue, bleeding, recurrent infections, fever, splenomegaly, pallor Myelodysplastic Syndrome
fatigue/anemia, recurrent infections, lytic lesions predisposing pts to bone pain, pathologic fractures and hypercalcemia, kidney failure, hyperviscosity of blood; Multiple Myeloma
probable precursor to multiple myeloma Monoclonal Gammopathy of Unknown Significance (MGUS)
fatigue, hyperviscosity syndrome (nausea, vertigo, visual, mucosal or GI bleeding); weight loss, headache, cold hypersensitivity, peripheral neuropathy, hepatomegaly, splenomegaly, engorged retinal veins Waldenstrom's Macroglobulinemia
male 2: female 1; 25% asymptomatic at diagnosis; fatgue, drenching night sweats, weight loss, frequent and/or persistent infections, lymphadenopathy (80%), skin infections/shingles less common Chronic Lymphocytic Leukemia
young to middle age adults; phily chromosome present in over 95% of cases; bcr-abl is another way of diagnosing CML; fever with no infection, bone pain, LUQ pain due to enlarged spleen, fatigue, weakness, night sweats, bleeding and brushing, petechiae Chronic Myelogenous Leukemia
pts acutely sick over days/weeks, not months; primarily children's disease; can affect T or B cells; malaise, fatigue, fever, bleeding gums, lympadenopathy, splenomegaly, petechiae, weight loss, meningitis, lethargy, anorexia, dyspnea Acute Lymphoblastic Leukemia
similar to ALL; pancytopenia with circulating blasts, bone marrow with >20% blasts; peripheral smears showing wbc with Auer Rods; hepatomegaly, splenomegaly, elevated erythrocyte sedimentation rate Acute Myelogenous Leukemia
median age of onset is mid 50s; male 5: female 1; fatique, abd discomfort from splenomegaly Hairy Cell Leukemia
enlargement of lymphoid tissue, spleen, liver; painless cervical, supraclavicular, and mediastinal lymphadenopathy; constitutional/b symptoms (fever, drenching night sweats, weight loss); shortness of breath common with mediastinal mass Hodgkin's Lymphoma
Three grades: indolent (slow growing); intermediate (aggressive, mix of small to large cells); high grade (very aggressive); lymphadenopathy persistent and painless, isolated or difuse; B symtpoms; occasional ab pain, vomiting, bleeding, edema Non-Hodgkin's Lymphoma
usually in immunocompromised pts; organism in neutrophils and monocytes on Wright-Giemsa stained blood film; organism in macrophages on bone marrow smear Histoplasmosis
nose bleeds, gum bleeds, bruising, menorrhagia, petechia Acute Thrombocytopenia
same as acute (no systemic illness, spleen normal); common in childhood, starts with viral infection and have it intermittently throughout life; adult form is chronic Idiopathic (Immune) Thrombocytopenic Purpura
heparin for 4-10 days (if plt count drops more by half or more than assume HIT); inflammation/necrosis at subcutaneous sites, limb asymmetry, cool/pulseless extremities; arterial or venous thrombosis Heparin Induced Thrombocytopenia
mental status changes and symptoms correlating to end-organ damage (fever +/- mild renal insufficiency); associated with some meds; rare disease, but really sick; most prevelent in young women Thrombotic Thrombocytopenic Purpura
renal failure; no mental status changes; most common in infants, children and pregnant women Hemolytic Uremic Syndrome
hepatic coagulopathy Liver Disease (prolonged PT)
bruises easily, increased bleeding after minor procedures (dental), menorrhagia* von Willebrand Disease
can act in concert with smoking, birth control pills/hormone replacement Prothrombin 20210A Mutation
anti-phospholipid (recurrent thromboses, 2nd trimester miscarriages, thrombocytopenia, valvular heart disease, migraines) anticoagulation disorders
excessive thrombosis + bleeding (bc using up clotting products), organ dysfunction, shock, death; can get subacute DIC (Trousseau's syndrome) - see recurrent superficial cloting and DVTs Disseminated Intravascular Coagulation
spontaneous hemarthroses Hemophilia A
Created by: ac202