Hematology
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| P. vera lab data | Positive JAK-2 (janus kinase) serum test (pos in 74-97% of pts). Radiolabeled RBC study. Low EPO. WBC 10-20, PLt possibly >1M. High B12, LAP, uric acid. Pseudohyperkalemia. Normal SaO2.
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| JAK-2 mutations may be associated with: | Myelofibrosis. 50% of patients with essential thrombocytosis. 97% of patients with P vera
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| Multiple myeloma evaluation | SPEP (M-spike); 24 hr urine (Bence-Jones pro); Serum viscosity (may req plasma pheresis); Metastatic bone survey (lytic lesions); BM bx (inc. cytogenetics for q13- chromosome abnormality); Beta-2 microglobulins
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| Part of eval for multiple myeloma (if elevated = very poor outcome) | Beta-2 microglobulins
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| Dohle bodies | blue patch near edge; PMN; infxn
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| Toxic gran | purple/blue-black; PMN; severe infxn/toxic
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| Hyperseg | 6or more/3% w/5 or more; PMN; megaloblastic anemia, B12-folate def
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| Vacuoles | Monos/PMN; poss sepsis
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| LAP = | leukocyte alkaline phosphatase; Low in CML; High in leukemoid reactions
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| Platelets in leukemias | Increased (acute); normal (chronic)
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| Auer rods | AML
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| Smudge cells | CLL
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| Fried egg | hairy cell
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| Hypercellular bone marrow with reticulin or collagen fibrosis | myelofibrosis
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| Reed-Sternberg cells | large cells with multiloculated or bilobed nuclei with halo around inclusion nucleoli; seen in Hodgkin Disease
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| NHL labs | Anemia, high LDH and ESR. Test for HIV. CXR, CT of chest & A/P, LN bx, LP if CNS involvement
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| Test needed for dx of NHL | LN bx (excisional LN bx is preferred)
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| ALL: anterior mediastinal mass on CXR is suggestive of: | T-cell ALL
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| CML findings | Median WBC = 170,000 at dx; splenomegaly; BM/PBS: Phil. Chr (bcr/abl fusion gene); FISH for bcr/abl (quantitative); RT-PCR for bcr/abl (qualitative); thrombocytopenia (30%)
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| Hemochromatosis labs | High plasma iron (>200), transferrin saturation (70-100%), serum ferritin, LFTs, hepatic iron. Low TIBC. HFE gene mutation.
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| Gold standard for Hemochromatosis dx: | Liver biopsy with parenchymal hemosiderin
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Created by:
Abarnard
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