Miscellaneous
Pancytopaenia differential
"All Of My Blood Has Taken Some Poison":
Aplastic anaemias
Overwhelming sepsis
Megaloblastic anaemias
Bone marrow infiltration
Hypersplenism
TB
SLE
Paroxysmal nocturnal haemoglobinuria
Haematology: key numbers
3 and 4 are key in in haematology:
1.34 cm3 of oxygen is carried by a gram of hemoglobin.
There's 3.4mg of iron in each gram of hemoglobin.
There's an average of 3.4 lobes per neutrophil.
There's 34mg bilirubin from each gram of hemoglobin.
Sickle cell disease complications
SICKLE:
Strokes/ Swelling of hands and feet/ Spleen problems
Infections/ Infarctions
Crises (painful, sequestration, aplastic)/ Cholelithiasis/ Chest syndrome/ Chronic hemolysis/ Cardiac problems
Kidney disease
Liver disease/ Lung problems
Erection (priapism)/ Eye problems (retinopathy)
ADP: role in platelet aggregation
ADP = Aggregation from the Dense bodies of Platelets.
Anion gap metabolic acidosis: causes
A MUDPILE CAT:
Alcohol
Methanol
Uremia
Diabetic ketoacidosis
Paraldehyde
Iron/ Isoniazid
Lactic acidosis
Ethylene glycol
Carbamazepine
Aspirin
Toluene
HbA2: concentration in normal blood
HbA2:
Concentration of HbA2 is 2% in normal adult blood.
Metabolic acidosis: causes
USED CAR:
Ureteroenterostomy
Saline hydration
Endocrinopathies (hyperparathyroid, hyperthyroid, Addison's)
Diarrhea/ DKA/ Drugs
Carbonic anhydrase inhibitors
Ammonium chloride
Renal tubular acidosis
· Alternatively: USED CARP, to include Parenteral nutrition/ Pancreatic fistula.
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Non-gap acidosis: causes
HARD UP:
Hyperalimentation
Acetazolamide (carbonic anhydrase inhibitors)
RTA
Diarrhea
Ureterosigmoidostomy
Pancreatic fistula
Toxicity/ sepsis: signs
6 T's:
Tachycardia
Tachypnea
Tremors
Toxic look
Tiredness
Temperature (fever)
Macrocytic anemia: causes
ABCDEF:
Alcohol + liver disease
B12 deficiency
Compensatory reticulocytosis (blood loss and hemolysis)
Drug (cytotoxic and AZT)/ Dysplasia (marrow problems)
Endocrine (hypothyroidism)
Folate deficieny/ Fetus (pregnancy)
Metabolic acidosis: causes
KUSSMAL:
Ketoacidosis
Uraemia
Sepsis
Salicylates
Methanol
Alcohol
Lactic acidosis
Raynaud's disease: causes
BAD CT:
Blood disorders (eg polycythaemia)
Arterial (eg atherosclerosis, Buerger's)
Drugs (eg beta-blockers)
Connective tissue disorders (rheumatoid arthritis, SLE)
Traumatic (eg vibration injury)
Ulcers: types
VAN:
Venous/ Vasculitic
Arterial
Neuropathic
Anemia: non-megaloblastic causes of macrocytic anemia
HAND LAMP:
Hypothyroidism
Aplastic anaemia
Neonates
Drugs
Liver disease
Alcohol
Myelodyplasia
Pregnancy
NSAIDs: contraindications
NSAID:
Nursing and pregnancy
Serious bleeding
Allergy/ Asthma/ Angioedema
Impaired renal function
Drug (anticoagulant)
ACEI: contraindictions
PARK:
Pregnancy
Allergy
Renal artery stenosis
K increase (hyperkalemia)
Haemoptysis: causes
CAVITATES:
CHF
Airway disease, bronchiectasis
Vasculitis/ Vascular malformations
Infection (eg TB)
Trauma
Anticoagulation
Tumour
Embolism
Stomach
Anion gap metabolic acidosis: causes
MUDPILES:
Methanol
Uremia
Diabetic ketoacidosis
Paraldehyde
Infection
Lactic acidosis
Ethylene glycol
Salicylates
Cyanosis: DDx
COLD PALMS:
· Peripheral cyanosis:
Cold
Obstruction
LVF and shock
Decreased cardiac output
· Central cyanosis:
Polycythemia
Altitude
Lung dz
Met-, sulphaemoglobinaemia
Shunt
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