Summary
Haematology - Summary
- Course
- Institution
Haematology - Summary Table of all haematology conditions organised by history findings, examination findings, investigation findings and management according to Australian guidelines.
[Show more]
Seller
Follow
nikitagoyal
Content preview
Anaemia: reduction in red blood cell numbers and/or Hb below normalEpi: most common blood disorder
Ax – blood loss (trauma, surg, haematemesis), reduced production from bone marrow (nutritional deficiencies i.e vegetarian or vegan + Fe, B12, folate; increased demand e.g pregnancy; EPI deficiency i.e ESRF;
haematological malignancy; infection of progenitors e.g parovirus B19 – aplastic anaemia) , increased breakdown
Hx – asymptomatic, fatigue, loss of energy, exertional SOB, dizziness, palpitations, CP if IHD, pallor of mucous membranes
Examination – pallor, conjunctivae first; flow murmur, tachycardia
Blood Film – RBC size, colour, shape
Normal – biconcave with central pallor + smaller than WBCs
Spherocytes – loss of central pallor + round + red
Sickle cells – bananas
Tear drops cells – thalassaemia, myelofibrosis
Pencil cells – elliptocytosis
Info History/RF Examination Investigation Management
Iron deficiency Ax – Fatigue Koilonychia Bedside – ECG Address the cause
anaemia Decreased absorption – atrophic gastritis, IBD, coeliac disease; increased Pallor Conjunctival Bloods – 1 Oral Iron Replacement
Hypochromic, demand – during pregnancy, childrens/adolescents; increased loss of Lethargy pallor FBE – ↓Hb/HCr, ↓ MCV, ↑RDW (variation Give w/ Vit C
microcytic anaemia iron – GIT bleeding – right sided colon Ca, PUD, menorrhagia; dietary – Hair loss Hair loss of cell sizes), ↓ reticulocytes AD: Constipation, black
due to low cellular insuffient intake i.e vegetarian or vegan, malnutrition Brittle nails Nail changes UEC stools
iron Prolonged deficiency – depletes iron stores in the body resulting in Pica – thinning, Iron studies – ↓ ferritin, ↑TIBC/↑ 2 Parenteral iron
decreased erythropoiesis and anaemia Palpitations flattening? transferrin, ↓ iron saturation replacement
Most common cause Pathophys – SOB Atrophic Peripheral blood smear – microcytic Superior efficacy to oral
of anaemia Iron deficiency → ↓ binding of iron protoporphyrin → ↓ production of glossitis hypochromic, pencil red cells, target red Indication – absorption
Hb RF – Angular cells, anisocytosis (sizes), poikilocytosis issues, unable to tolerate
Epi – most common cause of anaemia, prevalence highest in children up pregnancy, cheilitis (shapes) oral iron, rapid iron loss,
Hb<130g/L in men
to 5 yrs, young women of reproductive age, pregnant women young EPO – normal or ↑ correction needed quickly
and <120g/L in
children, Tachy Imaging – 3 Red cell transfusion
nonpregnant women
vegetarians Postural Other – Low Hb and Sx – dyspnoea
and <110g/L in
, older pts drop Urea breath test, gastroscopy at rest, CP, pre-syncope
pregnant women
*Ferritin – acute phase reactant i.e Not given at same time as
infection, inflammation, malignancy IV ferritin – too much Fe
, Changing diet if they want?
Could give OCP if primary
cause is menorrhagia
Megaloblastic Ax – vitB12 deficiency – increased use e.g pregnancy; decreased intake – Pallor, SOB, fatigue, Bedside – Urea breath test (exclude iron Treat underlying Ax
Anaemia alcoholism, chronic pancreatitis, vegetarian; impaired absorption – glossitis deficiency anaemia) B12 def – life-long B12
Impairment of DNA intrinsic factor deficiency); malabsorption (coeliac disease); ileal resection Jaundice Bloods – supplementation
synthesis affecting or inflammation (Crohn’s), toxins FBE – ↓Hb, ↑ MCV, +/- ↓WCC, ↓platelets Oral – w/o autoimmune
haematopoesis and Folate deficiency – increased use e.g pregnancy; decreased intake – B12 deficiency – Peripheral Blood Smear – macrocytosis, gastritis
causing a distinct alcoholism, drugs (methotrexate); impaired absorption (coeliac, Crohns, neurological signs as it may hypersegmented neutrophils (6-7 lobes), Parenteral (injection or
morphological change chronic pancreatitis); impaired utilization – folic acid antagonists e.g affect the posterior column ovalocytes, tear drops infusion) – W/
in the RBCs methotrexate or trimethoprim and the corticospinal tract B12 def – ↓B12, ↓ holotranscobalamin autoimmune gastritis
Pathophys – B12 and folate are co-enzymes required for thymidine – changes in reflexes, poor Folate def – ↓ serum folate, ↓ Red cell
Folate – vitB9 synthesis – both are needed for an effective DNA synthesis for RBCs muscle function, memory Folate Blood transfusion if
Deficiency – impairment of cell division → cell grows for too long without problems Intrinsic factor/parietal cell antibodies symptomatic
division → large RBCs = megaloblastosis Neuropsych Sx – Schilling Test – give oral radioactive B12 + Med Hx – antacids, long-
Pregnant woman –
Co-enzymes – even if you supplement one, the other needs to be normal depression, cognitive IM non-radioactive B12 which will flush out term PPI, metformin
impairment in the
for it to work → supplement both slowing, forgetfulness, radiolabelled B12 – THEN 24 hr urine associated w/ reduced B12
closure of anterior
Humans cannot make folate, therefore must come from diet dementia, psychosis collection absorption
and posterior
Pernicious anaemia – from b12 deficiency due to autoimmune gastritis Chronic atrophic gastritis,
neuropore
Antibodies against parietal cells → loss of intrinsic factor → prevents gastric resection
Folate deficiency – no
normal absorption of the IF-B12 complex at the terminal ileum Phenytoin, trimethoprim,
neurological signs
Epi – B12 deficiency is the most common Ax of megaloblastic anaemia sulfasalazine,
methotrexate – interfere
Increased risk of IHD, stroke Trial of B12/Folate supplementation w/ folate absorption
Haemolytic Anaemia Ax – Congenital – Hereditary spherocytosis, G6PD deficiency, pyruvate Pallor CHURBL
Abnormal and kinase deficiency, sickle cell disease, thalassaemia; Acquired – infection, Jaundice Coombs Test (Direct) – Add known anti-
excessive destruction autoimmune, drug-induced, cardiac, haemolytic transfusion reaction, Fatigue human Ab (coombs serum) to pt blood →
of RBCs before their microangiopathic (haemolytic uraemia syndnrome, thrombotic Dyspnoea agglutination – Ab on RBC; detects
normal 120-day life thrombocytopenic purpura), paroxysmal nocturnal haemoglobinuria Dizziness autoimmune haemolytic anaemia
span; encompasses Splenomegaly Haptoglobin binds free Hb → therefore, ↓
several different Fava beans exacerbate G6PD deficiency when a lot of haemolysis (lots of Hb); also
conditions Leg ulcers is an acute phase reactant
Unconjugated hyperbilirubinaemia
Hereditary Spherocytosis – autosomal dominant; disorder of RBC, cells
↑ Reticulocytes
are less deformable, therefore get stuck in blood vessels and are RF – any of the Ax,
Blood film – reticulocytes, RBC fragments,
destroyed by the spleen autoimmune disorders,
Helmet cell (schistocytes), bite cells (small
mechanical prosthetic
piece of RBCs), spherocytes (small dense
heart valves, family origin is
RBC)
Mediterranean, Middle
↑ LDH – cellular breakdown
East, Africa, Asia
+ urinary haemosiderin test – Free Hb →
degraded to alpha-beta dimers → filtered
through the glomerulus → deposited as
haemosiderin → renal tubular cells →
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller nikitagoyal. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.79. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75323 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now