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    Hematology Review: Dr. Baher Krayem Imc-Emek Medical Center

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    asal shibli
    The document discusses various types of anemia and hematological disorders. It covers the classification, symptoms, diagnosis, and treatment of conditions like iron deficiency anemia, B12 deficiency, folate deficiency, hemolytic anemias, leukemia, lymphoma, and platelet disorders. Key points include clinical manifestations of anemia, workup involving blood counts and smears, and management depending on etiology. Evaluation and management of coagulation disorders such as DIC are also summarized.

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    Hematology Review: Dr. Baher Krayem Imc-Emek Medical Center

    Uploaded by

    asal shibli
    69 views44 pages
    The document discusses various types of anemia and hematological disorders. It covers the classification, symptoms, diagnosis, and treatment of conditions like iron deficiency anemia, B12 deficiency, folate deficiency, hemolytic anemias, leukemia, lymphoma, and platelet disorders. Key points include clinical manifestations of anemia, workup involving blood counts and smears, and management depending on etiology. Evaluation and management of coagulation disorders such as DIC are also summarized.

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    The document discusses various types of anemia and hematological disorders. It covers the classification, symptoms, diagnosis, and treatment of conditions like iron deficiency anemia, B12 deficiency, folate deficiency, hemolytic anemias, leukemia, lymphoma, and platelet disorders. Key points include clinical manifestations of anemia, workup involving blood counts and smears, and management depending on etiology. Evaluation and management of coagulation disorders such as DIC are also summarized.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    69 views44 pages

    Hematology Review: Dr. Baher Krayem Imc-Emek Medical Center

    Uploaded by

    asal shibli
    The document discusses various types of anemia and hematological disorders. It covers the classification, symptoms, diagnosis, and treatment of conditions like iron deficiency anemia, B12 deficiency, folate deficiency, hemolytic anemias, leukemia, lymphoma, and platelet disorders. Key points include clinical manifestations of anemia, workup involving blood counts and smears, and management depending on etiology. Evaluation and management of coagulation disorders such as DIC are also summarized.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 44

    Hematology

    Review
    Dr. Baher Krayem
    IMC- EMEK MEDICAL CENTER
    Classification of Anemia
    Anemia
    – Clinical Manifestation
    • Weakness
    • Fatigue
    • Dizziness
    • Exertional dyspnea
    • Chest pain
    – Diagnosis
    • Check Hb, MCV
    • Reticulocytes count
    – Treatment
    • According to etiology
    – Blood transfusion
    • Indications:
    – Active bleeding
    – Hb level less than 7
    Iron metabolism
    Iron Deficiency Anemia
    IDA Blood Smear
    • Microcytosis = small RBC
    • Hypochromia = No Hb in RBC
    • Poikilocytosis = Different RBC shapes
    • Anisocytosis = Different RBC sizes
    Iron Deficiency Anemia
    Vs
    Anemia of Inflammation
    Question
    B12 Anemia
    B12 Anemia

    – Pancytopenia
    – Increased LDH
    – Blood smear
    Treatment of B12 Anemia
    Folate Deficiency Anemia
    Hemolytic Anemias Classification
    Lab of Hemolytic Anemia
    Features of HA
    G6PD
    AIHA

    – Etiology
    – Clinical
    • Back pain
    • Symptoms of anemia
    • Jaundice
    • Splenomegaly
    – Diagnosis
    • Lab diagnosis
    • Positive Coombs
    – Treatment
    • Supportive treatment
    • Steroids
    PNH = Paroxysmal Nocturnal
    Hemoglobinuria

    – Triad
    • Hemolytic anemia
    • Thrombocytopenia
    • VTE = DVT, PE, Portal Vein thrombosis
    – Diagnosis
    • Flow cytometry CD55 CD59
    – Treatment
    • Supportive
    • Ecolizumab

    – When to suspect PNH?


    Bone marrow cells
    AML
    – Etiology: HRED
    • Hereditary
    • Radiation
    • Exposure to toxic substances
    • Drugs like chemotherapy
    – Blood smear
    • Myeloblasts with Auer rods
    – Presentation
    • Anemia = Symptoms of anemia
    • Thrombocytopenia = bleeding symptoms
    • Leukopenia = infections
    – Diagnosis
    • Blood smear
    • Bone marrow aspiration
    • Bone marrow biopsy
    – Treatment
    • HSCT= Hematopoietic stem cell transplant
    Acute Promyelocytic Leukemia

    – Subtype of AML
    • Translocation 15,17
    – Bleeding symptoms
    – Better prognosis
    – ATRA [Vitamin A derivative] proved to be useful
    – Also Arsenic acid is useful
    Chronic Myeloid Leukemia

    – Translocation 9,22
    – Symptoms:
    • Usually asymptomatic
    – Diagnosis
    • Incidentally usually
    • Leukocytosis
    • Elevated neutrophils
    – Treatment
    • TKIs = Tyrosine kinase inhibitors like Imatinib
    CLL

    – Blood Smear
    • Lymphocytosis
    – Clinical:
    • Lymphocytosis
    • Adenopathy
    • Splenomegaly
    • Anemia and Thrombocytopenia
    – Diagnosis
    • Blood smear
    • BM biopsy and aspiration
    – Flow cytometry
    – Treatment
    • Most cases watch and wait
    Multiple Myeloma
    – Plasma cell disorders
    – Clinical:
    • Bone pain
    • Infections
    • Hypercalcemia
    • CKD
    • Anemia
    – Diagnosis
    • BM biopsy
    – Urine stick
    • High protein without albumin
    – Treatment
    • Prednisone
    • Bortezomib = Proteasome inhibitors
    • Thalidomide \ Lenalidomide
    Hodgkin’s Lymphoma
    – Age distribution
    • Early 20s
    • Second peak 70-80
    – Clinical manifestation:
    • Lymph node enlargement
    • Mediastinal mass
    – Types
    • Nodular sclerosing
    • Lymphocyte rich
    • Lymphocyte depleted
    • Mixed cellularity
    – Diagnosis
    – BM biopsy = Owl’s eyes = Reed Steinberg cells
    – Treatment
    • Aggressive chemotherapy
    • Radiation if Bulky disease = more than 7 cm
    • Complications of radiation?
    Platelets Disorders
    ITP = Idiopathic thrombocytopenic
    Purpura
    HIT = Heparin Induced thrombocytopenia

    – Definition
    • 50% drop in thrombocytes 5 days after administration of heparin/Clexane
    – Timing
    • 5-14 days after imitation of therapy
    – Manifestation
    • Thrombosis mainly
    – 4Ts for diagnosis
    – Diagnosis
    • Clinical diagnosis
    • Test for heparin-PF4
    – Treatment
    • Stop heparin
    • Start fondaparinux
    HUS TTP
    – High prevalence in SLE patients
    – HUS  associated with E.Coli
    – TTP  ADAMTS-13 deficiency

    Microangiopathic hemolytic anemia


    HUS TTP
    Hemolytic anemia Hemolytic anemia
    Thrombocytopenia Thrombocytopenia
    Acute renal failure Acute renal failure
    Fever
    Neurologic symptoms
    TTP HUS Treatment
    – HUS:
    • Mainly suppurative therapy
    • Eculizumab = anti complement agent
    – TTP:
    • Plasmapheresis
    • If due to a drug [like cyclosporin]  stop the drug
    Warfarin
    – Mechanism of action
    • Vitamin K antagonist: factors 2 7 9 10
    – Complications of warfarin:
    • Asymptomatic increased INR:
    – Thorough medical history and physical examination
    » INR 3.5 – 10 = stop the drug until INR reaches 2-3
    » INR 10+ = give PO vitamin K 2.5-5 mg
    • Bleeding:
    – Give IV vitamin K 5-10 mg
    – Give Fresh frozen plasma
    – Give Prothrombin complex concnetrate
    Clotting Factors
    – I II V VII VIII IX X XI XII XIII
    • Vitamin K related = 2 7 9 10
    – Liver Related = all but 8
    – Endothelium Related = 8
    – Coagulation Cascade
    • Intrinsic pathway
    • Extrinsic pathway
    DIC = Disseminated Intravascular
    Coagulation
    – Etiology:
    – Diagnosis:
    • PT PTT increased
    • Fibrinogen low
    – TTP: PT PTT are normal
    – Treatment:
    • Treat the cause
    • Suppurative treatment
    » Fresh frozen plasma
    » PCC
    » Cryoprecipitate
    » Vitamin K

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