Hematology and Oncology

• Purpuric rash + abdominal pain + glomerulonephritis in a child/young patient: HENOCH-SCHONLEIN PURPURA (HSP):

mnemonic: AGAR

Abdominal pain

Glomerulonephritis

Arthralgia

Rash

• Purpura (livedo reticularis) after a coronary angiogram: think CHOLESTEROL ATHEROEMBOLIC DISEASE

• Purpura (livedo reticularis) + hepatitis B + abdominal pain after meals + footdrop + HTN: think POLYARTERITIS NODOSA

• THROMBOTIC THROMBOCYTOPENIC PURPURA (TTP): mnemonic: FAT RN

Pentad: 1. Fever

2. Anemia, microangiopathic hemolytic (+) schistocytes

3. Thrombocytopenia

4. Renal abnormalities

5. Neurologic abnormalities (confusion, aphasia, headache, coma, seizures)

• HEMOLYTIC UREMIC SYNDROME (HUS): mnemonic: RAT

Renal failure

Anemia, microangiopathic hemolytic Thrombocytopenia

(1) Normal coagulation tests (normal PT/PTT)

(2) Elevated LDH

• HUS is similar to TTP, except that it only affects the RENAL system

• Patients with chronic low-grade lymphoproliferative disorders for years who develop new lymphadenopathy: consider transformation to a high-grade lymphoma

• Patients with ACUTE LEUKEMIAS usually present with low to normal WBC, whereas patients with CHRONIC LEUKEMIAS may present with splenomegaly and high WBC

MORE COMMON PERIPHERAL SMEARS AND GENETIC MARKERS:

• Smudge cells (mature lymphocytes): chronic lymphocytic leukemia

• Auer rods: acute myelogenous leukemia/promyelocytic leukemia

• Reed-Sternberg cells: Hodgkin's disease

• Spur cells: liver disease, DIC

• Reactive lymphocytes: infectious mononucleosis

• "Fried egg" appearance of cells that are TRAP (+): hairy cell leukemia

• Target cells: liver disease, iron deficiency, thalassemia

• Helmet cells: traumatic hemolysis, DIC

• Polychromasia and spherocytosis: implies autoimmune hemolytic anemia

• Young patients with unexplained pancytopenia: consider paroxysmal nocturnal hemoglobinuria

• Philadelphia chromosome t(9,22)/bcr-abl gene: chronic myelogenous leukemia

• Bite cells/Heinz bodies: Think glucose-6-phosphate dehydrogenase (G6PD) deficiency

IRON-DEFICIENCY

ANEMIA OF

ANEMIA

vs. CHRONIC DISEASE

IRON

Decreased

Decreased

FERRITIN

Decreased

Increased

TIBC

Increased

Decreased

Naturally Cure Your Headaches

Naturally Cure Your Headaches

Are Headaches Taking Your Life Hostage and Preventing You From Living to Your Fullest Potential? Are you tired of being given the run around by doctors who tell you that your headaches or migraines are psychological or that they have no cause that can be treated? Are you sick of calling in sick because you woke up with a headache so bad that you can barely think or see straight?

Get My Free Ebook


Post a comment