Anemia | Fe | Ferritin | Transferrin [TIBC] | Saturation = Fe ÷ TIBC | Defect |
---|---|---|---|---|---|
Thalassemia | - | - | - | - | Hemoglobin |
Anemia of chronic disease (ACD) | ↓ | ↑ | ↓ | - | Fe |
Iron deficiency anemia (IDA) | ↓ | ↓ | ↑ | ↓ | Fe |
Lead poisoning | ↑ | ↑ | ↓ | ↑ | Heme |
Sideroblastic anemia | ↑ | ↑ | ↓ | ↑ | Heme |
Intravascular | Extravascular | |
---|---|---|
Peripheral smear | Schistocyte | Spherocyte |
Haptoglobin | ↓ | - |
Hemoglobin | ↑ | - |
Hematuria | + | - |
Indirect bilirubin | - | ↑ |
Direct bilirubin | - | - |
Urine bilirubin | - | - |
Urine urobilinogen | - | ↑ |
LDH | ↑ | ↑ |
Jaundice | - | + |
Thalassemia | IDA | |
---|---|---|
Mentzer index = MCV ÷ RBC | < 13 | > 13 |
RDW | - | ↑ |
Iron profile | Normal | Abnormal |
Blood smear | Target cells | - |
α-Globin | Disease | α-Globin Defect | Disease | |
---|---|---|---|---|
β-Globin | α2β2 [HbA] | - | β4 [HbH] | α-thalassemia :: 3 deletion |
γ-Globin | α2γ2 [HbF] | β-thalassemia major | γ4 [Hb Barts] | α-thalassemia :: 4 deletion |
δ-Globin | α2δ2 [HbA2] | β-thalassemia minor | - | - |
s-Globin | α2s2 [HbS] | Sickle cell disease | - | - |
c-Globin | α2c2 [HbC] | HbC disease | - | - |
Type | Causes | Onset |
---|---|---|
Allergic | Anti-plasma proteins IgE Anti-IgA IgE | Minutes ~ Hours |
Hemolytic (HTR) | Anti-ABO Anti-Rh | Minutes ~ Days |
Febrile non-hemolytic (FNHTR) | Cytokines | Hours |
Tumor | Mutation | Gene |
---|---|---|
AML | t(15;17) | PML/RARA |
t(8;21) | RUNX1/RUNX1T1 | |
t(16;16) | CBFB/MYH11 | |
- | NPM1 | |
- | CEBPA | |
- | FLT3 | |
CML | t(9;22) | BCR/ABL1 |
Tumor | Mutation | Gene |
---|---|---|
ALL | t(12;21) | ETV6/RUNX1 |
t(1;19) | TCF3/PBX1 | |
t(9;22) | BCR/ABL1 | |
t(4;11) | MLL/AF4 | |
Hyperdiploidy > 50 | - | |
Hypodiploidy < 44 | - | |
CLL | - | - |
HCL | - | - |
Tumor | Mutation | Gene |
---|---|---|
Adult T-cell lymphoma | - | - |
Cutaneous T-cell lymphoma | - | - |
Tumor | Mutation | Gene |
---|---|---|
Hodgkin lymphoma | - | - |
Burkitt lymphoma | t(8;14) | C-MYC/IGH |
Diffuse large B-cell lymphoma (DLBCL) | - | - |
Marginal zone lymphoma MALT lymphoma (MALToma) | - | - |
Mantle cell lymphoma | t(11;14) | Cyclin D (CCND) |
Follicular lymphoma | t(14;18) | BCL2 |
Leukemia | Treatment |
---|---|
AML | Anthracyclines Cytarabine All-trans retinoic acid (ATRA) |
CML | Imatinib |
ALL | - |
CLL | Fludarabine Cyclophosphamide Rituximab |
HCL | Cladribine |
Tumors | Genetics | RBC | WBC | PLT |
---|---|---|---|---|
Polycythemia vera | JAK2 | ↑ | ↑ | ↑ |
Chronic myelogenous leukemia (CML) | t(9;22) | ↓ | ↑ | ↑ |
Essential thrombocytosis | JAK2 | - | - | ↑ |
Myelofibrosis | JAK2 | ↓ | ↑/↓ | ↑/↓ |
Enzyme | Targets |
---|---|
VKOR | ↑ Factor 2 & 7 & 9 & 10 & Protein C/S |
Antithrombin | ↓ Factor 2 & 7 & 9 & 10 & 11 & 12 |
Protein C/S | ↓ Factor 5 & 8 |
Plasmin | ↓ Factor 1 |
Cause | Effect |
---|---|
Stasis | VTE |
Hypercoagulability | ATE / VTE |
Endothelial injury | ATE |
Etiology | Mechanism | PLT | BT | PT | PTT | Clots |
---|---|---|---|---|---|---|
Disseminated intravascular coagulation (DIC) | - | ↓ | ↑ | ↑ | ↑ | + |
Thrombotic thrombocytopenic purpura (TTP) | ↓ ADAMTS13 | ↓ | ↑ | - | - | + |
Hemolytic uremic syndrome (HUS) | ↓ ADAMTS13 Shiga-like toxin | ↓ | ↑ | - | - | + |
HELLP syndrome | - | ↓ | ↑ | - | - | - |
Immune thrombocytopenic purpura (ITP) | Anti-Gp1b Anti-Gp2b/3a | ↓ | ↑ | - | - | - |
Heparin-induced thrombocytopenia (HIT) | Anti-platelet factor 4 (Anti-PF4) | ↓ | ↑ | - | - | + |
Antiphospholipid syndrome (APS) | Anti-cardiolipin Anti-β2-glycoprotein I Lupus anticoagulant | - | - | - | ↑ | + |
Von Willebrand disease (VWD) | ↓ vWF | - | ↑ | - | ↑ | - |
Bernard-Soulier disease (BSD) | ↓ Gp1b | - | ↑ | - | - | - |
Glanzmann disease | ↓ Gp2b/3a | - | ↑ | - | - | - |
Hemophilia A & B & C | ↓ Factor 8 & 9 & 11 | - | - | - | ↑ | - |
Vitamin K deficiency | ↓ Factor 2 & 7 & 9 & 10 | - | - | ↑ | ↑ | - |
Cirrhosis | ↓ Thrombopoietin (TPO) ↓ Factors | ↓ | ↑ | ↑ | - | - |
Etiology | Mechanism |
---|---|
Homocysteinemia | ↑ Factor 7 |
Factor 5 Leiden mutation | ↑ Factor 5 |
Prothrombin gene mutation | ↑ Factor 2 |
Antithrombin deficiency | ↓ Antithrombin |
Protein C/S deficiency | ↓ Protein C/S |
Nephrosis | ↓ Protein C/S |
Pregnancy | ↑ Factor 1 |
Mechanism | Medication |
---|---|
Gp2b/3a inhibitors | Abciximab Eptifibatide Tirofiban |
ADP antagonists | Clopidogrel Prasugrel Ticagrelor Ticlopidine |
PDE inhibitors | Dipyridamole Cilostazol |
COX inhibitors | NSAIDs |
Mechanism | Medication |
---|---|
VKOR inhibitors | Warfarin Coumadin |
Antithrombin inducers | Unfractionated heparin (UFH) |
Low-molecular-weight heparin (LMWH): Enoxaparin Dalteparin | |
Fondaparinux | |
Factor 10a inhibitors | Apixaban Edoxaban Rivaroxaban |
Factor 2a inhibitors | Hirudin Bivalirudin Argatroban Dabigatran |
Tissue plasminogen activators (tPAs) | Urokinase Streptokinase Alteplase Reteplase Tenecteplase |
UFH | LMWH | |
---|---|---|
Bioavailability | - | ↑ |
Half-life | - | ↑ |
Specificity to Factor 10a | - | ↑ |
Monitor | PTT | - |
Side Effect | HIT & Osteoporosis | - |
Antidote | Protamine sulfate | - |
Condition | INR |
---|---|
Venous thromboembolism (VTE) | 2.0 ~ 3.0 |
Atrial fibrillation | 2.0 ~ 3.0 |
Bioprosthetic valve | 2.0 ~ 3.0 |
Mechanical valve | 2.5 ~ 3.5 |
INR | Management |
---|---|
< 4.5 | Hold warfarin |
4.5 ~ 10 | Hold warfarin Low-dose oral vitamin K |
> 10 | Hold warfarin High-dose oral vitamin K |
Bleeding | Hold warfarin High-dose IV viatamin K FFP / PCC |
Mnemonic | Cause |
---|---|
S | Sepsis :: GNB |
T | Trauma |
O | Obstetric complications |
P | Pancreatitis :: acute |
Making | Malignancy |
New | Nephrotic symdrome |
Thrombi | Transfusion |
Product | Indications |
---|---|
FFP / PCC | Warfarin toxicity Factor 10a inhibitors toxicity |
Cryoprecipitate | tPA toxicity Fibrinogen deficiency Hemophilia A Von Willebrand disease (VWD) Uremic bleeding |
Factor concentrate | Factor deficiency |