Hematology

Microcytic Clinical Causes Diagnosis Management

anemia features
Iron deficiency Koilonychia ( nail Lack of iron in diet CBC Ferrous sulfate 200mg
anemia spooning ) Increased utilization MCV <80 TDS For 3-6 months
Angular cheilitis as in pregnancy Thrombocytosis Ferrous gluconate 300 mg
Atrophic glossitis Blood loss BD
Pica Colorectal cancer Iron profile
Plummer vinson Celiac disease Decreased blood iron
syndrome Decreased ferritin
Decreased transferrin

Thalassemia Beta thalassemia HbA = 2 alpha 2 Anisocytosis( variation in Folate supplements 5 mg

minor beta adult ( 98%) RBCs size) daily
Beta thalassemia 1 mutated beta chain HbA2= 2 alpha 2 Poikilocytosis ( variation Transfusion
Minor microcytic anemia delta adult 2% in RBCs shape ) Iron chelators for iron
Major No transfusion HbF = 2 alpha 2 Target cells overload
required gamma ( fetal ) Reticulocytes count deferoxamine
Iron profile normal increased Splenectomy
Bone marrow transplant
Beta thalassemia
major
(cooley's anemia )
2 mutated beta
chains
Microcytic anemia
Requires blood
transfusion
Hepatosplenomegaly
Skull bossing
Alpha
thalassemia Types
—-------------- Silent carrier —---------------- —-----------------
1 gene deleted
Alpha thalassemia
trait
2 gene deleted
HbH disease
3 gene deleted
Hydrops fetalis
4 gene deleted
Coagulation Clinical Causes Diagnosis Management
disorders features
Von willebrand vWF act as platelet Platelet count normal Mild bleeding
disease Type 1 75% of all vwf glue Bleeding time increased Desmopressin
Type 2 25% of all vwf Decrease in vWF Prothrombin time PT
Type 3 levels or activity normal Severe bleeding
Partial thromboplastin vWF replacement
time PTT increased Cryoprecipitate
vWF level decreased Recombinant vWF
Active vWF decreased Increased conc of Factor
VIII

Hemophilia A Hemorrhages Decreased in factor Platelet count normal Mild case

Bleeding in joints VIII levels or activity Bleeding time normal Desmopressin
after trauma PT normal Severe case
Muscle hematomas Mild = 6-50% PTT increased Recombinant factor VIII
Crippling arthropathy normal factor VIII
activity Hemophilia B
Moderate = 2-5% Recombinant factor IX
normal factor VIII
activity
Severe = <1%
normal factor VIII
activity

Disseminated Acute DIC cause Abnormal blood Platelet count decreased Treatment of cause
intravascular bleeding coagulation in Bleeding time increased Cryoprecipitate
coagulation DIC vessels PT increased Platelets
Chronic DIC cause PTT increased Fresh frozen plasma
thrombosis Sepsis Fibrinogen decreased
Placental abruption D dimer increased
Thrombi found in Carcinoma of
heart pancreas
Brain Crush injuries
Lungs Burns
Kidneys Extensive surgeries

Normocytic Clinical Causes Diagnosis Management

anemia features