4th Stage chennels and Important things
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1- intravascular hemolysis due to drug induced in patient most likely have G6PD deficiency
2-blood film: reticulocytosis, bite cell......
Urine:hemoglobinurea.....
G6PD Level only in recovery phase
3- avoid trigger and this treatment
Parvo virus B19 causes aplastic crisis (pure red cell aplasia)
1- hemolytic anemia(hemolysis)
2- s. Bilirubin + blood film reticulocytosis + S. LDH...................
3- Extravascular
Adverse effects of cyclosporin: hirsutism, gum hypertrophy, hypertension, nephrotoxicity, hepatotoxicty
1-decrease in all blood cell elements (pancytopenia with normal morphology)
2- BM biopsy
3- supportive treatment
1- macrocytosis due to megaloblastic anemia (B12 D.)
OR due to hypothyroidism
2- subacute combind degeneration of the spinal cord
3- bone marrow study to exclude other causes of megaloblastic disorder like MDS
Serum B12 and folate to differenate this combind defiency or only folate
4-pernicious anemia causing B12 defeciency resulting in megaloblastic anemia with subacute combind degeneration of the spinal cord
1))
1-anemia of chronic disease because he have underlying chronic diseases and mild haemoglobin defect and accidently discovered
2- may he have peptic ulcer that induced by NSAID and asprin and he have dyspepsia so may develop IDA
2))
1-MCV : IDA more smaller(sever microcytosis) 70fl or less, ACD may normocytic 80fl or more in 80% of cases and if microcytic it is mild (70-80 fl)
2-TIBC or transferrin conc. is high in IDA but normal or low in ACD
3-soluble transferrin receptor: high in IDA and low in ACD
3)) accordingly if IDA ==> Iron
If ACD ==> control underlying chronic disease and give him Erythropoiesis stimulating agent like Erythropotien
**Aspirin as prophylaxis to ischemic heart disease
NSAID to treat joint pain in RA
1- 10
2- blood loss
3- microcytosis, anisocytosis....
4- S. Iron,, TIBC,, S. FERRITIN
Hct 33
Hb 9
2//dilutional
بالبدايه صار عندي هيموكونستركشن فما بين عندي، بس من صار كوركشن ودليوشن بين
3/ shock State, hypovolemia
4/ normal
