Clinical Pearls💉

#Clinical_Pearl The CMS criteria for starting continous O2 are: ▪︎ a resting PaO2 ≤ 55 mmHg or an SaO2 ≤ 88% or ▪︎ a resting PaO2 ≤ 59 mmHg or an SaO2 ≤ 89% in a patieny with cor pulmonale.

A decreased DlCO seen in: ▪︎ emphysema ▪︎ interstitial lung diseases ▪︎ pulmonary vascular diseases ▪︎ anemia

Question: How can we differentiate between Intrathoracic and Extrathoracic Restrictive lung diseases on PFTs?

Quick Review: ◼️ Remember these conditions associated with an increased risk of lymphoma: ▪︎ Chronic autoimmune thyroiditis (a.k.a. Hashimoto’s) ▪︎ Sjögren syndrome ▪︎ Sarcoidosis ▪︎ Celiac disease ▪︎ Chronic H.pylori ▪︎ EBV ▪︎ HIV/AIDS ▪︎ Organ transplant

PTHrP in short: *Rule no.1* PTHrP, like PTH, activates PTH receptors in kidney and bone. *Rule no.2* PTHrP mimics PTH on calcium and phosphorus, but lowers serum PTH, causing high PTHrP and low PTH levels. *Rule no.3* Hypercalcemia syndrome of malignancy are caused by elevated concentrations of PTHrP.

Fill in the space: In patients with symptomatic splenic MZL, treat _ prior to considering splenectomy.

Because APML (AML-M3) is characterised by a translocation between chromosomes 15 and 17, involving the promyelocytic leukemia gene and retinoic acid receptor α gene. The expression of the PML- RAR α fusion protein renders physiologic levels of retinoic acid ineffective in their innate function to differentiate myeloid blasts, resulting in the development of APML. Note: Patients with APML are classically at an increased risk for developing disseminated intravascular coagulation (DIC) due to release of procoagulants from cytoplasmic granules => the diagnosis of APML needs to be made quickly, because DIC can change APML from a curable disease into a fetal one within hours.