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First Aid for the USMLE Step 2 CK (10th Ed.) | Medicine (MD/DO) School Study Aid
Anemia Lab Values
- Iron Deficiency Anemia
- Serum Iron Decreased
- Transferrin Increased
- Ferritin Decreased
- % Transferrin Saturation Decreased
- Pregnancy and OCP Use
- Serum Iron Normal
- Transferrin Increased
- Ferritin Normal
- % Transferrin Saturation Decreased
- Anemia of Chronic Disease
- Serum Iron Decreased
- Transferrin Decreased
- Ferritin Increased
- % Transferrin Saturation Decreased or Normal
- Hemochromatosis
- Serum Iron Increased
- Transferrin Decreased
- Ferritin Increased
- % Transferrin Saturation Increased
3 mins
Iron Deficiency Anemia
- Causes
- Malnutrition/Malabsorption
- Hemorrhage
- Signs
- Microcytic, Hypochromic Anemia
- Decreased Heme Synthesis
- Labs
- Decreased Reticulocytes
- Decreased Ferritin
- Increased Red Cell Distribution Width (RDW)
- Poikilocytosis
- Anisocytosis
- Increased Central Pallor
2 mins
Normocytic Hemolytic Anemia Causes
- Intrinsic Hemolytic
- Hereditary Spherocytosis
- RBC Enzyme Deficiency
- Hemoglobin C Defect
- Paroxysmal Nocturnal Hemoglobinuria (PNH)
- Sickle Cell Anemia
- Extrinsic Hemolytic
- Autoimmune
- Microangiopathic
- Mechanical Destruction
- Prosthetic Cardiac Valves
- Infection
- Snake Venom
2 mins
Normocytic Nonhemolytic Anemia Causes
- MCV 80-100
- Nonhemolytic
- Anemia of Chronic Disease/Inflammation
- Aplastic Anemia
- Chronic Kidney Disease
- Early Iron Deficiency
1 min
Microcytic Anemia Causes
- MCV < 80
- Causes
- Thalassemias
- Chronic Disease or Illness
- Lead Toxicity
- Late Iron Deficiency
- Sideroblastic Anemia
1 min
Macrocytic Anemia Causes
- MCV > 100
- Megaloblastic
- B12 Deficiency
- Folate Deficiency
- Orotic Aciduria
- Non Megaloblastic
- Alcoholism
- Liver Disease
- Reticulocytosis
2 mins
Vitamin B6 (Pyridoxine) Deficiency
- Deficiency From Isoniazid
- Deficiency From Oral Contraceptives
- Seizures
- Hyperirritability
- Peripheral Neuropathy
- Sideroblastic Anemia
3 mins
Vitamin B12 (Cobalamin) Mechanism and Deficiency
- Mechanism
- Cobalamin
- Large reserve pool in the liver
- Homocysteine to methionine
- Methylmalonyl CoA to succinyl CoA
- Deficiency Signs and Symptoms
- Macrocytic Megaloblastic Anemia
- Hypersegmented Neutrophils
- Neurologic defects
- Posterior column
- Lateral corticospinal tract
- Spinocerebellar tract
5 mins
G6PD Mechanism
- Turns NADP+ to NADPH
- NADPH Used by Glutathione Reductase
- Detoxifies Free Radicals and Peroxides
- X-linked Recessive
2 mins
G6PD Deficiency
- X-linked Recessive
- Hemolytic Anemia
- Inflammatory Response
- Fava Beans
- Sulfonamides
- Primaquine
- Anti TB Drugs
- Heinz Bodies
- Bite Cells
- Prevalent Among African Americans due to Increased Malarial Resistance
2 mins
Paroxysmal Nocturnal Hemoglobinuria (PNH)
- Pathophysiology
- Defective PIG-A Gene
- Deficiency of DAF (Decay Accelerating Factor CD55)
- Symptoms
- Dark Urine in the Morning
- Intravascular Hemolysis
- Thrombosis
- Diagnosis
- Decreased CD55 and CD59
- Treatment
- RBC Transfusion
- Eculizumab
- Bone Marrow Transplant is Curative
3 mins
Hereditary Spherocytosis Disease
- Northern Europeans
- Mechanisms
- Autosomal Dominant
- Spectrin/Ankyrin Deficiency
- Spherocyte Formation
- Hemolytic Anemia
- Symptoms
- Bilirubin Gallstones
- Jaundice
- Splenomegaly
3 mins
Hereditary Spherocytosis Diagnosis & Treatment
- Labs
- Increased MCHC
- Spherocytes
- Normocytic Anemia
- Diagnosis
- Eosin-5-Maleimide (EMA) Binding Test
- Osmotic Fragility Test
- Glycerol Lysis Test
- Treatment
- Folic Acid
- Splenectomy
2 mins
Sickle Cell Anemia (Mechanism)
- Intrinsic Normocytic Hemolytic Anemia
- Point Mutation
- Autosomal Recessive
- African American
- Dehydration or Decreased O2
- Newborns Asymptomatic
- Heterozygote Malarial Resistance
2 mins
Sickle Cell Anemia (Signs and Complications)
- Signs
- Crew-cut on Skull X-ray
- Complications
- Auto-splenectomy
- Painful Crisis
- Aplastic Crisis
- Splenic-sequestration Crisis
- Hyper-hemolytic Syndrome
- Renal Papillary Necrosis
- Salmonella osteomyelitis
- Pulmonary Hypertension
- Hyposthenuria
2 mins
Sickle Cell Anemia (Management)
- Long Term Treatment
- Hydroxyurea
- Bone Marrow Transplant
- Folate
- Acute Treatment
- Exchange Transfusion
- Prophylaxis
- Penicillin Prophylaxis
1 min
Cold Agglutinin Autoimmune Hemolytic Anemia (C-AIHA)
- Pathophysiology
- IgM Binds to RBCs at Cold Temperatures (28-31C)
- Extravascular Hemolysis
- Waldenstrom's Macroglobulinemia
- Mycoplasma Pneumoniae
- Infectious Mononucleosis
- Lymphomas and CLL
- Symptoms
- Acrocyanosis with Cold Exposure
- Blue Fingers and Toes
- Diagnosis
- Positive Coombs Test
- Treatment
- Avoid Cold
- Rituximab
- +/- Fludarabine
4 mins
Warm Agglutinin Autoimmune Hemolytic Anemia (W-AIHA)
- Pathophysiology
- Most Common Autoimmune Hemolytic Anemia
- IgG Coats RBCs at Warm Temperatures
- Fc Portion of IgG Recognized By Macrophages
- Extravascular Hemolysis
- Medications
- Alpha Methyldopa
- Chronic Lymphocytic Leukemia (CLL)
- Systemic Lupus Erythematosus (SLE)
- Diagnosis
- Positive Coombs Test
- Treatment
- Corticosteroids
- Splenectomy
- Intravenous Immunoglobulin (IVIG)
- Rituximab
3 mins
Beta Thalassemia
- Mechanism
- Microcytic, Hypochromic Anemia
- Mediterranean Populations
- Decreased Beta-Globin
- Beta-Thalassemia Minor
- Increased HbA2
- No Intervention
- Beta-thalassemia Major
- Blood Transfusions
- Hemochromatosis
- Crew-cut on Skull X-Ray
- Diagnosis
- Electrophoresis
2 mins
Polycythemia Vera Disease
- Pathophysiology
- JAK2 Mutation leading to increased red blood cells
- Tyrosine Kinase
- Symptoms
- Erythromelalgia
- Pruritus
- Often After Hot Shower
- Headache
- Treatment
- Phlebotomy
- Aspirin
1 min
Polycythemia Vera Labs
- Lab Findings (The 4 H's)
- Hypervolemia
- Histaminemia
- Hyperviscosity
- Hyperuricemia
- Diagnosis
- Elevated Hemoglobin or Hematocrit
- Positive Jak2 Mutation
1 min
Transfusion Reactions
- Acute Hemolytic
- Febrile, Non-Hemolytic
- Mild Allergic
- Anaphylactic
- Circulatory Overload
- Sepsis Reaction
- Transfusion-Related Acute Lung Injury (TRALI)
- Massive Blood Transfusion
2 mins
Blood Transfusion Administration
- Proper Patient Identification
- Large Bore Needle
- Y Tubing
- Baseline Vital Signs
- Slow IV Infusion
- Monitor During First 15 Minutes or 50 mL of Blood
- Monitor for Reactions
- Considerations
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
3 mins
Methemoglobinemia Characteristics
- Characteristics
- Oxidized Iron in Hemoglobin
- Decreased Affinity for Oxygen
- Increased Affinity for Cyanide
- Etiologies
- Dietary Nitrates
- Drugs
- Nitroglycerin
- Lidocaine
- G6PD Deficiency
2 mins
Diamond-Blackfan Anemia
- Characteristics
- Red Blood Cell Aplasia
- Macrocytic Anemia
- Clinical Features
- Short Stature
- Craniofacial Anomalies
- Triphalangeal Thumbs
- Diagnosis
- Increased HbF (Fetal Hemoglobin)
- Management
- RBC Transfusion
- Steroids
- Hematopoietic Stem Cell Transplantation
2 mins
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