Richard Shared "BCH E4" - 21 Picmonics
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BCH E4
Acute Intermittent Porphyria (AIP)
- Pathophysiology
- Autosomal Dominant
- Inhibited Porphobilinogen Deaminase
- Increased Serum Porphobilinogen
- Increased Serum Delta-ALA
- Increased Urinary Porphyrin Precursors
- Signs & Symptoms
- Precipitated By P450 Inducers
- Painful Abdomen
- Polyneuropathy
- Psychological Disturbances
- Port Wine-Colored Urine
- Treatment
- Glucose and Hemin
- Considerations
- Avoid Triggers
3 mins
Porphyria Cutanea Tarda (PCT)
- Pathophysiology
- Inhibited Uroporphyrinogen Decarboxylase (UROD)
- Most Common Porphyria
- 20% Autosomal Dominant
- 80% Sporadic Type
- Hepatitis C Association
- Signs & Symptoms
- Photosensitivity
- Blistering of Skin
- Tea Colored Urine
- Diagnosis
- Increased Uroporphyrins (Urinary & Serum)
- Treatment
- Avoid Sunlight
- Phlebotomy
- Hydroxychloroquine (Low Dose)
3 mins
Winter's Formula
- Evaluates Respiratory Compensation
- Used in Metabolic Acidosis
- Equation
- (HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
- Steps
- Bicarbonate (HCO3) x 1.5
- + 8
- ± 2
- = Expected Value for PCO2
2 mins
Normal Gap Metabolic Acidosis
- HARD-ASS
- Hyperalimentation
- Addison's Disease
- Renal Tubular Acidosis
- Diarrhea
- Acetazolamide
- Spironolactone
- Saline Infusion
2 mins
Respiratory Acidosis
- Hypoventilation
- Increased PaCO2 > 45
- Barbiturates Depress Central Respiratory Center of Brain
- Opioids Depress Central Respiratory Center of the Brain
- Airway Obstruction
- Respiratory Muscle Weakness/Paralysis
3 mins
Anion Gap Metabolic Acidosis
- Pathophysiology
- Increased Anion Gap
- MUDPILES
- Methanol
- Uremia
- Diabetic Ketoacidosis (DKA)
- Propylene Glycol
- Isoniazid or Iron
- Lactic Acid
- Ethylene Glycol
- Salicylates
1 min
Respiratory Alkalosis
- Hyperventilation
- High Altitude
- Aspirin
- Restrictive Lung Disease
- Pulmonary Embolism
- Pregnancy
- Progesterone
- Rib Fracture
- Anxiety
2 mins
Metabolic Alkalosis
- Diuretic use
- Vomiting
- Antacid
- Hyperaldosteronism
26 secs
Chloride (Cl-) Lab Value
- 95-105 mEq/L
28 secs
Gilbert's Syndrome
- Pathophysiology
- Decreased UDP-Glucuronosyltransferase Activity
- Decreased Bilirubin Conjugation
- Signs and Symptoms
- Often Asymptomatic
- Jaundice (Mild)
- Fasting
- Stress
- Alcohol Intake
- Labs
- Increased Unconjugated Bilirubin
2 mins
Microcytic Anemia Causes
- MCV < 80
- Causes
- Thalassemias
- Chronic Disease or Illness
- Lead Toxicity
- Late Iron Deficiency
- Sideroblastic Anemia
1 min
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
Macrocytic Anemia Causes
- MCV > 100
- Megaloblastic
- B12 Deficiency
- Folate Deficiency
- Orotic Aciduria
- Non Megaloblastic
- Alcoholism
- Liver Disease
- Reticulocytosis
2 mins
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
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
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
Lesch-Nyhan Syndrome
- X-linked Recessive
- Absence of HGPRT
- Hypoxanthine to IMP
- Guanine to GMP
- Excess uric acid
- Gout
- Retardation
- Self-mutilation
- Choreoathetosis
- PRPP is increased
2 mins
