Polycythemia/Hyperviscosity
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Section 8: Hematology CHAPTER 47: ANEMIA
Section 8: Hematology CHAPTER 47: ANEMIA Q.1. A 56-year-old man presents with symptoms of severe dyspnea on exertion and fatigue. His laboratory values are as follows: Hemoglobin 6.0 g/dL (normal: 12–15 g/dL) Hematocrit 18% (normal: 36%–46%) RBC count 2 million/L (normal: 4–5.2 million/L) Reticulocyte count 3% (normal: 0.5%–1.5%) Which of the following caused this man’s anemia? A. Decreased red cell production B. Increased red cell destruction C. Acute blood loss (hemorrhage) D. There is insufficient information to make a determination Answer: A. This man presents with anemia and an elevated reticulocyte count which seems to suggest a hemolytic process. His reticulocyte count, however, has not been corrected for the degree of anemia he displays. This can be done by calculating his corrected reticulocyte count ([3% × (18%/45%)] = 1.2%), which is less than 2 and thus suggestive of a hypoproliferative process (decreased red cell production). Q.2. A 25-year-old man with pancytopenia undergoes bone marrow aspiration and biopsy, which reveals profound hypocellularity and virtual absence of hematopoietic cells. Cytogenetic analysis of the bone marrow does not reveal any abnormalities. Despite red blood cell and platelet transfusions, his pancytopenia worsens. Histocompatibility testing of his only sister fails to reveal a match. What would be the most appropriate course of therapy? A. Antithymocyte globulin, cyclosporine, and prednisone B. Prednisone alone C. Supportive therapy with chronic blood and platelet transfusions only D. Methotrexate and prednisone E. Bone marrow transplant Answer: A. Although supportive care with transfusions is necessary for treating this patient with aplastic anemia, most cases are not self-limited. -
Subcutaneous Emphysema, Pneumomediastinum, Pneumoretroperitoneum, and Pneumoscrotum: Unusual Complications of Acute Perforated Diverticulitis
Hindawi Publishing Corporation Case Reports in Radiology Volume 2014, Article ID 431563, 5 pages http://dx.doi.org/10.1155/2014/431563 Case Report Subcutaneous Emphysema, Pneumomediastinum, Pneumoretroperitoneum, and Pneumoscrotum: Unusual Complications of Acute Perforated Diverticulitis S. Fosi, V. Giuricin, V. Girardi, E. Di Caprera, E. Costanzo, R. Di Trapano, and G. Simonetti Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University Hospital Tor Vergata, Viale Oxford 81, 00133 Rome, Italy Correspondence should be addressed to E. Di Caprera; [email protected] Received 11 April 2014; Accepted 7 July 2014; Published 17 July 2014 Academic Editor: Salah D. Qanadli Copyright © 2014 S. Fosi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pneumomediastinum, and subcutaneous emphysema usually result from spontaneous alveolar wall rupture and, far less commonly, from disruption of the upper airways or gastrointestinal tract. Subcutaneous neck emphysema, pneumomediastinum, and retropneumoperitoneum caused by nontraumatic perforations of the colon have been infrequently reported. The main symptoms of spontaneous subcutaneous emphysema are swelling and crepitus over the involved site; further clinical findings in case of subcutaneous cervical and mediastinal emphysema can be neck and chest pain and dyspnea. Radiological imaging plays an important role to achieve the correct diagnosis and extension of the disease. We present a quite rare case of spontaneous subcutaneous cervical emphysema, pneumomediastinum, and pneumoretroperitoneum due to perforation of an occult sigmoid diverticulum. Abdomen ultrasound, chest X-rays, and computer tomography (CT) were performed to evaluate the free gas extension and to identify potential sources of extravasating gas. -
A Rapid and Quantitative D-Dimer Assay in Whole Blood and Plasma on the Point-Of-Care PATHFAST Analyzer ARTICLE in PRESS
MODEL 6 TR-03106; No of Pages 7 ARTICLE IN PRESS Thrombosis Research (2007) xx, xxx–xxx intl.elsevierhealth.com/journals/thre REGULAR ARTICLE A rapid and quantitative D-Dimer assay in whole blood and plasma on the point-of-care PATHFAST analyzer Teruko Fukuda a,⁎, Hidetoshi Kasai b, Takeo Kusano b, Chisato Shimazu b, Kazuo Kawasugi c, Yukihisa Miyazawa b a Department of Clinical Laboratory Medicine, Teikyo University School of Medical Technology, 2-11-1 Kaga, Itabashi, Tokyo 173-8605, Japan b Department of Central Clinical Laboratory, Teikyo University Hospital, Japan c Department of Internal Medicine, Teikyo University School of Medicine, Japan Received 11 July 2006; received in revised form 7 December 2006; accepted 28 December 2006 KEYWORDS Abstract The objective of this study was to evaluate the accuracy indices of the new D-Dimer; rapid and quantitative PATHFAST D-Dimer assay in patients with clinically suspected Deep-vein thrombosis; deep-vein thrombosis (DVT). Eighty two consecutive patients (34% DVT, 66% non-DVT) Point-of-care testing; with suspected DVT of a lower limb were tested with the D-Dimer assay with a Chemiluminescent PATHFAST analyzer. The diagnostic value of the PATHFAST D-Dimer assay (which is immunoassay based on the principle of a chemiluminescent enzyme immunoassay) for DVT was evaluated with pre-test clinical probability, compression ultrasonography (CUS). Furthermore, each patient underwent contrast venography and computed tomogra- phy, if necessary. The sensitivity and specificity of the D-Dimer assay using 0.570 μg/ mL FEU as a clinical cut-off value was found to be 100% and 63.2%, respectively, for the diagnosis of DVT, with a positive predictive value (PPV) and negative predictive value (NPV) of 66.7% and 100%, respectively. -
Consensus Guidelines for Partial Exchange Transfusion for Polycythemia in Neonates UCSF (NC)2 (Northern California Neonatal Consortium)
Consensus Guidelines for Partial Exchange Transfusion for Polycythemia in Neonates UCSF (NC)2 (Northern California Neonatal Consortium) Executive summary Objectives • Standardize the approach to screening and management of polycythemia in infants ≥ 34 weeks gestation using current practice standards and best available evidence • Improve quality and safety of care for neonates ≥ 34 weeks GA with possible polycythemia; specifically: o Improve recognition of infants showing symptoms of polycythemia o Decrease unnecessary screening o Provide recommendations on how to perform partial exchange transfusion safely and effectively o Decrease morbidity associated with unnecessary partial exchange transfusions Recommendations • Who to Screen o Asymptomatic patients should not be routinely screened regardless of risk factors o Only screen symptomatic patients for polycythemia • Who Should Receive Partial Exchange Transfusion o Do NOT perform PET in asymptomatic infant with Hct <=75% o Consider PET in infants with Hct >65% who are demonstrating signs listed in Section A or B on page 3 o Consider PET in asymptomatic infants with Hct >75%, but note there is minimal data for benefit of PET in asymptomatic infants. • Timing of Partial Exchange Transfusion o PET should be performed as soon as possible in symptomatic infants Methods This guideline was developed through local consensus based on published evidence and expert opinion as part of the UCSF Northern California Neonatal Consortium. Metrics Plan UCSF NC2 (Northern California Neonatology Consortium). -
Introduction to Hematological Assessment (PDF)
UPDATED 01/2021 Introduction to Hematological Assessment Objectives After completing this lesson, you will be able to: • State the main purposes of a hematological assessment. • Explain the procedures for collecting and processing a blood sample. • Understand the importance of hand washing. • Understand the importance of preventing blood borne pathogen transmission. • Describe and follow the hemoglobin test procedure using the Hemocue Hemoglobin Analyzer. Overview The most common form of nutritional deficiency is “iron deficiency”. It is observed more frequently among children and women of childbearing age (particularly pregnant women). Iron deficiency can result in developmental delays and behavioral disturbance in children, as well as increased risk for a preterm delivery in pregnant women. Iron status can be determined using several different types of laboratory tests. The two tests most commonly used to screen for iron deficiency are hemoglobin (Hgb) concentration and hematocrit (Hct). Proper screening for iron deficiency requires sound laboratory methods and procedures. Often, CPAs will hear the following questions: “Do you have to stick my finger? What does this have to do with my WIC foods anyway? Will it hurt?” For most of us, the thought of having blood taken, even from a finger, is not pleasant. However, evaluating the results of a blood test is a part of screening for nutritional risk. Why Does WIC Require Hematological Assessment? WIC requires that each applicant be screened for risk of a medical condition known as iron deficiency anemia. Anemia is a condition of the blood in which the amount of hemoglobin falls below a level considered desirable for good health. -
Your Blood Cells
Page 1 of 2 Original Date The Johns Hopkins Hospital Patient Information 12/00 Oncology ReviseD/ RevieweD 6/14 Your Blood Cells Where are Blood cells are made in the bone marrow. The bone marrow blood cells is a liquid that looks like blood. It is found in several places of made? the body, such as your hips, chest bone and the middle part of your arm and leg bones. What types of • The three main types of blood cells are the red blood cells, blood cells do the white blood cells and the platelets. I have? • Red blood cells carry oxygen to all parts of the body. The normal hematocrit (or percentage of red blood cells in the blood) is 41-53%. Anemia means low red blood cells. • White blood cells fight infection. The normal white blood cell count is 4.5-11 (K/cu mm). The most important white blood cell to fight infection is the neutrophil. Forty to seventy percent (40-70%) of your white blood cells should be neutrophils. Neutropenia means your neutrophils are low, or less than 40%. • Platelets help your blood to clot and stop bleeding. The normal platelet count is 150-350 (K/cu mm). Thrombocytopenia means low platelets. How do you Your blood cells are measured by a test called the Complete measure my Blood Count (CBC) or Heme 8/Diff. You may want to keep track blood cells? of your blood counts on the back of this sheet. What When your blood counts are low, you may become anemic, get happens infections and bleed or bruise easier. -
CDHO Advisory Polycythemia, 2018-11-09
CDHO Advisory | P olycythemia COLLEGE OF DENTAL HYGIENISTS OF ONTARIO ADVISORY ADVISORY TITLE Use of the dental hygiene interventions of scaling of teeth and root planing including curetting surrounding tissue, orthodontic and restorative practices, and other invasive interventions for persons1 with polycythemia. ADVISORY STATUS Cite as College of Dental Hygienists of Ontario, CDHO Advisory Polycythemia, 2018-11-09 INTERVENTIONS AND PRACTICES CONSIDERED Scaling of teeth and root planing including curetting surrounding tissue, orthodontic and restorative practices, and other invasive interventions (“the Procedures”). SCOPE DISEASE/CONDITION(S)/PROCEDURE(S) Polycythemia INTENDED USERS Advanced practice nurses Nurses Dental assistants Patients/clients Dental hygienists Pharmacists Dentists Physicians Denturists Public health departments Dieticians Regulatory bodies Health professional students ADVISORY OBJECTIVE(S) To guide dental hygienists at the point of care relative to the use of the Procedures for persons who have polycythemia, chiefly as follows. 1. Understanding the medical condition. 2. Sourcing medications information. 3. Taking the medical and medications history. 4. Identifying and contacting the most appropriate healthcare provider(s) for medical advice. 1 Persons includes young persons and children Page | 1 CDHO Advisory | P olycythemia 5. Understanding and taking appropriate precautions prior to and during the Procedures proposed. 6. Deciding when and when not to proceed with the Procedures proposed. 7. Dealing with adverse events arising during the Procedures. 8. Keeping records. 9. Advising the patient/client. TARGET POPULATION Child (2 to 12 years) Adolescent (13 to 18 years) Adult (19 to 44 years) Middle Age (45 to 64 years) Aged (65 to 79 years) Aged 80 and over Male Female Parents, guardians, and family caregivers of children, young persons and adults with polycythemia. -
Blood Donor Information
Blood Donor Information Thank you for coming to donate blood. We are Did you know that some causes sorry that we cannot accept you as a donor today of anemia are invisible? because your hematocrit level was too low. You may not know you have bleeding from We care about your health and want to help you your digestive tract. This can be a result of: understand what having a low hematocrit level means.You are not alone, having a low hematocrit • Stomach ulcers level is the most frequent cause for not being able • Growths in intestines (polyps) to donate blood. You may return to donate when • Colon cancer your hematocrit level has increased and you can • Certain medications help immediately by asking your friends, family • Other diseases of the digestive tract and/or coworkers to donate. There are several Anemia is often the first symptom of these simple ways to improve your hematocrit level. conditions so it should be taken seriously. If you feel You may be eligible to donate another time. you don’t fit in any of the previous categories, What is Hematocrit? or just want to rule out these possibilities, make an appointment with your physician without delay. Blood is made up of red blood cells, white blood cells, platelets, and plasma. Hematocrit is the percentage of blood You should see your doctor if your volume that is red blood cells. Red blood cells contain hematocrit is low and you: hemoglobin which carries oxygen to all the cells in the body. • donate less than three times per year, Why do we test potential blood • are a non-menstruating woman of any donors for hematocrit levels? age with a hematocrit below 36%, Hematocrit is measured prior to each donation as part of • a man with a hematocrit less than 38%, and donor screening. -
Polycythemia in the Newborn
AIIMS- NICU protocols 2007 Polycythemia in the Newborn Jeeva Sankar, Ramesh Agarwal,Deepak Chawla, Vinod K Paul ,Ashok Deorari Division of Neonatology, Department of Pediatrics WHO Collaborating Centre for Training & Research in Newborn Care All India Institute of Medical Sciences Ansari Nagar, New Delhi –110029 Address for correspondence: Dr Ashok Deorari Professor Department of Pediatrics All India Institute of Medical Sciences Ansari Nagar, New Delhi 110029 Email: [email protected] Downloaded from www.newbornwhocc.org 1 AIIMS- NICU protocols 2007 Abstract Polycythemia is defined as a venous hematocrit above 65%. The hematocrit in a newborn peaks at 2 hours of age and decreases gradually after that. The etiology of polycythemia is related either to intra-uterine hypoxia or secondary to fetal transfusion. The relationship between hematocrit and viscosity is almost linear till 65% and exponential thereafter. Increased viscosity of blood is associated with symptoms of hypo-perfusion. Clinical features related to hyperviscosity may affect all organ systems and this entity should be screened for in high-risk infants. Polycythemia maybe symptomatic or asymptomatic and guidelines for management of both types based on the current evidence are provided in the protocol. Downloaded from www.newbornwhocc.org 2 AIIMS- NICU protocols 2007 Polycythemia or an increased hematocrit is associated with hyperviscosity of blood. As the viscosity increases, there is an impairment of tissue oxygenation and perfusion and a tendency to form microthrombi. Significant damage may occur if these events occur in the cerebral cortex, kidneys and adrenal glands. Hence this condition requires urgent diagnosis and prompt management. Polycythemia and Hyperviscosity The viscosity of blood is directly proportional to the hematocrit and plasma viscosity and inversely proportional to the deformability of red blood cells. -
116588NCJRS.Pdf
If you have issues viewing or accessing this file contact us at NCJRS.gov. " "'- u.s. Department of Justice Federal Bureau of Investigation PROCEEDINGS OF THE INTERNATIONAL SYMPOSIUM ON FORENSIC IMMUNOLOGY FBI ACADEMY QUANTICO, VIRGINIA JUNE 23-26, 1986 Proceedings of the International Symposium on Forensic Immunology co 00 L() \0 u, r-l O§ r-l Ql C. If) 05~ Ql 0- 0 ~ o~ Ql E C/) Ql >. c:0 If) C/) ~ * ....,a: () a: z Ql '*02 Ql iii :5 ...... ....,::> a Ql {ij "...:0- Ql c: !!lc: °E ::>;: B 00 {ij c: 0 ~I::> z~ "e CD ~~ :5 .... ~o- S 1::C: Lt .~ Host Laboratory Division Federal Bureau of Investigation June 23-26, 1986 Forensic Science Research and Training Center FBI Academy Quantico, Virginia NOTICE This publication was prepared by the U. S. Government. Neither the U. S. Government nor the U. S. Department of Justice nor any of their employees makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness or usefulness of any information, apparatus, product or process disclosed, or represents that in use would not infringe privately owned rights. Reference herein to any specific commercial product, process or service by trade name, mark, manufacturer or otherwise does not necessarily constitute or imply its endorsement, recommendation or favoring by the U. S. Government or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or reflect those of the U. S. Government or any agency thereof. Published by: The Laboratory Division Roger T. Castonguay Assistant Director in Charge Federal Bureau of Investigation U. -
Understanding Blood Tests
PATIENT EDUCATION patienteducation.osumc.edu Understanding Blood Tests Your heart pumps the blood in your body through a system of blood vessels. Blood delivers oxygen and nutrients to all parts of the body. It also carries away waste products. Blood is made up of red blood cells, white blood cells, platelets and a clear fluid called plasma. There are also other parts in the blood such as electrolytes, proteins, fats, sugar, and hormones. Your doctor can check for certain diseases and conditions by doing blood tests. A small sample of blood is taken and sent to the lab. The test results help your doctor: • Check your general health • See how well your body organs are working • Find health problems, diseases and disorders • Watch the body’s response to medicines and treatments Common blood tests include a Complete Blood Count (CBC) with differential, and a Comprehensive Metabolic Panel (CMP). Note: Some health problems may require ongoing monitoring or repeat testing. It is important to know that normal range values can vary from laboratory to laboratory. Talk with your doctor if you have questions about your test results. Complete Blood Count (CBC) A CBC shows the number of white and red blood cells, hematocrit, hemoglobin and platelets in your blood. This test helps your doctor look for signs of anemia, infection, bleeding problems or certain diseases and disorders. This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care. © January 9, 2018. The Ohio State University Comprehensive Cancer Center – Arthur G. -
TITLE: Complete Blood Count (CBC) Basics PRESENTER: Sarah Drawz and Michael Linden
TITLE: Complete Blood Count (CBC) Basics PRESENTER: Sarah Drawz and Michael Linden Slide 1: Good afternoon, my name is Dr. Michael Linden. I am the Director of Hematopathology at the University of Minnesota in Minneapolis, MN. With me is Dr. Sarah Drawz, who is a Hematopathology Fellow, also at the University of Minnesota. I would like to introduce Dr. Sarah Drawz, who will be beginning our presentation as part of this AACC Pearl of Laboratory Medicine on “Complete Blood Count (CBC) Basics.” Slide 2: The complete blood count (CBC) is an important initial test in the evaluation of a patient’s hematologic function. The CBC is performed on whole blood, which is composed of two primary components: plasma and cells. The plasma fraction contains mostly water, numerous proteins, electrolytes, and clotting factors. The cellular component of blood is comprised of the three major categories of blood cells: red blood cells (RBCs), white blood cells (WBCs), and platelets. The CBC test yields numbers of these main types of cells, but also additional information, such as the volume of red blood cells, or hematocrit, and quantity of different types of white blood cells, the differential. Slide 3: CBCs are collected from patients in both inpatient and outpatient settings. Generally, 3 to 10 ml of whole blood are drawn from a peripheral vein directly into a tube. The tube must contain anticoagulant to prevent clots from obscuring the CBC analysis. Various types of anticoagulants are used including ethylenediaminetetraacetic acid (EDTA), heparin, and citrate. The most common anticoagulant used for the CBC is EDTA.