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Monday, December 8, 2014

Hematology List of Most Commons for Physician Assistant Students

Most Commons in Hematology
  • Iron Deficiency Anemia - most common cause of anemia
  • Anemia of Chronic Disease - most common cause of normocytic anemia
  • Glucose-6-Phosphate Dehydrogenase Deficiency - most common RBC enzyme defect
    • More common in males
    • Highest frequency among Mediterranean regions, Africa, and China
    • Most commonly seen in tropical geographic areas prevalent for malaria
  • G6PD “A-” is the most common variant
  • Sickle Cell SS disease - most common and most severe of the sickle cell disorders
  • Warm-antibody AIHA (autoimmune hemolytic anemia) - most common of all AIHA
  • Immune Hemolytic Anemia - commonly DRUG related
  • Idiopathic Thrombocytopenic Purpura (ITP)
    • Acute ITP - most common in children, preceded by viral illness, self-limiting
    • Chronic ITP - most common in adult women (20-40), idiopathic, not self-limiting
  • Thrombotic Thrombocytopenic Purpura (TTP)
    • Most commonly acquired due to an inhibitory antibody that blocks ADAMTS 13 activity
  • Hemophilia A and B - most common in males
    • X-linked recessive bleeding disorders
  • Von Willebrand Disease - most common inherited bleeding disorder
    • Most common form: Type I (autosomal dominant) or partial deficiency in vWF
  • Factor V Leiden Gene Polymorphism - most common known inheritable risk factor for VTE
    • DVT - most common manifestation of F5LGP
  • Acute Lymphocytic Leukemia (ALL) - most common malignant disease in childhood
  • Acute Myeloid Leukemia (AML) - most common in adults
  • Acute Leukemia
    • More common among whites than blacks
    • More common among Jews than non-Jews
  • Chronic Lymphocytic Leukemia - most common adult leukemia
    • More common in men than women
    • Incidence increases with age
  • Classical Hodgkin Lymphoma - more common in men
    • Nodular Sclerosis - most common subtype
      • Most common in young women with mediastinal mass
  • Multiple Myeloma - second most common hematologic cancer
    • Most common in African American men


Other Helpful Hints and Tricks
  • Partial Thromboplastin Time (PTT) vs. Prothrombin Time (PT)
    • You can remember which corresponds to which pathway (intrinsic vs. extrinsic) by remembering PET and PITT.
    • PTT = Test activity of factors 2, 5, 8-12 (everything except 7)
      • Plasma + contact activating agent + phospholipid + calcium
    • PT = Test activity of factors 2, 5, 7, 10 or fibrinogen
      • Plasma + brain tissue thromboplastin (TF) + calcium
  • Mixing Studies: add normal plasma to patient sample that has a prolonged PT or PTT
    • Clotting time corrects = factor deficiency
    • Clotting time does NOT correct = factor inhibitor; this is because you are adding back the factors in normal blood, so clotting time should have corrected if it was a factor deficiency issue.


Sources:
Anemia, Laura Sanza, PA-C
Hemostasis & Platelet Disorders, Laura Sanza, PA-C
Coagulation Disorders & Hemophilia, Laura Sanza, PA-C
HIV/AIDS, Durward Watson, PA-C
Leukemias & Stem Cell Transplant, Jennifer Potter, PA-C
Lymphoma, Kathleen O’Connell, PA-C

Multiple Myeloma, Jennifer Potter, PA-C

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