I3 Creation CRM for IPAD โปรแกรมบริหาร... · I3 Creation CRM for IPAD โปรแกรมบริหารความสัมพันธ์ลูกค้า
Clinical Findings I3-1 (Emmeline)Components of Blood Chart
-
Upload
ivankcurry -
Category
Documents
-
view
214 -
download
0
description
Transcript of Clinical Findings I3-1 (Emmeline)Components of Blood Chart
CLINICAL FINDINGS – I3 Test 1
BIOCHEMISTRY
Folic acid/folate deficiency Nutritional deficiency
Absorption defect
- Glutamate carboxypeptidase II (GCPII) deficiency/mutation
- PCFT mutation (protein-coupled folate transporter)
- GI disease
- Reduced folate carrier deficiency
Metabolism defect
- Dihydrofolate reductase deficiency/mutation
- Serine hydroxymethyltransferase deficiency/mutation
- Methylene tetrahydrofolate reductase (MTHFR) deficiency/mutation
Methyl-folate trap
- Methionine synthase deficiency/mutation
- Vitamin B12 deficiency (See Vitamin B12 deficiency)
Hemochromatosis/iron
overload
Hepcidin deficiency
- Mutation in hepcidin gene itself (hereditary hemochromatosis)
- Mutation in regulators of hepcidin synthesis
- Liver disease
Thalassemia
Iron deficiency Nutritional deficiency (esp in rapidly growing children)
Absorption defect
- Reduced production of acid in gastric compartments
- Vitamin C deficiency
- Intestinal disorder/surgical removal (eg. Chrohn’s, celiac, etc.)
- Other molecules interacting (eg. phytanic acids in plants)
- Transporter deficiency
Bleeding (loss of ability to recycle)
- Heavy menstruation, childbirth
- Chronic, slow internal bleeding (gastrointestinal, genitourinary, pulmonary)
- Frequent blood donations
Hepheastin deficiency
- Mutation in gene
- Copper deficiency
Bacterial infection (overexpress hepcidin)
Pregnancy and lactation
Vitamin B12 deficiency Nutritional deficiency (vegans)
Absorption defect
- Parietal cells defect (no IF release)
- Autoimmunity against IF or parietal cells
- Defective TCII
- Pancreatic disease (no R factor digestion) – eg. Zollinger-Ellison syndrome
- Drug-induced (esp. those that affect gastric acid production)
Blind loop syndrome (bacteria binds to cobalamin)
ANEMIAS
Decreased RBC Stem cell defect
- Aplastic anemia
- Pure red cell anemia
- Anemia associated with myelodysplasia
- Renal failure (EPO deficiency)
Defect in cell differentiation
- DNA synthesis problem
> Folate deficiency
> Vitamin B12 deficiency
- Hb synthesis problem
> Iron deficiency
> Thalassemia
> Sideroblastic anemia (no heme)
Anemia of chronic disease
Myelophthistic anemia
Hemolytic anemia G6PD deficiency
Pyruvate kinase deficiency
Hereditary spherocytosis
Infection
Immune-mediated (IgG or IgM)
Mechanical stress
- Tight aortic stenosis
- DIC
- TTP
- Malignant hypertension
- Hemangiomas
Sickle cell anemia
Increased RBC Immune mediated
- Transfusion reaction
- Hemolytic disease of newborns
- Autoimmune hemolytic anemia
- Lymphoma
- Mycoplasma infection
Non-immune mediated
- DIC
- Burns/trauma
- Infectious disease (eg. malaria)
- Hypersplenism
Microcytic anemia Iron deficiency (See Iron deficiency)
Lead poisoning
Thalassemia
Sideroblastic anemia
Anemia of chronic disease/inflammation (slight)
Sickle cell anemia
Macrocytosis Megaloblastic anemia
Alcohol
Liver disease
Myelodysplasia
Aplastic anemia
Raised retic count
Cytotoxic drugs
Pregnancy
Megaloblastic anemia Folic acid/folate deficiency, especially:
- Methionine synthase deficiency/mutation
- Vitamin B12 deficiency (See Vitamin B12 deficiency)
Antineoplastic drugs (methotrexate, AZT)
Hereditary disorders of DNA synthesis
- Orotic aciduria
- Lesch-Nyhand syndrome
Acquired disorders of DNA synthesis
- Erythroleukemia
- Refractory sideroblastic anemia
Myelophthisic anemia Fibrosis
Bone marrow tumor
Granuloma
Normocytic anemia Aplastic anemia
Anemia of chronic disease
Myelophistic anemia
Hemolytic anemia
Acute bleeding
X-linked sideroblastic
anemia (XLSA)
δ-ALA synthase 2 deficiency/mutation
Vitamin B6 deficiency
CLOTTING
Coagulation tests
Normal PT and PTT
- Thrombocytopenia
- Qualitative platelet defect
- von Willebrand’s disease
- Factor 8 deficiency
- Vascular purpura
Isolated prolonged PT
Isolated prolonged PTT
Prolonged PT and PTT
- Final pathway factor deficiency (X, V, prothrombin, fibrinogen)
- Severe vitamin K deficiency
- DIC (disseminated intravascular coagulation)
Prolonged bleeding time
Arachidonic acid pathway defect/thromboxane defect
Hemophilia A/B
Factor 8 inhibitor
Liver disease
Platelet function disorders
- Membrane defect
- Storage pool disease
- Granule deficiency
- Diminished response to agonists
Thrombocytopenia
Severe Vitamin K deficiency
Von Willebrand’s disease
Thrombocytopenia Decrease in number/production
- Inherited
Tar baby syndrome
Wiscott-Aldrich syndrome
May-Hegglin anomaly
Alport syndrome
Acquired amegakaryoctic thrombocytopenic purpuria (AATP)
- Acquired
Radiation exposure
Drugs
Chemicals (especially benzenes)
Infections
Bone marrow dysfunction
Liver/kidney disease
Increased destruction
- Drug induced
- ITP (immune thrombocytopenic purpura)
- TTP (thrombotic thrombocytopenia purpura)
- DIC (disseminated intravascular coagulation)
- hypersplenism
Pregnancy related
- Preeclampsia
- HELLP syndrome
- Neonatal autoimmune thrombocytopenia
- Antiphospholipid Ig syndrome
Transfusion reaction
Vitamin K deficiency Antibiotics
Biliary tract disease
Fat malabsorption
Severe malnutrition
Vitamin K epoxide reductase deficiency
Vitamin K antagonist-drugs (warfarin)