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differential hyperkalemia nephrology blood hematology management product reactions algorithm classification dm2 elevation false hba1c hgba1c increase laboratory reduction transfusions
Causes of False Elevation and Reduction in HbA1c == False Elevation == Decreased RBC turnover • Iron, B-12,
Causes of False ... -12, or folate deficiency ... Hypertriglyceridemia • Uremia High ... blood loss • Hemolytic ... #Decrease #Diagnosis
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
- Differential Diagnosis ... phlebotomy High ... • Recent IV potassium ... #causes #potassium ... #high #nephrology
Hyperkalemia: Diagnostic algorithm Decreased renal potassium excretion • Acute renal failure • Chronic renal failure • Drugs Increased
Hyperkalemia: Diagnostic ... algorithm Decreased ... diet • Blood transfusion ... • Tumor lysis/hemolysis ... Normal, Renin High
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
- Differential Diagnosis ... phlebotomy High ... • Recent IV potassium ... #causes #potassium ... #high #nephrology
Blood Product Transfusions One Pager Summary Type and screen - determines blood type and detects in recipient
Transfusion Thresholds ... recipients w/ IgA deficiency ... High mortality. ... products contain potassium ... #diagnosis #management
Blood Transfusion Reactions Immune Mediated: • Febrile Non-Hemolytic Transfusion Reaction (FNHTR): Most common immune reaction to transfusion.
recipients w/ IgA deficiency ... Causes purpura & ... High mortality. ... products contain potassium ... #diagnosis #management
Causes of HyperKalemia - Differential Diagnosis Increased extracellular K+: • Tissue injury • Hemolysis • Rhabdomyolysis •
Causes of HyperKalemia ... Tissue injury • Hemolysis ... glycosides • High ... intake • Blood transfusion ... of injection Decreased
Causes of Hyperkalemia Pseudohyperkalemia - Tourniquet use - Hemolysis (in vitro) - Leukocytosis - Thrombocytosis Intra- to extracellular
Causes of Hyperkalemia ... Tourniquet use - Hemolysis ... drugs - Transfusion ... tissue necrosis Decreased ... #diagnosis #differential
Causes of Hyperkalemia - Differential Diagnosis Framework • Cellular Shift: - Exercise
Causes of Hyperkalemia ... - Insulin deficiency ... Crush injury, Hemolysis ... #Causes #potassium ... #high
Causes of Hyperkalemia l. Pseudohyperkalemia A Cellular efflux; thrombocytosis, erythrocytosis, leukocytosis, in vitro hemolysis B.
leukocytosis, in vitro hemolysis ... Decreased distal ... aldosterone synthase deficiency ... #Differential #Diagnosis ... #High #Potassium
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