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diagnosis differential hyperkalemia management potassium algorithm nephrology anemia cardiology criticalcare hematology blood classification clinical pathophysiology product reactions abnormal acanthocytes bilirubin
Causes of False Elevation and Reduction in HbA1c == False Elevation == Decreased RBC turnover • Iron, B-12,
Causes of False ... Hypertriglyceridemia • Uremia High ... Content • RBC Transfusions ... blood loss • Hemolytic ... #Decrease #Diagnosis
Hemolytic Anemia - Differential Diagnosis Algorithm Hereditary: • Peripheral blood smear + DAT + further History •
Hemolytic Anemia ... further History • Bite ... Immune mediated hemolysis ... disease, drugs, transfusions ... Diagnosis #Algorithm #causes
Blood Product Transfusions One Pager Summary Type and screen - determines blood type and detects in recipient
Transfusion Thresholds ... Causes purpura & ... TRALI): Leading cause ... High mortality. ... more likely to cause
Blood Transfusion Reactions Immune Mediated: • Febrile Non-Hemolytic Transfusion Reaction (FNHTR): Most common immune reaction to transfusion.
• Febrile Non-Hemolytic ... Causes purpura & ... TRALI): Leading cause ... High mortality. ... more likely to cause
Differential Diagnosis for Hemolytic Anemia Intrinsic Causes: • Enzyme deficiencies ex. G6PD, pyruvate kinase • Hemoglobinopathies
Diagnosis for Hemolytic ... Anemia Intrinsic Causes ... , spider/snake bites ... prosthetic valve • Transfusion ... udaygulati #Hemolytic
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
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
venipuncture • Hemolysis ... phlebotomy High ... - Transfusion ... differential #diagnosis #causes ... #potassium #high
Hyperkalemia: Diagnostic algorithm Decreased renal potassium excretion • Acute renal failure • Chronic renal failure • Drugs Increased
Diagnostic algorithm Decreased ... diet • Blood transfusion ... • Tumor lysis/hemolysis ... Normal, Renin High ... hypoplasia Aldosterone high
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
venipuncture • Hemolysis ... phlebotomy High ... - Transfusion ... differential #diagnosis #causes ... #potassium #high
Several artifacts can cause significant and potentially misleading alterations to measured RBC parameters: 1. Old samples
falsely high Hgb ... Hemolysis causes ... PCV to decrease ... PCV and MCV to decrease ... Echinocytes #BurrCells #Bite
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