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diagnosis differential hyperkalemia high nephrology management blood hematology product reactions algorithm classification dm2 elevation hba1c hgba1c increase k laboratory reduction
Causes of False Elevation and Reduction in HbA1c == False Elevation == Decreased RBC turnover • Iron, B-12,
Causes of False ... Content • RBC Transfusions ... blood loss • Hemolytic ... Effect • RBC Transfusions ... #Decrease #Diagnosis
Blood Product Transfusions One Pager Summary Type and screen - determines blood type and detects in recipient
Transfusion Thresholds ... antigens (often false ... Causes purpura & ... TRALI): Leading cause ... products contain potassium
Blood Transfusion Reactions Immune Mediated: • Febrile Non-Hemolytic Transfusion Reaction (FNHTR): Most common immune reaction to transfusion.
antigens (often false ... Causes purpura & ... TRALI): Leading cause ... products contain potassium ... more likely to cause
Hyperkalemia: Diagnostic algorithm Decreased renal potassium excretion • Acute renal failure • Chronic renal failure • Drugs Increased
Diagnostic algorithm Decreased ... renal potassium ... Drugs Increased potassium ... diet • Blood transfusion ... • Tumor lysis/hemolysis
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
venipuncture • Hemolysis ... • Recent IV potassium ... - Transfusion ... differential #diagnosis #causes ... #potassium #high
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
venipuncture • Hemolysis ... • Recent IV potassium ... - Transfusion ... differential #diagnosis #causes ... #potassium #high
Causes of HyperKalemia - Differential Diagnosis Increased extracellular K+: • Tissue injury • Hemolysis • Rhabdomyolysis •
Causes of HyperKalemia ... Tissue injury • Hemolysis ... intake • Blood transfusion ... of injection Decreased ... Differential #Diagnosis #Causes
Causes of Hyperkalemia Pseudohyperkalemia - Tourniquet use - Hemolysis (in vitro) - Leukocytosis - Thrombocytosis Intra- to extracellular
Causes of Hyperkalemia ... Tourniquet use - Hemolysis ... drugs - Transfusion ... aged blood - Hemolysis ... tissue necrosis Decreased
Causes of Hyperkalemia - Differential Diagnosis Framework • Cellular Shift: - Exercise
Causes of Hyperkalemia ... tacrolimus) - Decrease ... Crush injury, Hemolysis ... Differential #Diagnosis #Causes ... #potassium #high
Hyperkalemia - Diagnosis and Management - GrepMed Handbook S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
injury, ischemia, hemolysis ... , transfusions), ... Pseudohyperkalemia - hemolysis ... only if no clear cause ... Management #Treatment #potassium
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