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diagnosis differential hyperkalemia hematology high management nephrology blood product reactions treatment algorithm classification coagulation dic disseminated dm2 elevation false hba1c
Causes of False Elevation and Reduction in HbA1c == False Elevation == Decreased RBC turnover • Iron, B-12,
Causes of False ... • Asplenia Laboratory ... Content • RBC Transfusions ... blood loss • Hemolytic ... HbA1c #HgbA1c #Laboratory
Blood Product Transfusions One Pager Summary Type and screen - determines blood type and detects in recipient
Transfusion Thresholds ... 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
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 ... products contain potassium ... more likely to cause
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
venipuncture • Hemolysis ... • Recent IV potassium ... - Transfusion ... differential #diagnosis #causes ... #potassium #high
TTP - Laboratory Evaluation for Thrombotic Thrombocytopenic Purpura Activity of von Willebrand factor-cleaving protease activity - A
TTP - Laboratory ... Mild-to-moderate decrease ... in most cases; ... Platelet count - Decreased ... nucleated RBCs, and decreased
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
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
incompatible blood transfusion ... venipuncture sites Laboratory ... Treat primary cause ... hydration • RBC transfusion ... Coagulation #diagnosis #causes
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