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diagnosis management algorithm cobalamin hematology aafp altered ana antibody antinuclear crrt cytoplasmic fatigue folate folicacid homocysteine macrocytosis managment mcv mds
Algorithm for the evaluation of macrocytic anemia. (RBC = red blood cell; MMA = methylmalonic acid.) Physicians
evaluation of macrocytic ... red blood cell; MMA ... the most likely cause ... B12 deficiency ... deficiency.
Causes of Vitamin B12 Deficiency - Cobalamin Decreased Intake Pancreas: Insufficiency Intestine: SIBO, Celiac disease, IBD, Lymphoma, Amyloidosis, Resection,
Causes of Vitamin ... B12 Deficiency ... Celiac disease, IBD ... Stomach: Pernicious anemia ... #B12 #Deficiency
Diagnostic Framework for Anemia (Morphological Approach - MCV) Low MCV - <80fL - "Microcytic" • Iron deficiency
MCV - >96fL - "Macrocytic ... Megaloblastic: Vitamin ... B12 deficiency, ... morphologic #mcv #differential ... #diagnosis #causes
Vitamin B12 (Cobalamin) Deficiency Etiology: • Vit B12 - aka cobalamin. Present in foods derived from animal
Vitamin B12 (Cobalamin ... ) Deficiency Etiology ... • Common Causes ... : • Worsening macrocytic ... - Elevated MMA
Fatigue and IBD Algorithm • 40-50% patients have fatigue despite clinical remission • Risk factors: BMI,
Crohn's > UC Anemia ... Receptor (sTfR) to differentiate ... (B12, MMA) for ... restricted diet/deficiency ... /other causes •
Altered Mental Status - Differential Diagnosis • Neurologic: Stroke, Cerebral hypoxia, Cerebral hemorrhage, Seizure, Trauma, TBI,
Diagnosis • Neurologic ... , Hypercarbia, Vitamin ... deficiency, Thyroid ... Mental #Status #AMS ... Diagnosis #Causes
Myelodysplastic Syndromes (MDS) What? Myelodysplastic syndromes are a group of disorders caused by blood cells that are poorly
formed or don’t work ... common cytopenia: Macrocytic ... • Nutritional: vitamin ... B12 or folic acid ... blood count with differential
Antinuclear Antibody Testing - Nuclear and Cytoplasmic Patterns Nuclear Patterns: • Homogeneous pattern: -
• Reticular/AMA ... PBC/SjS OS - AMA ... , OJ, PL-7, PL-12 ... body-like: - Neurologic ... Cytoplasmic #Patterns #differential
Transverse Myelitis Overview Focal inflammatory disorder of the spinal cord resulting in rapid onset of weakness, sensory
• Infectious causes ... • Nutritional Deficiency ... : - Vitamin B12 ... diagnosis #management #neurology ... #differential
Renal Replacement Therapy (RRT) - ICU One Pager Summary Indications (AIEOU): • A: Acidosis (usually severe metabolic)
Dialyzer is rigid case ... in the ICU: • IHD ... (Sustained low efficiency ... daily dialysis): ~12 ... RRT #managment #nephrology
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