Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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diagnosis hematology nutrition b12 cobalamin folate folicacid iron management vitamin workup aafp abnormal color discoloration extravascular fatigue fe hemolysis homocysteine
Hemolytic Anemia - Differential Diagnosis Algorithm Hereditary: • Peripheral blood smear + DAT + further History •
Hemolytic Anemia ... DAT (-) → G6PD Deficiency ... anemia (TTP, HUS ... #Anemia #Differential ... #causes
Causes of Vitamin B12 Deficiency - Cobalamin Decreased Intake Pancreas: Insufficiency Intestine: SIBO, Celiac disease, IBD, Lymphoma, Amyloidosis, Resection,
Causes of Vitamin ... Insufficiency Intestine ... Celiac disease, IBD ... Stomach: Pernicious anemia ... #Cobalamin #differential
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes Intravascular Hemolysis: • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... anemia): ... uremic syndrome (HUS ... G6PD deficiency) ... #differential #
Hemolytic Anemia - Differential Diagnosis Algorithm • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... - Differential ... Diagnosis Algorithm ... DIC, TTP, HELLP, HUS ... #Anemia #Differential
Causes of Iron Deficiency • Diet: ↓ Intake, e.g. vegan, Malnutrition, Polyphenol / tannins, ↓ Vitamin
Causes of Iron Deficiency ... Inflammation: IBD ... hepcidin) • Others: Hemolysis ... #Causes #differential ... #diagnosis #anemia
Algorithm for the evaluation of macrocytic anemia. (RBC = red blood cell; MMA = methylmalonic acid.) Physicians
Algorithm for the ... Hemorrhage or hemolysis ... cause if the reticulocyte ... also causes an ... if vitamin B12 deficiency
Fatigue and IBD Algorithm • 40-50% patients have fatigue despite clinical remission • Risk factors: BMI,
, Anemia • Prevalence ... Crohn's > UC Anemia ... Receptor (sTfR) to differentiate ... restricted diet/deficiency ... /other causes •
Causes of Iron Deficiency - Differential Diagnosis Algorithm • Blood loss: GI (cancer, ulcer, IBD), GU
Causes of Iron Deficiency ... - Differential ... Diagnosis Algorithm ... cancer, ulcer, IBD ... Intravascular hemolysis
Vitamin B12 (Cobalamin) Deficiency Etiology: • Vit B12 - aka cobalamin. Present in foods derived from animal
B12 (Cobalamin) Deficiency ... • Common Causes ... disorders of small intestine ... diarrhea related to IBD ... B12 #Cobalamin #Deficiency
Etiologies of Folate Deficiency • Decreased dietary intake - uncommon in this era • Increased requirements
pregnant have hemolytic ... anemia, or psoriasis ... folate that can cause ... if intake is not ... #FolicAcid #differential
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