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=[[Anemia]]=
=[[Anemia]]=
*Micro: Thalassemia (Mentzer Index < 13: MCV/RBC), Iron (RDW high), Chronic inflammation (ESR, CRP), Lead (serum level), Sideroblastic
*Normo:
** Non-Hemolytic (retic count ≤ 2%, normal LDH/haptoglobin/RDW): Chronic inflammation, Iron, CKD, Aplastic
** Hemolytic (retic count > 2%, elevated LDH, low haptoglobin, elevated RDW):
*** Intrinsic: MEH (HS/PNH, G6PD/Pyruvate kinase, SCD/HbC)
*** Extrinsic: MAMI
*Macro:
** Megaloblastic: B12 Folate Fanconi
** Non-Megaloblastic: Alcohol Liver disease
=Thrombocytopenia=
=Thrombocytopenia=
*Dx: Bone marrow biopsy showing >10% clonal plasma cells + end organ damage (CRAB) OR >60% clonal plasma cells without end organ damage. M-spike on SPEP (also shows up in smoldering myeloma). Bone scan shows punched out lesions. Hyperviscosity syndrome when there is monoclonal IgM, this leads to impaired platelet function and epistaxis/gingival bleeding (overall more common in Waldenstrom's macroglobulinemia). β2 microglobulin is a prognostic marker.
*Dx: Bone marrow biopsy showing >10% clonal plasma cells + end organ damage (CRAB) OR >60% clonal plasma cells without end organ damage. M-spike on SPEP (also shows up in smoldering myeloma). Bone scan shows punched out lesions. Hyperviscosity syndrome when there is monoclonal IgM, this leads to impaired platelet function and epistaxis/gingival bleeding (overall more common in Waldenstrom's macroglobulinemia). β2 microglobulin is a prognostic marker.
*Tx: Autologous Stem Cell Transplant or chemotherapy
*Tx: Autologous Stem Cell Transplant or chemotherapy
https://www.ohsu.edu/knight-cancer-institute/thomas-deloughery-mds-famous-handouts