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Anemia by Mind Map: Anemia

1. Hemostatic Disorders

1.1. Primary (Platelet Sticking)

1.1.1. Disorders of Platelets

1.1.1.1. Qualitative (bad platelets)

1.1.1.1.1. Platelet Aggregation Disorder

1.1.1.1.2. Platelet Function Disorder

1.1.1.1.3. Platelet Adhesion Disorder

1.1.1.2. Quantitative (Too few platelets)

1.1.1.2.1. Thrombocytopenia

1.1.2. Disorders of von Willebrand Factor

1.1.2.1. Type 1

1.1.2.1.1. treatment is desmopressin

1.1.2.2. Type 2

1.1.2.2.1. treatment is factor concentrates

1.1.2.3. Type 3

1.1.2.3.1. treatment is factor concentrates

1.1.3. Disorders of connective tissue

1.1.3.1. Marfans

1.1.3.2. Ehlers-Danlos

1.1.3.3. Osteogenesis Imperfecta

1.2. Secondary (Clotting)

1.2.1. Congenital

1.2.1.1. Hemophilia A

1.2.1.2. Hemophilia B

1.2.1.3. Hemophilia C

1.2.2. Acquired

1.2.2.1. Liver Disease

1.2.2.2. Acquired Inhibitors

1.2.2.2.1. antibodies against certain factors

1.2.2.3. Disseminated Intravascular Coagulation

1.2.2.3.1. Obstetric complications

1.2.2.3.2.  Intravascular hemolysis

1.2.2.3.3.  Septicemia

1.2.2.3.4.  Viremia

1.2.2.3.5.  Malignancy

1.2.2.3.6.  Leukemia

1.2.2.3.7.  Snake bites

1.2.2.3.8.  Burns

1.2.2.3.9.  Crush injuries

1.2.2.3.10.  Tissue necrosis

1.2.2.3.11.  Liver disease

1.2.2.3.12.  Prosthetic devices

1.2.2.3.13.  Peripheral vascular

1.2.2.3.14. disorders

1.2.2.3.15.  Surgery

2. Anemia II

2.1. Microcytic

2.1.1. Anemia of Chronic Disease

2.1.1.1. Chronic inflammation

2.1.1.2. Cancer

2.1.2. Iron Deficiency Anemia

2.1.2.1. Nutritional Lack

2.1.2.1.1. Malnutrition

2.1.2.1.2. Malabsorption

2.1.2.2. Blood loss

2.1.2.2.1. Peptic Ulcer Disease

2.1.2.2.2. Menorrhagia

2.1.2.2.3. Carcinoma (colonic polyps)

2.1.3. Sideroblastic Anemia

2.1.3.1. Congenital

2.1.3.1.1. ALAS deficiency

2.1.3.2. Acquired

2.1.3.2.1. Alcoholism

2.1.3.2.2. Lead poisoning

2.1.3.2.3. Vitamin B6 deficiency

2.1.4. Thalassemia

2.1.4.1. alpha

2.1.4.1.1. 1 gene deleted

2.1.4.1.2. 2 genes deleted

2.1.4.1.3. 3 genes deleted

2.1.4.1.4. 4 genes deleted

2.1.4.2. beta

2.1.4.2.1. Normal Beta/Mutated Beta

2.1.4.2.2. Mutated Beta/Mutated Beta

2.1.4.2.3. Absent Beta/Mutated Beta

2.1.4.2.4. Absent Beta/Absent Beta

2.1.4.2.5. Hb Barts (gamma globin tetramers)

2.2. Normocytic

2.2.1. Underproduction

2.2.1.1. Renal failure (decreased EPO)

2.2.1.2. Damage to bone marrow precursor cells

2.2.1.2.1. Parvovirus B19

2.2.1.2.2. Aplastic Anemia

2.2.1.2.3. Myelophthisic Process

2.2.2. Hemolysis

2.2.2.1. Predominant Intravascular

2.2.2.1.1. Paroxysmal Nocturnal Hemoglobinuria

2.2.2.1.2. G6PD Deficiency

2.2.2.1.3. Immune Hemolytic Anemia

2.2.2.1.4. Microangiopathic Hemolytic Anemia

2.2.2.1.5. Malaria

2.2.2.2. Predominant Extravascular

2.2.2.2.1. Hereditary Spherocytosis

2.2.2.2.2. Sickle Cell Anemia

2.2.2.2.3. Hemoglobin C

2.3. Macrocytic

2.3.1. Megaloblastic Anemia

2.3.1.1. Folate Deficiency

2.3.1.1.1. Dietary deficiency (months)

2.3.1.1.2. Increased demand

2.3.1.1.3. Folate antagonists

2.3.1.2. Vitamin B12 Deficiency

2.3.1.2.1. Dietary deficiency (years)

2.3.1.2.2. Malabsorption

2.3.2. Liver Disease

2.3.2.1. Alcoholism

2.3.2.2. Hepatitis

2.3.3. Drugs

2.3.4. Myelodysplastic Syndrome

3. Thrombophillia

3.1. Alterations in blood flow

3.1.1. Arterial/Aortic

3.1.1.1. Aneurysms

3.1.1.2. Dilated atrium

3.1.1.2.1. Atrial Fibrillation

3.1.1.2.2. Mitral valve stenosis

3.1.1.2.3. Left ventricular dysfunction

3.1.1.3. Ulcerated atherosclerotic plaques

3.1.2. Venous

3.1.2.1. vascular access

3.1.2.2. mechanical compression

3.1.2.3. prolonged immobilization

3.1.2.4. surgery

3.1.2.5. congestive heart failure

3.1.2.6. pregnancy

3.1.2.7. malignancy

3.1.2.8. varicose veins

3.1.2.9. dehydration

3.1.3. Hyperviscosity

3.1.3.1. Polycythemia

3.1.3.1.1. Primary

3.1.3.1.2. Secondary

3.2. Endothelial injury

3.2.1. hypertension

3.2.2. cellulitis

3.2.3. thrombophlebitis

3.2.4. vasculitis

3.2.5. heart valve

3.2.6. vascular access

3.2.7. atherosclerosis

3.2.7.1. hypercholesterolemia

3.2.8. mechanical trauma

3.2.9. bacterial endotoxins

3.2.10. tobacco smoke toxins

3.2.11. radiation injury

3.3. Hypercoagulable state

3.3.1. Congenital

3.3.1.1. Factor 5 leiden

3.3.1.2. Factor 2 hyperprothrombinemia

3.3.1.3. Antithrombin deficiency

3.3.1.4. Protein C deficiency

3.3.1.4.1. Type 1 (quantitative)

3.3.1.4.2. Type 2 (qualitative)

3.3.1.5. Protein S deficiency

3.3.2. Acquired

3.3.2.1. Antithrombin deficiency secondary to nephrotic syndrome

3.3.2.2. heparin induced thrombocytopenia

3.3.2.3. antiphospholipid syndrome

3.3.2.4. cancer

3.3.2.5. estrogen therapy

3.3.2.6. pregnancy

3.3.2.6.1. decreased protein S

3.3.2.6.2. increased fibrinogen + prothrombin

3.3.2.6.3. increased estrogen

3.3.2.6.4. impaired fibrinolysis

3.3.2.6.5. vascular congestion

4. 161209L1 WBC Abnormalities

4.1. Neutrophils

4.1.1. neutropenia

4.1.1.1. decreased production

4.1.1.1.1. pharmaceuticals

4.1.1.1.2. viral infections

4.1.1.1.3. EtOH

4.1.1.1.4. congenital

4.1.1.2. increased demand

4.1.1.2.1. autoimmune

4.1.1.2.2. drug-induced

4.1.1.3. sequestration

4.1.1.4. splenomegaly

4.1.2. neutrophillia

4.1.2.1. increased production

4.1.2.1.1. infections

4.1.2.1.2. inflammation

4.1.2.1.3. pharmaceuticals

4.1.2.1.4. malignancy

4.1.2.2. release of immature cells

4.1.2.2.1. leukemoid reaction

4.1.2.2.2. leukoerythroblastic reaction

4.1.2.3. demargination

4.1.2.3.1. epinephrine

4.1.2.3.2. exercise

4.1.2.3.3. glucocorticoids

4.1.2.3.4. stress

4.1.2.3.5. sickle cell anemia

4.1.2.4. decreased egress from peripheral blood to tissue

4.1.2.4.1. corticosteroids

4.1.3. agranulotcytosis

4.1.3.1. drug induced

4.1.3.1.1. levamisole-tainted cocaine use

4.1.4. left shift

4.1.4.1. metamyelocytes

4.1.4.2. myelocytes

4.1.4.3. promyelocytes

4.1.4.4. blasts

4.1.5. dysgranulopoiesis

4.1.5.1. myelodysplastic syndrome

4.1.5.1.1. circulating immature cells including blasts (auer rods)

4.1.5.1.2. Neutrophil changes

4.1.5.1.3. RBC changes

4.1.5.1.4. dysmegakaryopoiesis

4.2. Eosinophils

4.2.1. eosinophillia

4.2.1.1. pharmaceuticals

4.2.1.2. allergy

4.2.1.3. asthma

4.2.1.4. infection with parasite

4.2.1.4.1. Filariasis

4.2.1.5. classical hodgkins lymphoma

4.2.1.6. Chronic Adrenal Insufficiency

4.3. Basophils

4.3.1. basophillia

4.3.1.1. allergy

4.3.1.2. hypothyroidism

4.3.1.3. malignancy

4.3.1.3.1. CML

4.4. Monocytes

4.4.1. monocytosis

4.4.1.1. malignancy

4.4.1.1.1. carcinoma

4.4.1.1.2. multiple myeloma

4.4.1.1.3. lymphoma

4.4.1.2. chronic infections

4.4.1.2.1. tuberculosis

4.4.1.2.2. bacterial endocarditis

4.4.1.2.3. rickettsia

4.4.1.2.4. malaria

4.4.1.3. autoimmune disorders

4.4.1.3.1. SLE

4.4.1.4. regeneration of marrows

4.4.1.4.1. bone marrow transplant

4.4.1.4.2. chemotherapy

4.4.1.5. splenectomy

4.4.1.6. neutropenia

4.4.1.7. EBV

4.4.2. monocytopenia

4.5. Lymphocytes

4.5.1. lymphocytosis

4.5.1.1. activated

4.5.1.1.1. post-vaccination

4.5.1.1.2. cytomegalovirus

4.5.1.1.3. viral hepatitis

4.5.1.1.4. ebstein-barr virus

4.5.1.2. non-activated

4.5.1.2.1. stress

4.5.1.2.2. over-production

4.5.2. lymphocytopenia

4.5.2.1. glucocorticoids

4.5.2.2. infections

4.5.2.2.1. HIV

4.5.2.3. congenital immunodeficiencies

4.5.2.4. autoimmune diseases

4.5.2.5. malnutrition

5. 161206L2 Coagulation Pharmacology

5.1. Pro-Bleeding

5.1.1. Antiplatelet

5.1.1.1. prevent activation

5.1.1.1.1. Thromboxane pathway

5.1.1.1.2. Protein Kinase A pathway

5.1.1.2. prevent aggregation

5.1.1.2.1. abciximab (Reopro)

5.1.2. Anticoagulant

5.1.2.1. parenteral

5.1.2.1.1. Direct thrombin (2a) inhibitors

5.1.2.1.2. Binds with Antithrombin to inactivate F10a

5.1.2.1.3. Inactivates factors 5a and 8a

5.1.2.2. oral

5.1.2.2.1. Direct F10a inhibitors

5.1.2.2.2. Direct thrombin (F2a) inhibitors

5.1.2.2.3. Epoxide reductase inhibitor

5.1.3. Fibrinolytic

5.1.3.1. rTPA

5.1.3.1.1. recombinant tissue plasminogen activator

5.1.3.2. streptokinase

5.1.3.2.1. activates [plasminogen --> plasmin]

5.2. Pro-Hemostasis

5.2.1. Fibrinolytic Inhibitors

5.2.1.1. transexamic acid

5.2.2. Reversal

5.2.2.1. protamine sulfate

5.2.2.1.1. heparin reversal

5.2.2.2. kcentra

5.2.2.2.1. warfarin reversal

5.2.2.3. idarucizumab

5.2.2.3.1. dabigatran reversal

6. 161208L2 Bone Marrow Failure

6.1. Constitutional

6.1.1. Fanconi anemia

6.1.1.1. chromosomal breakage repair mechanism is broken. pancytopenia by age 7

6.1.2. dyskeratosis congenita

6.1.2.1. shortened telomeres cause bone marrow failure by age 20

6.1.3. Shwachman-Diamond

6.1.3.1. mutation to RNA processing genes (chr 7) cause bone marrow failure and exocrine pancreatic insufficiency in infancy

6.1.4. Diamond-Blackfan syndrome (red cell aplasia)

6.1.4.1. mutations to ribosomal genes cause morphological abnormalities, erythroid precursor problems

6.2. Acquired

6.2.1. Acquired Aplastic anemia

6.2.1.1. pathogenesis

6.2.1.1.1. cytotoxic T cells induce apoptosis of hematopoietic progenitors

6.2.1.2. causes

6.2.1.2.1. idiopathic

6.2.1.2.2. pharmaceuticals

6.2.1.2.3. Infection

6.2.2. bone marrow replacement

6.2.2.1. leukemia

6.2.2.2. lymphoma

6.2.2.3. metastatic cancer

6.2.2.4. fibrosis

6.2.3. ineffective hematopoiesis

6.2.3.1. myelodysplastic syndrome

6.2.3.2. B12/folate deficiency

6.2.3.3. copper deficiency

7. Liquid Tumors

7.1. Leukemia (bone marrow)

7.1.1. Lymphoid

7.1.1.1. T cell

7.1.1.1.1. Mature

7.1.1.1.2. Precursor

7.1.1.2. B cell

7.1.1.2.1. Mature

7.1.1.2.2. Precursor

7.1.2. Myeloid

7.1.2.1. Mature (Myeloproliferative Disorders)

7.1.2.1.1. Chronic Myeloid Leukemia

7.1.2.1.2. Polycythemia Vera

7.1.2.1.3. Essential Thrombocytopenia

7.1.2.1.4. Primary Myelofibrosis

7.1.2.2. Precursor

7.1.2.2.1. Acute Myeloid Leukemia (AML)

7.1.3. Myelodysplastic Syndrome

7.2. Lymphoma (lymph nodes)

7.2.1. T cell

7.2.1.1. Mature

7.2.1.1.1. T-cell lymphoma (TCL)

7.2.1.1.2. Peripheral T cell lymphoma, unspecifed

7.2.1.1.3. Mycosis Fungoides

7.2.1.2. Precursor

7.2.1.2.1. Precursor T lymphoblastic lymphoma

7.2.2. B cell

7.2.2.1. Mature

7.2.2.1.1. Germinal Center B cells

7.2.2.1.2. Diffuse Large B cell lymphoma

7.2.2.1.3. Mantle zone B cells

7.2.2.1.4. Memory B cells

7.2.2.2. Precursor

7.2.2.2.1. B Acute Lymphoblastic Lymphoma (B-ALL)

7.2.3. Langerhans cell histiocytosis

7.2.3.1. letterer-siwe disease

7.2.3.2. eosinophilic granuloma

7.2.3.3. hand-schuller-christian disease

8. Hematologic Anti-neoplastics

8.1. Classical

8.1.1. akylating agents

8.1.1.1. bendamustine

8.1.1.2. chlorambucil

8.1.1.3. cyclophosphomide

8.1.1.4. dacarbazine

8.1.2. anti-tumor antibiotic

8.1.2.1. bleomycin

8.1.2.2. doxorubicin

8.1.3. antimetabolite

8.1.3.1. cytarabine

8.1.3.2. methotrexate

8.1.4. immunomodulatory

8.1.4.1. interferon

8.1.4.2. thalidomide

8.1.5. purine analog

8.1.5.1. cladribine

8.1.5.2. fludarabine

8.1.5.3. mercaptopurine

8.1.5.4. pentostatin

8.1.6. vinca alkaloid

8.1.6.1. vinblastine

8.1.6.2. vincristine

8.2. New

8.2.1. mab

8.2.1.1. bortezomib

8.2.1.2. brentuximab

8.2.1.3. eculizumab

8.2.1.4. ibrutinib

8.2.1.5. idelalisib

8.2.1.6. imatinib

8.2.1.7. rituximab

8.2.1.8. ruxolitinib

8.3. Other

8.3.1. glucocorticoid

8.3.1.1. hydrocortisone

8.3.1.2. prednisone

8.3.2. immunomodulatory

8.3.2.1. horse anti-thymocyte globulin

8.3.2.2. cyclosporine

8.3.3. inorganic compound

8.3.3.1. arsenic trioxide

8.3.3.2. bisphosphonate

8.3.4. organic compound

8.3.4.1. all-trans retinoic acid

8.3.4.2. asparaginase