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Anemia by Mind Map: Anemia

1. Hemostatic Disorders

1.1. Primary (Platelet Sticking)

1.1.1. Disorders of Platelets Qualitative (bad platelets) Platelet Aggregation Disorder Platelet Function Disorder Platelet Adhesion Disorder Quantitative (Too few platelets) Thrombocytopenia

1.1.2. Disorders of von Willebrand Factor Type 1 treatment is desmopressin Type 2 treatment is factor concentrates Type 3 treatment is factor concentrates

1.1.3. Disorders of connective tissue Marfans Ehlers-Danlos Osteogenesis Imperfecta

1.2. Secondary (Clotting)

1.2.1. Congenital Hemophilia A Hemophilia B Hemophilia C

1.2.2. Acquired Liver Disease Acquired Inhibitors antibodies against certain factors Disseminated Intravascular Coagulation Obstetric complications  Intravascular hemolysis  Septicemia  Viremia  Malignancy  Leukemia  Snake bites  Burns  Crush injuries  Tissue necrosis  Liver disease  Prosthetic devices  Peripheral vascular disorders  Surgery

2. Anemia II

2.1. Microcytic

2.1.1. Anemia of Chronic Disease Chronic inflammation Cancer

2.1.2. Iron Deficiency Anemia Nutritional Lack Malnutrition Malabsorption Blood loss Peptic Ulcer Disease Menorrhagia Carcinoma (colonic polyps)

2.1.3. Sideroblastic Anemia Congenital ALAS deficiency Acquired Alcoholism Lead poisoning Vitamin B6 deficiency

2.1.4. Thalassemia alpha 1 gene deleted 2 genes deleted 3 genes deleted 4 genes deleted beta Normal Beta/Mutated Beta Mutated Beta/Mutated Beta Absent Beta/Mutated Beta Absent Beta/Absent Beta Hb Barts (gamma globin tetramers)

2.2. Normocytic

2.2.1. Underproduction Renal failure (decreased EPO) Damage to bone marrow precursor cells Parvovirus B19 Aplastic Anemia Myelophthisic Process

2.2.2. Hemolysis Predominant Intravascular Paroxysmal Nocturnal Hemoglobinuria G6PD Deficiency Immune Hemolytic Anemia Microangiopathic Hemolytic Anemia Malaria Predominant Extravascular Hereditary Spherocytosis Sickle Cell Anemia Hemoglobin C

2.3. Macrocytic

2.3.1. Megaloblastic Anemia Folate Deficiency Dietary deficiency (months) Increased demand Folate antagonists Vitamin B12 Deficiency Dietary deficiency (years) Malabsorption

2.3.2. Liver Disease Alcoholism Hepatitis

2.3.3. Drugs

2.3.4. Myelodysplastic Syndrome

3. Thrombophillia

3.1. Alterations in blood flow

3.1.1. Arterial/Aortic Aneurysms Dilated atrium Atrial Fibrillation Mitral valve stenosis Left ventricular dysfunction Ulcerated atherosclerotic plaques

3.1.2. Venous vascular access mechanical compression prolonged immobilization surgery congestive heart failure pregnancy malignancy varicose veins dehydration

3.1.3. Hyperviscosity Polycythemia Primary 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 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 Factor 5 leiden Factor 2 hyperprothrombinemia Antithrombin deficiency Protein C deficiency Type 1 (quantitative) Type 2 (qualitative) Protein S deficiency

3.3.2. Acquired Antithrombin deficiency secondary to nephrotic syndrome heparin induced thrombocytopenia antiphospholipid syndrome cancer estrogen therapy pregnancy decreased protein S increased fibrinogen + prothrombin increased estrogen impaired fibrinolysis vascular congestion

4. 161209L1 WBC Abnormalities

4.1. Neutrophils

4.1.1. neutropenia decreased production pharmaceuticals viral infections EtOH congenital increased demand autoimmune drug-induced sequestration splenomegaly

4.1.2. neutrophillia increased production infections inflammation pharmaceuticals malignancy release of immature cells leukemoid reaction leukoerythroblastic reaction demargination epinephrine exercise glucocorticoids stress sickle cell anemia decreased egress from peripheral blood to tissue corticosteroids

4.1.3. agranulotcytosis drug induced levamisole-tainted cocaine use

4.1.4. left shift metamyelocytes myelocytes promyelocytes blasts

4.1.5. dysgranulopoiesis myelodysplastic syndrome circulating immature cells including blasts (auer rods) Neutrophil changes RBC changes dysmegakaryopoiesis

4.2. Eosinophils

4.2.1. eosinophillia pharmaceuticals allergy asthma infection with parasite Filariasis classical hodgkins lymphoma Chronic Adrenal Insufficiency

4.3. Basophils

4.3.1. basophillia allergy hypothyroidism malignancy CML

4.4. Monocytes

4.4.1. monocytosis malignancy carcinoma multiple myeloma lymphoma chronic infections tuberculosis bacterial endocarditis rickettsia malaria autoimmune disorders SLE regeneration of marrows bone marrow transplant chemotherapy splenectomy neutropenia EBV

4.4.2. monocytopenia

4.5. Lymphocytes

4.5.1. lymphocytosis activated post-vaccination cytomegalovirus viral hepatitis ebstein-barr virus non-activated stress over-production

4.5.2. lymphocytopenia glucocorticoids infections HIV congenital immunodeficiencies autoimmune diseases malnutrition

5. 161206L2 Coagulation Pharmacology

5.1. Pro-Bleeding

5.1.1. Antiplatelet prevent activation Thromboxane pathway Protein Kinase A pathway prevent aggregation abciximab (Reopro)

5.1.2. Anticoagulant parenteral Direct thrombin (2a) inhibitors Binds with Antithrombin to inactivate F10a Inactivates factors 5a and 8a oral Direct F10a inhibitors Direct thrombin (F2a) inhibitors Epoxide reductase inhibitor

5.1.3. Fibrinolytic rTPA recombinant tissue plasminogen activator streptokinase activates [plasminogen --> plasmin]

5.2. Pro-Hemostasis

5.2.1. Fibrinolytic Inhibitors transexamic acid

5.2.2. Reversal protamine sulfate heparin reversal kcentra warfarin reversal idarucizumab dabigatran reversal

6. 161208L2 Bone Marrow Failure

6.1. Constitutional

6.1.1. Fanconi anemia chromosomal breakage repair mechanism is broken. pancytopenia by age 7

6.1.2. dyskeratosis congenita shortened telomeres cause bone marrow failure by age 20

6.1.3. Shwachman-Diamond 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) mutations to ribosomal genes cause morphological abnormalities, erythroid precursor problems

6.2. Acquired

6.2.1. Acquired Aplastic anemia pathogenesis cytotoxic T cells induce apoptosis of hematopoietic progenitors causes idiopathic pharmaceuticals Infection

6.2.2. bone marrow replacement leukemia lymphoma metastatic cancer fibrosis

6.2.3. ineffective hematopoiesis myelodysplastic syndrome B12/folate deficiency copper deficiency

7. Liquid Tumors

7.1. Leukemia (bone marrow)

7.1.1. Lymphoid T cell Mature Precursor B cell Mature Precursor

7.1.2. Myeloid Mature (Myeloproliferative Disorders) Chronic Myeloid Leukemia Polycythemia Vera Essential Thrombocytopenia Primary Myelofibrosis Precursor Acute Myeloid Leukemia (AML)

7.1.3. Myelodysplastic Syndrome

7.2. Lymphoma (lymph nodes)

7.2.1. T cell Mature T-cell lymphoma (TCL) Peripheral T cell lymphoma, unspecifed Mycosis Fungoides Precursor Precursor T lymphoblastic lymphoma

7.2.2. B cell Mature Germinal Center B cells Diffuse Large B cell lymphoma Mantle zone B cells Memory B cells Precursor B Acute Lymphoblastic Lymphoma (B-ALL)

7.2.3. Langerhans cell histiocytosis letterer-siwe disease eosinophilic granuloma hand-schuller-christian disease

8. Hematologic Anti-neoplastics

8.1. Classical

8.1.1. akylating agents bendamustine chlorambucil cyclophosphomide dacarbazine

8.1.2. anti-tumor antibiotic bleomycin doxorubicin

8.1.3. antimetabolite cytarabine methotrexate

8.1.4. immunomodulatory interferon thalidomide

8.1.5. purine analog cladribine fludarabine mercaptopurine pentostatin

8.1.6. vinca alkaloid vinblastine vincristine

8.2. New

8.2.1. mab bortezomib brentuximab eculizumab ibrutinib idelalisib imatinib rituximab ruxolitinib

8.3. Other

8.3.1. glucocorticoid hydrocortisone prednisone

8.3.2. immunomodulatory horse anti-thymocyte globulin cyclosporine

8.3.3. inorganic compound arsenic trioxide bisphosphonate

8.3.4. organic compound all-trans retinoic acid asparaginase