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Hematologic System (5%)

NLMEB - Never Let Monkeys Eat Bananas

The results of a White Count differential indicate the percentage of each type of white blood cell that is present in a sample of blood. This mnemonic helps you remember the cell types in descending order of presentation.

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• Neutrophils (AKA PMNs or PolyMorphonuclear Lymphocytes)
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• Lymphocytes (Not Leukocytes - all these are Leukocytes)
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• Monocytes
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• Eosinophils
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• Basophils
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If the WBC count is normal and the Lymphocyte count is high, or greater than the neutrophil count, be suspicious of an acute viral infection.

APETM - All Pigs Eat Too Much

Auscultate Aortic and Pulmonic at the 2nd intercostal space.\r\n

But place EKG leads 1 and 2 at the 4th intercostal space.\r\n

I was embarrassed in a debate when I confused the two spaces!\r\n

Anemias

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• Anemia of chronic disease
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• Aplastic anemia
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• Folate deficiency
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• G6PD deficiency
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• Hemolytic anemia
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• Iron deficiency
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• Sickle cell anemia
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• Thalassemia
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• Vitamin B12 deficiency
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Coagulation Disorders

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• Clotting factor disorders
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• Hypercoagulable states
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• Thrombocytopenia\r\n
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  • Idiopathic thrombocytopenic purpura
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  • Thrombotic thrombocytopenic purpura
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Malignancies

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• Acute/chronic lymphocytic leukemia
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• Acute/chronic myelogenous leukemia
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• Lymphoma
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• Multiple myeloma
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Thrombotic Thrombocytopenic Purpura can affect any organ system, including the blood, the CNS, and kidneys. It is diagnosed by bland thrombi in the microvasculature of the affected organs. These thrombi are made mainly of platelets with fibrin and red blood cells mixed in. The cause is unknown at present.

Henoch-Schönlein purpura is an inflammatory disorder characterized by a generalized vasculitis involving the small vessels of the skin, kidneys, GI tract, joints, lungs, and CNS. It is the most common vasculitis in children. It is thought to be an immunoglobulin A (IgA)-mediated autoimmune disease. An antigenic stimulant is thought to cause a rise in IgA, and the resulting antigen-antibody complexes deposit locally throughout the body and activate pathways leading to necrotizing vasculitis. Physical exam shows a rash, migratory polyarthritis, and renal and GI involvement. There will be antigen-antibody complexes depositing throughout the body, which can cause migratory arthralgias, abdominal cramping, the petechial and/or vasculitic rash, and hematuria. Lab tests would not show bacteria within the blood.\r\n