Muhammad's spleen is palpable

causes of leukocytosis
1. Neoplastic
  1. Histiocytic Neoplasms
  2. Lymphoid Neoplasms
    1. Hodgkin's lymphoma
    2. Non Hodgkin's lymphoma
    3. multiple myeloma
    4. WBC (lymphocyte) proliferations leading to discrete tissue masses in lymphoid organs -lymphoma
    5. Acute Lymphoblastic Leukemia/ Lymphoma
      1. 0-14 years
      2. composed of pre-B or pre-T lymphoblasts
      3. abrupt onset
      4. blood film showing blasts
      5. immunophenotyping= +Tdt and +Pas
    6. Chronic Lymphocytic Leukemia
      1. age=60+
      2. proliferation of neoplastic lymphoid cells (B cells)
      3. C/P=hepatosplenomegaly and lymphadenopathy
      4. absolute lymphocytosis-hypogammaglobulinemia
        IHC=CD5+
  3. Myeloid Neoplasms
    1. Acute Myeloid Leukemia
      1. 15-60 years of age
      2. Abrupt Onset
      3. C/P=Pancytopenia
        Immunophenotype= CD13+ & MPO+
        >20% blast cells in BM and blood
      4. may present as discrete tissue masses-chloroma
      5. FAB classification
        M3=RARA t(15:17)
        treatment=ATRA
        can present as DIC
    2. Chronic Myeloproliferative Disorder
      1. hyper proliferation of neoplastic myeloid progenitor cells while retaining capacity for terminal differentiation
        JAK mutation
        polycythemia vera
        primary myelofibrosis
        Essential thrombocythemia
        Chronic Myeloid Leukemia
        Etiology
        more than 95% of patients with Philadelphia chromosome
        increase activity of tyrosine kinase due to formation of BCR-ABL complex
        escape from apoptosis
        less dependant on GF
        activation of RAS
        Treatment=tyrosine kinase inhibitor
        Imatinib
        Annual incidence= 1 to 2 cases per 100,00
        abrupt onset of pancytopenia
        40-60 years
        stages
        Investigations
        CBC
        Blood film
        Genetic tests
        FISH
        PCR
2. Reactive
  1. Neutrophilia
    1. bacterial infections
    2. corticosteroids
    3. MI
  2. Lymphocytosis
    1. viral infections
    2. phenytoin
  3. Eosinophilia
    1. Type 1 hypersensitivity
    2. helminthic infection
  4. Monocytosis
    1. Chronic infection
    2. Autoimmune disease
    3. Malignancy
  5. Leukemoid Reaction
    1. excessive leukocytosis
      1. 15-100,00/mm3
    2. elevated NAP
    3. toxic granulations & doehle bodies
Hematological History Taking
1. Anemia symptoms
  1. Fatigue, weakness
  2. dyspnea
  3. palpatations
  4. dizziness
  5. splenomegaly
    1. feeling of fullness
2. WBC symptoms
  1. infections
  2. LN swelling
  3. B symptoms
    1. weight loss
    2. fever
    3. night sweats
3. platelet symptoms
  1. rashes
  2. ecchymosis
  3. easy bruising
  4. gum/nose bleeding
4. Past medical/surgical history
  1. transfusions
  2. GI surgery
  3. Drugs
    1. NSAID
    2. corticosteroids
    3. warfarin
5. Haematological Physical RExamination
  1. Inspection
    1. hand
      1. nail changes
      2. pale palmar creases
    2. forearm
      1. scratch marks
      2. joint swelling
    3. eyes
      1. pallor
      2. jaundice
    4. mouth
      1. angular stomatitis
      2. gum hypertrophy
  2. Palpation
    1. of Lymph nodes
      1. Cervical
      2. Axillary
      3. Inguinal
      4. epitrochlear

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Muhammad's spleen is palpable

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	Criado por Salma Mk aproximadamente 7 anos atrás