Normal MCV: Acute loss, ACD.
Low MCV: Iron-def, Thalaessaemia. (Mennorhagia)
High MCV: B12/Folate def.
Neutrophilia = Infection. Infarct. Inflammation. Cancer. Myeloproliferative. Preggers/exercise.
Eosinophilia – Steroids. Asthma etc.
Lymphophilia: CLL/Lymphoma/NO SPLEEN/renal failure–> raised lymphocytes.
a) Reactive i.e. cancer, chronic inflammation, no spleen (raised lympho’s and platelets), haemolysis (raised platelets)
b) Cancer: PCV. Myelfibrosis. ET.
– Infilitration of marrow e.g. by lymphoma, myelofibrosis.
– Nutrients: Low B12/folate –> macrocytic anaemia and low platelets.
– Destruction: DIC/ITP/Infections
– Too much of a spleen – Lymphoma or liver disease causing hypersplenism.
Too much spleen –> low platelets. Too little spleen –> High platelets. Paradoxical buggers, platelets.
– Acidosis releases potassium.
– Renal failure causes high potassium.
– Addisons (adrenocortical deficiency) causes high potassium.
– Digoxin and amiloride cause high potassium.
Big K+: No P wave, prolonged PR interval, broad QRS, peaked T waves. Eventually hyperkalaemia causes sinusoidal.
Hyperkalaemia = Ca gluconate, Insulin-Dex, Neb Sab, Dialysis
Low K+: Renal or GI loss.
1) Renal loss – RTA, Conn’s (lots of aldosterone).
2) GI loss via D + V (Eloise had LOW POTASSIUM and she is also an asthmatic – sab!)
3) Insulin causes low potassium. Acidosis causes high potassium.
Low Na: Replace no more than 10mMol in a day
High Na: Due to water loss e.g. too many drips, Inspidus, Conn’s (aldosterone!)
Addison’s is reduced adrenocortical drive. Low Na, high K+, high Ca++.
Cushing’s is excess of glucocorticoids (cortisol up). OPPOSITE of ADDISON’S.
Conn’s is excess of aldosterone. Low K+ with normal or high sodium.
Raised urea, normal creatinine = dehydration, GI bleed, high protein diet.
Urea + creatinine up = Renal failure.
CRF –> Causes anaemia of chronic disease, lowered Calcium in chronic renal failure, high phosphate.