Title: Bone Wizardry / Mnemonics / Hematology
Tags: bw-mnemonics hematology
On every note of this deck, unless a note says otherwise:
System: hematology

Acronym: Psammoma Bodies: Papillary Thyroid, Serous Ovarian, Meningioma, Mesothelioma
Title: Laminated Calcified Structures
Emoji: 🔬
Path: ? P
. 📋 Papillary thyroid carcinoma
? S
. 🫁 Serous ovarian cystadenocarcinoma
? M
. 🧠 Meningioma (benign brain tumor)
? M
. 🫁 Mesothelioma (asbestos)
? Note
. Concentric calcified lamellae on histology
? Note
. All carcinomas EXCEPT meningioma (benign)
? Note
. NOT medullary thyroid CA

Acronym: Coombs: Direct = ON cell (Warm IgG, Cold IgM); Indirect = IN plasma
Title: Antiglobulin Testing
Emoji: 🧪
Path: ? Direct
. 🔴 Antibodies ON the RBC (in vivo): detects autoimmune hemolysis
? Indirect
. 🧫 Antibodies IN the plasma (in vitro): pre-transfusion crossmatch
? Warm
. 🌡️ IgG at 37C: extravascular hemolysis in spleen
? Cold
. ❄️ IgM at 4C: intravascular hemolysis + complement
? Note
. Direct Coombs+: AIHA, HDN, drug-induced
? Note
. Indirect: does recipient have anti-donor antibodies?
? Note
. Warm AIHA: SLE, CLL, methyldopa

Acronym: RBC Morphology: Shape = Diagnosis
Title: Peripheral Smear Associations
Emoji: 🔬
Path: ? Heinz
. 💜 G6PD: denatured Hb precipitates (bite cells too)
? Howell-Jolly
. ⚫ Asplenia: nuclear remnants not cleared
? Schistocytes
. 🔪 Microangiopathic: TTP/HUS, DIC, mech valves
? Target
. 🎯 Iron deficiency, thalassemia, liver disease
? Tear drops
. 💧 Myelofibrosis: squeezed from fibrotic marrow
? Basophilic stippling
. 🔵 Lead poisoning (also thalassemia, sideroblastic)
? Note
. Schistocytes = hallmark of MAHA
? Note
. Howell-Jolly = functional asplenia confirmed
? Note
. Heinz bodies need supravital stain (crystal violet)

Acronym: Aplastic Anemia: Parvo B19 (#1), Chloramphenicol, Benzene, AZT, Vinblastine
Title: Bone Marrow Failure Causes
Emoji: 🦴
Path: ? Parvovirus B19
. 🦠 #1 cause: attacks erythroid precursors
? Chloramphenicol
. 💊 Dose-independent, irreversible, idiosyncratic
? Benzene
. 🏭 Industrial exposure, also increases leukemia risk
? AZT
. 💊 Zidovudine: bone marrow suppression
? Vinblastine
. 💉 "Blasts the marrow" (vinca alkaloid)
? Note
. Pancytopenia + hypocellular (fatty) marrow on biopsy
? Note
. Tx: BMT (young) or immunosuppression (ATG + cyclosporine)
? Note
. Fanconi anemia: inherited + short stature + thumb anomalies

Acronym: 3 Types of Hemoglobin
Title: Normal hemoglobin variants
Emoji: 🩸
Path: ? Hb A (2 alpha, 2 beta)
. 🔴 98% of adult hemoglobin
? Hb A2 (2 alpha, 2 delta)
. 🔴 2% of adult hemoglobin
? Hb F (2 alpha, 2 gamma)
. 🔴 Fetal; high O2 affinity, low 2,3-DPG affinity

Acronym: Factors That Shift O2-Hb Curve Right
Title: Increase O2 delivery to tissues
Emoji: 📈
Path: ? Increased CO2
. 💨 Hypercapnia
? Increased acid (low pH)
. 🧪 Acidosis
? Increased 2,3-DPG
. 🔬 Hypoxia response
? Increased exercise
. 🏃 Metabolic demand
? Increased temperature
. 🌡️ Raised BMR

Acronym: 3 Adaptations to Chronic Hypoxia
Title: High-altitude training effects
Emoji: 🏔️
Path: ? Polycythemia
. 🩸 EPO released, more RBCs
? Increased mitochondrial density
. ⚡ More ATP, stay in first-order
? Increased angiogenin
. 🌿 More vessels to muscles

Acronym: 4 Functions of the Spleen
Title: What the spleen removes
Emoji: 🫘
Path: ? Old RBCs (spherocytes)
. 🔴 Aged cells
? Oddly shaped RBCs
. 🔴 Abnormal morphology
? Nuclear remnants (Howell-Jolly bodies)
. 🔵 From old RBCs
? Encapsulated organisms
. 🦠 Strep pneumo, HiB, Meningococcus

Acronym: 4 Complications of Vaso-Occlusive Crisis
Title: Sickle cell crisis complications
Emoji: 🫁
Path: ? CVA
. 🧠 Cerebrovascular accident
? Pulmonary infarction
. 🫁 Lung ischemia
? Splenic sequestration
. 🫘 Blood trapping
? Priapism
. ⬆️ Penile ischemia

Acronym: Iron Deficiency Anemia MCC by Age
Title: Most common cause varies by age
Emoji: 🩸
Path: ? Children
. 🍼 Inadequate intake
? Young adults
. 🍔 Inadequate intake
? Adults 20-40
. 🫁 IBD
? Men over 40
. 🩸 GI bleeding (rule out colon cancer)
? Women over 40
. 🩸 Endometrial bleeding (rule out cancer)

Acronym: Iron Deficiency vs Chronic Disease Labs
Title: Lab differentiation
Emoji: 🧪
Path: ? Serum Fe
. ⬇️ Low in both
? Ferritin
. ⬇️ Low in iron deficiency; normal/high in chronic disease
? TIBC (transferrin)
. ⬆️ High in iron deficiency; low in chronic disease

Acronym: 9 Blood Products
Title: Types and uses
Emoji: 🩸
Path: ? Whole blood
. 🩸 Acute hemorrhage/trauma only
? FFP
. 🩸 All clotting factors; acute bleeding disorder
? PRBCs
. 🩸 Anemic patient; raises Hb by 1-2 g
? Platelets
. 🩸 BM suppression; not for destructive processes
? DDAVP
. 🩸 Releases Factor 5, 8, vWF; mild hemophilia A
? Factor 8 concentrate
. 🩸 Severe hemophilia A
? Albumin
. 🩸 Volume expander (5% isotonic, 25% hypertonic)
? Cryoprecipitate
. 🩸 Factor 8, fibrinogen, vWF; moderate hemophilia A
? Immunoglobulins
. 🩸 Passive immunity; blocking antibodies

Acronym: 5 Transfusion Reactions
Title: Types of transfusion adverse events
Emoji: ⚠️
Path: ? Anaphylaxis
. 😱 Selective IgA deficiency; stop transfusion, epinephrine
? Acute febrile reaction
. 🌡️ WBC antigens
? ABO incompatibility
. 🩸 Most common; stop, re-type and cross
? TRALI
. 🫁 Cytokine release, ARDS picture; steroids
? TACO
. 💧 Circulatory overload; vigorous diuresis

Acronym: Hemochromatosis Organ Involvement
Title: Iron overload deposition
Emoji: 🟤
Path: ? Skin
. 🟫 Bronze pigmentation
? Liver
. 🟫 Bronze cirrhosis
? Pancreas
. 🟫 Bronze diabetes
? Heart
. 🟫 Restrictive cardiomyopathy
? Joints
. 🟫 Arthritis

Acronym: 3 Important Porphyrias
Title: Key porphyria types
Emoji: 🔴
Path: ? Porphyria Cutanea Tarda . ☀️ Onset >1yr; skin blisters from sunlight; uroporphyrinogen decarboxylase def ? Acute Intermittent Porphyria . 🫁 5 Ps: Pain, Polyneuropathy, Psych, Pink urine, Precipitated by drugs ? Erythrocytic Protoporphyria . 👶 Onset <1yr; ferrochetalase def; burns from light; MCC death: skin infections

Acronym: Most Common Causes of Clotting
Title: Clotting etiologies
Emoji: 🩸
Path: ? MCC overall
. 🩸 Stasis
? MCC venous clots
. 🩸 Stasis
? MCC arterial clots
. 🩸 Endothelial injury, BM exposure
? MCC genetic venous clots
. 🩸 Factor V Leiden defect

Acronym: 3 Steps of Platelet Plug Formation
Title: Primary hemostasis
Emoji: 🩸
Path: ? Step 1: Adhesion
. 🔗 Collagen exposed, vWF binds collagen, GpIb binds vWF
? Step 2: Degranulation
. 💥 Release TXA2, ADP, Ca2+; exposes GpIIb/IIIa
? Step 3: Aggregation
. 🔗 Fibrinogen bridges GpIIb/IIIa on adjacent platelets

Acronym: 4 Classes of Anti-Platelet Drugs
Title: Antiplatelet categories
Emoji: 💊
Path: ? ADP-receptor blockers
. 💊 Clopidogrel, ticlopidine, ticagrelor, prasugrel
? PDE inhibitors
. 💊 Cilostazol, dipyridamole
? GpIIb/IIIa inhibitors
. 💊 Abciximab, eptifibatide, tirofiban
? COX inhibitors
. 💊 Aspirin (irreversible), NSAIDs (reversible)

Acronym: Hemophilia A Treatment by Severity
Title: Factor VIII deficiency management
Emoji: 💊
Path: ? Mild bleeding
. 💊 DDAVP
? Moderate bleeding
. 💊 Cryoprecipitate
? Severe bleeding
. 💊 Factor VIII concentrate

Acronym: Direct Factor Xa Inhibitors
Title: Newer anticoagulants
Emoji: 💊
Path: ? Rivaroxaban
. 💊 Factor Xa inhibitor
? Apixaban
. 💊 Factor Xa inhibitor
? Edoxaban
. 💊 Factor Xa inhibitor

Acronym: Leukemia by Age Range
Title: Which leukemia to pick based on patient age
Emoji: 🩸
Path: ? ALL: age 0-15, PAS+, TdT+, CALLA+
. 👶 youngest patients get lymphoblastic
? AML: age 15-30, Auer rods, Sudan Black+, t(15;17)
. 🔬 young adults with worst prognosis
? CML: age 30-50, t(9;22) Philadelphia chromosome, BCR-abl
. ⚗️ mid-age peripheral cancer
? CLL: age >50, B-lymphocytes elevated, diffuse lymphadenopathy
. 👴 oldest patients, slow growing

Acronym: Drugs That Cause Leukopenia
Title: Common drugs that blast the bone marrow
Emoji: 💊
Path: ? Vinblastine
. 💉 vinca alkaloid chemotherapy
? AZT
. 💉 antiretroviral nucleoside analog
? Chloramphenicol
. 💉 protein synthesis inhibitor
? Benzene
. 🏭 industrial solvent exposure

Acronym: Lymphoma Staging (1-4)
Title: Staging system for lymphomas and solid tumors
Emoji: 📊
Path: ? Stage 1: one group of lymph nodes
. 📍 single location
? Stage 2: two groups, same side of diaphragm
. 📍📍 ipsilateral
? Stage 3: both sides of diaphragm
. ↕️ crosses the diaphragm
? Stage 4: metastases
. 🌐 distant spread

Acronym: Hodgkin Lymphoma Subtypes by Prognosis
Title: RS cell count correlates inversely with prognosis
Emoji: 📉
Path: ? Lymphocyte Predominant: best prognosis, RS negative
. 😊 most lymphocytes = best outcome
? Nodular Sclerosis: more common in women, fewest RS cells, intermediate
. 👩 RS+ but low count
? Mixed Lymphocytic-Histiocytic: most RS cells (lacunar cells), intermediate
. 🔬 RS+ heavy
? Lymphocyte Depleted: worst prognosis, paucity of lymphocytes
. 💀 fewest lymphocytes = worst

Acronym: Myelodysplastic Syndromes
Title: Hyper vs hypoproliferative bone marrow diseases
Emoji: ⚖️
Path: ? Polycythemia Rubra Vera: all lines up, RBC most, HCT >60%, itching after hot bath, uric acid stones
. 🔴 hyperproliferative, increased LAP
? Essential Thrombocythemia: all lines up, platelets >600k, death from heart failure
. 🟣 too many platelets clot vessels
? Aplastic Anemia: all lines depleted, marrow replaced by fat, low reticulocytes
. ⬜ hypoproliferative, virus or drug cause
? Myelofibrosis: marrow replaced by scar, tear drop cells, low reticulocytes
. 🟤 cancer destroyed marrow

Acronym: ABO Blood Type Sugars
Title: Which sugar goes on which blood type
Emoji: 🍬
Path: ? A: Galactosamine
. 🅰️ amino sugar
? B: Galactose
. 🅱️ simple sugar
? O: Fucose
. 🅾️ base sugar only
? AB: both Galactosamine and Galactose
. 🆎 combination

Acronym: Grades of Anemia
Title: Severity classification
Emoji: 🩸
Path: ? Mild . 📊 Hb <11 (Hct 33) ? Moderate . 📊 Hb <9 (Hct 27) ? Severe . 📊 Hb <7 (Hct 21)

Acronym: 7 Drugs Causing Hemolytic Anemia
Title: Drug-induced hemolysis
Emoji: 💊
Path: ? Penicillins
. 💊 Immune-mediated
? Cephalosporins
. 💊 Immune-mediated
? Sulfa drugs
. 💊 Oxidative stress
? Alpha-methyldopa
. 💊 Autoimmune
? PTU
. 💊 Autoimmune
? Antimalarials
. 💊 Oxidative stress
? Dapsone
. 💊 Oxidative stress

Acronym: RBC Morphology and Causes
Title: What RBCs tell you
Emoji: 🔬
Path: ? Reticulocyte
. 🔬 Immature RBC; bone marrow is working
? Howell-Jolly bodies
. 🔬 Nuclear remnants; splenectomy
? Spherocytes
. 🔬 MCC: aged RBC; hereditary spherocytosis
? Schistocytes
. 🔬 Sheared RBCs; vasculitis
? Tear drop cells
. 🔬 Squeezed from BM; cancer in BM
? Target cells
. 🔬 Less Hb; iron deficiency, thalassemia
? Heinz bodies
. 🔬 Oxidized Hb; G6PD deficiency
? Basophilic stippling
. 🔬 Too many Heinz bodies; lead poisoning
? Acanthocytes
. 🔬 Lipid-coated RBC; hyperlipidemia, nephrotic syndrome

Acronym: Causes of Microcytic Hypochromic Anemia
Title: Low MCV, Low MCH
Emoji: 🩸
Path: ? Iron deficiency
. 🩸 Most common overall; low Fe, low ferritin, high TIBC
? Late chronic disease
. 🩸 Hepcidin; low Fe, normal/high ferritin, low TIBC
? Lead poisoning
. 🩸 Blocks delta-ALA dehydratase and ferrochetalase
? Thalassemia
. 🩸 Gene deletions
? Sideroblastic anemia
. 🩸 Hereditary; iron-stippled macrophages; Prussian blue stain

Acronym: Causes of Macrocytic Anemia
Title: High MCV
Emoji: 🩸
Path: ? B12 deficiency
. 🩸 MCC: pernicious anemia; neuropathy
? Folate deficiency
. 🩸 MCC: overcooked veggies
? Hypothyroidism
. 🦋 Permissive hormones needed
? Alcohol
. 🍺 Denatures proteins
? Chemotherapy drugs
. 💊 Damage DNA
? Anticonvulsants
. 💊 Block calcium and/or folate

Acronym: Causes of Aplastic Anemia
Title: Bone marrow failure
Emoji: 🦴
Path: ? Parvovirus B19
. 🦠 MCC; attacks BM
? Chloramphenicol
. 💊 Dose-dependent and independent
? Benzene
. 🧪 Chemical
? AZT
. 💊 Antiretroviral
? Vinblastine
. 💊 Blasts the marrow

Acronym: 3 Adaptations to Chronic Hypoxia (II)
Title: Body response to chronic low O2
Emoji: 🫁
Path: ? Increased EPO production
. 🩸 Kidney releases EPO, stimulates bone marrow
? Increased mitochondrial density
. ⚡ More ATP in skeletal muscle
? Angiogenesis
. 🌿 New blood vessels; leads to digital clubbing