Protocols - Hemorio
Protocols - Hemorio
Protocols - Hemorio
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ALGORITHM OF INVESTIGATION OF THE MACROCYTIC ANEMIAS:<br />
LOW<br />
TEST B12<br />
VIT B12 DEFICIENCY<br />
Pernicious anemia, Senility<br />
Changed absorption<br />
FOLIC TEST<br />
FOLIC DEFICIENCY<br />
Lack of food, increased demand,<br />
alcoholism<br />
MO / CYTOGENETICS<br />
SMD<br />
VCM > 100 fl<br />
RETICULOCYTE<br />
INVESTIGATION OF LYMPHONODOMEGALIAS<br />
LOCATED LYMPHONODOMEGALIA GENERAL LYMPHONODOMEGALIA<br />
Viruses, bacterial<br />
viral, (mononucleosis, rubella, dengue, CMV, HIV),<br />
CERVICAL<br />
infections, LA,<br />
paracoccus, BK, DH<br />
neoplasias, sarcoidosis<br />
INFECTIONS<br />
toxoplasmosis, syphilis, calazar, brucelosis,<br />
lysteriosis, hystoplasmosis, etc.<br />
OCCIPITAL Local infections,<br />
DH, LNH, MF, LLC,<br />
RETRO<br />
AURICULAR<br />
syphilis, BK, rubella. NEOPLASIA Immunoglobulinopathies<br />
SUPRA<br />
Idem + neoplasias + HYPERSENSI Anticonvulsant, ac. PAS, ionized, phenylbutazone,<br />
CLAVICULAR LNH<br />
TIVITY serum disease, vaccine<br />
MEDIASTINAL<br />
Idem + infections, DH,<br />
LNH, pulmonary<br />
abscess<br />
COLLA<br />
GENOUS<br />
LES, AR, Mix Disease of collagen, Sögren<br />
Syndrome<br />
RETRO<br />
PERITONEAL<br />
Acute infections,<br />
salmonelosis, BK, and<br />
abscess, LNH<br />
OTHERS<br />
Hystiocytosis X, D. of Wipple, mastocytosis,<br />
exfoliative dermatitis, amylloidosis<br />
INVESTIGATION OF LYMPHONODOMEGALIAS:<br />
CLINICAL<br />
CONDUCT<br />
1. Request Hemogram + VHS, LDH<br />
2. Mononucleosis Serology, HIV, CMV, syphilis, toxoplasmosis<br />
SUSPICION CASES 3. PPD, Chest X-Ray (dispensed in an urgency)<br />
4. Ganglial biopsy (dispensed in an urgency)<br />
5. Register / Hospitalize<br />
1. Send to the origin post, with a report (infection ?)<br />
NON-SUSPICION CASES<br />
2. Return if there is any suspicion<br />
1. Request Hemogram + VHS, LDH<br />
2. Mononucleosis Serology, HIV, CMV, syphilis, toxoplasmosis<br />
DOUBTFUL CASES<br />
3. Rubella, PPD, Chest X-Ray<br />
4. Ganglial biopsy<br />
LEUKOPENIA INVESTIGATION<br />
- In the cases of ISOLATED leukopenias, just investigate neutropenias below 1,200/mm 3<br />
- Above this value, send to the Clinician in order to remove any clinical cause (familiar leukopenia,<br />
hepatitis, LES, HIV, etc.)<br />
- Investigate ALL cases of BI or Pancytopenia<br />
187<br />
HIGH<br />
IMMUNOHEMATOLOGICAL STUDY<br />
AHAI<br />
HEMOGLOBIN STUDY<br />
HERITAGE<br />
HEMOGLOBINOPATHY<br />
CD 55 and CD 59<br />
HPN
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