Activate Windows

Go to Settings to activate Windows.

GY59 Gynaecology Toronto Notes 2023

References

Agency lor Healthcare Research and Quality.Clinical Guidelines andRecommendations [Internet].Rockville (MD): U.S.Department olHealth and HumanServices:2020Sep [updated 2018 Jut:cited 2020 Jun 22].

Available from:https://wivw.ahrq.gov/prevenIion/guidelines/indei.html.

American Psychiatric Association.Diagnostic and statistical manualof mental disorders.5th ed.Washington OC:AmericanPsychiatricAssociation:2013.

Anawait 80,PageST.Causes of maleinfertility.In:Post T.editor.UpToDate.[Internet].Waltham,Mass.:UpToDate:2019[cited 2020 Jun 221Available fiom:wvm.uptodate.com.

Anderson GL,UmacherM.AssafAR,elal.effects of conjugated equine estrogen in postmenopausal women with hysterectomy - Women's HealthInitiative randomised controlled trial. JAMA 2004:291:1701 1712.

Aoki Y,Brown HW.Brubakerl.elal. Urinary incontinencein women.Hal Rev Ois Primers 2017:3:1-19.

Bdllsle S,Blake J.Basson R,ct al.Canadtan consensus conference onmenopause. J ObslclGynaecol Can 2006:28(2Suppl1):$1 $94.

Bentley J, Bertrand M.Brydon L.et al.Cotposcopic management of abnormal cervical cytology and histology. J ObstelGynaecol Can 2012:284:1188-1202.

Berek JS.Hacker NF.Gynecologic oncology.5th ed.trppincott Wtlliams S Wilkins;2010.

Birth Control Implant,jlnternet]New York|HY):Planned Parenthood:[cited 2021March 30],Available from:https://vvww.plannedparenthood.org/learn/birth-control/birth-control-implant-neiplanon.

Brannstrom M.Johannessonl.livebirth after uterus transplantation,lancet 2015;385:607-16.

Brunham RC.Gottlieb SL,PaavonenJ.Pelvic inflammatory disease. NEJM 2015;372(21):2039-2048.

Bump RC. Matliasson A.Bo K. ct al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction.Am J Obstel Gynecol1996:176|1):10-17.

Burger RA.Brady MF.Bookman MA.et al.Incorporation olbevaciiumab in the primary treatment of ovarian cancer HEJM 2011:365:2473 2483.

Burnett M.lemyre M. Ho.345-Primary dysmenorrhea consensus guideline.JObstel GynecolCan 2017;39[7):585-S95.

Buys SS,Partridgel.Black A.et al.Effect of screening on ovarian cancer mortality:the prostate,lung,colorectal and ovarian (PLCO) cancer screening randomized conbol trial.JAMA 2011:305:2295-2303.

Cancer Care Ontario [Internet].Ontario Canada:Cervical Screening alAge 25;[cited 2021.June1[.Available from:https://wvrw.cancercareontario.cai'en/node/68141

Centres for Disease Control andPrevention|C0C|.Recommendations on the use of quadrivalent human papillomavirus vaccine in males-Advisory Committee on Immunization Practices (AGP).MMWR

2011;60:1705-1708.

Committee on Gynecologic Practice.Committee Opinion No. 698:Hormone therapy in primary ovarian insufficiency.ObstelGynecol. 2017;129[5):e134- e141.

Cunningham FG.McDonald PC. Gant NF. Williams Obstetrics.14th ed.Norwalk: Appleton and langc;1993.

Curtis KM,Teppev HK.Jatlaoui TC,etal.U.S. Medical Eligibility Criteria for Contraceptive Use.2016.MMWR Recomm Rep 2016 Jul 29;65|3):1103.

Davey E,Barratt A.Irwigl.et al.Effect of study design and quality of unsatisfactory rates,cytology classifications,and accuracy in liquid based vs. conventional cervical cytology: Asystematic review.Lancet

2006:367:122-132.

Davis V,DunnS.SOGC Clinical Practice Guidelines:Emergency postcoital contraception.JObstelGynaecol Can 2000:22(7}:544-54B.

DelPriore G,Goff 8,FalkS.Endometrial Sampling Procedures.In:Post T.editor. UpToDate.[Internet].Waltham.Mass.:UpToDate;2019[cited 2020 Jun 22].Available from:wwvr.uptodate.com.

Dickey RP. Managing contraceptive pillpatients.9th ed.Fort Collins.CO:EMIS.Inc. Medical Publishers,1998,

OonnezJ.TomaszcwskiJ.VasquezF,etal.Ulipristal acetate vs.leuprolidc acetate for uterine fibroids. NEJM 2012:366(5):421 432.

Duffy JM,Arambage K,Correa FJ. el al.laparoscopic surgery for endometriosis.Cochrane DB Syst Rev 2014:4:00011031.

Dunn S. Guilbert E.SOGC Clinical PracticeGuidelines:Emergency contraception. JObstelGynaecol Can 2012:34(91:870-878.

Elsan CJ.Salim R.Potdar N,elal.Diagnosis and management of ectopic pregnancy.BJOG 2016;123:e15-e55.

Erdroan JN.Humanrights inhealth equity:Cervical cancer and HPV vaccines.Am J Law Med 2009:35:365-387.

Espeland MA.Rapp SR.Shumaker SA.et al.Conjugated equine estrogens and global cognitive function in postmenopausal women:Women’s HealthInitiative memory study. JAMA 2004:2912959-2968.

Fashokun T8.Rogers RG. Pelvic organ prolapse in women: Diagnostic evaluation. In:PostI. editor. UpToDate.[Internet].Waltham, MA:UpToOate;2020[cited 2020 Apr 20],Available from:www.uptodate.com.

FIBRISTAL (ulipristalacetate tablets.5 mg|

- Voluntary Withdrawal inCanada due to Risk olDrug -Induced liver Injury.Ottawa (ON):Government of Canada:2020 Sept 30 [cited 2021March 30],Available from:

https://healtliycanadians.gc.ia/rccallalert rappelaviv/hcsc/2020/74063a -cng.php.

Fujiwara K.Shmtani D,NishikawaI.Clear- cell carcinoma ol the ovary.Ann Oncol 2016:27:150152.

Government of Canada [lnlernet|.Ottawa (OH):Public Health Agency ol Canada: CanadianGuidelines onSexually transmitted Infections:(modified 2020 May 6:cited 2020 Jun 22|.Available from:https://www.

canada.ca/en/public-liealth/setvicesJinfechous-diseases

'

sexual-ltealUi-sexually-transmitted-infections/canadian-guidelines/sexually-transniilted-infec tions.html.

Government of Canada [Internet!.Ottawa (ON):Public Health Agency of Canada; Important Nobce - Public HealthInformation Update on the Treatment for Gonococcal Infection:[modified 2011Dec 21;cited 2020

Jun 22],Available from:https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-bansmitled-infections/canadian-guidelines/alerts/2011fimportant-nolice-public-healthinlormation-update- on-trealment- gonococcal-infection.html.

Guilbert E.Boroditsky R, Black A,clal.Canadian consensus guideline on continuous and extended hormonal contraception. J ObstelGynaecol Can 2007:29(7 Suppl 2):S1-S32.

Guilbert E.Black A,Dunn S.et al. SOGC Committee Opinion on missedhormonal contraceptives:New recommendations. J Obstel Gynaecol Can 2008:30:1050-106.

Hacker NF.Moore JG.Essentials of obstetrics and gynecology.2nd ed.Philadelphia:WB Saunders;1992.

Hofmeister S.Bodden S.Premenstrual syndrome and premensbual dysphoric disorder.Am FamPhysician 2016:94(3):236-240.

JacobsI.Oram 0.Fairbanks J.et al.A risk of malignancy incorporabng CA125.ultrasound and menopausal status for the accurate preoperatnre diagnosis of ovarian cancer.BJOG 1990:97:922-929.

Jick SS,Hernandez RK.Risk of non-fatal venous thromboembolismin womenusing oral contraceptives containing drospirenone compared with women using oral contraceptives containing levonorgestrel:casecontrol study using United Stales daims data.BMJ 2011;342:d2151.

Joishy M.Ashtekar CS.Gonsalves R. Do we need to treat vulvovaginitis in prepubertal girls? BMJ 2005:330(7484):186 -188.

Jouia EA, Giuliano AR.Iversen OE.el al.A 9 valent HP!/ vaccine against infection and intraepithelial ncoplasiain women. NEJM 2015:372:711- 723.

Kimberlin DW,Rouse DJ. Clinical practice.Genital herpes. NEJM 2004:350:1970.

Klipping C.DuijkersI,Trummer D.et al.Suppression of ovarianacbvily with a drospirenone-containing oral contraceptive in a 24/4 regimen.Contraception 2008:78:16-25.

KrakowskyY,Grober ED.A practical guideto female sexual dysfunction:An evidence-based reviewfor physicians in Canada.Can Urol Assoc J2018:12(6): 211-216.

Kuhn E,Wu RC,Guan B.et al.Identification of molecular pathway aberrations in uterine serous carcinoma by genome-wide analyses.JNatl Cancer Inst 2012;104:1503-13.

Kuncharapu I.Majeroni BA.Johnson DW.Pelvic organ prolapse.Am Fam Physician 2010;81|9):1111-1117.

lainont J.Bajzak K.Bouchaid C.ct al.No. 279-Female sexualhealth consensus clinical guidelines. JObstel Gynaecol Can. 2017;39|12):e535- e541.

leron E. Wemlraub AY. Maslroliu SA. etal. Ovcractivc bladder syndrome:Evaluation andmanagement Curr Urol Rep 2018;11|3):117-125.

lidegaard 0.lokkegaard E. Jensen A.et al.Thrombotic stroke andmyocardial infarction with hormonal contraception. NEJM 2012:366:2257-2266.

Lipscomb GH.McCord ML.Stovall IG.et al.Predictors of success of melhobexale treatment in women with tubal ectopic pregnancies.NEJM 2001:341:1974 -1978.

Lopez LM,Chen M.Mullins S,et al.Steroidal contraceptives andbone fractures in women:Evidence from observational studies. Cochrane Database Syst Rev 2012:8:CD009849.

Luciano AA.Solima RG.Ectopic pregnancy:fromsurgical emergency tomedical management Ann NY Acad Sci 2001;943:235-254.

Lujan ME,Chizen OR.Pierson RA.Diagnostic criteria for polycystic ovary syndrome:Pitfalls and controversies.J Obstet Gynaecol Can 2008:30:671-9.

Madcnnan AH.Broadbent JL.Lester S.et al. Oral oesbogen and combined oestrogen/progestogen therapy vs.placebo for hoiHushes.Cochrane DB Syst Rev 2004;4:CD002978.

Management of uterine fibroids.Summary.Evidence Rcport/Tcchnology Assessment:Number 34. AHRO Publication No. 01- E051, January 2001.

Manson JE.Martin KA. Postmenopausal hormone replacement therapy. NEJM 2001:345:34 40.

Mantha S.Karp R.Raghavan V. et al.Assessing the risk of venous thromboembolic events in women taking progestmonly contraception:a meta-analysis.BMJ 2012; 345:c4944.

Marchbanks PA.Aneger JF.Coulman CB.elal.Risk factors for ectopic pregnancy:A population based study.JAMA 1998:259:1823-1827.

Martin JL.WiIliams KS.Abrams KR.etal.Systematic review and evaluation of methods of assessingurinary incontinence.Health TechnolAssess 2006;10:1-132,iii-iv.

Marjoribanks J.Farquhar C.Roberts H.elal.Long-termhormone therapyfor perimenopausal andpostmenopausal women.Cochrane Database Syst Rev 2017;1:CD004143.

Murphy J.Jumah N.Kupets R,et al.Clinical Guidance:Recommended Best Practices for Delivery of Colposcopy Services inOntario. Cancer Cate Ontario [Internet],Ontario.Canada: 2016[cited 2021 Sep 06|.

Available from:hllps://www,cancetcarconlaiio.ca/en/contcnl/clinical- guidancc recommended besl-pracliccs-delivory- colposcopy services ontario.

National Advisory Committee on Immunization|CA). Update on human papillomavirus (HPV) vaccines. An Advisory Committee Statement (ACS). Can Common Dis Rep [Internet]. 2012 Jan 1[cited 2020 Jun

22];38(ACS 1).Available from:https://www.canada.ca/content/dam/phat

-aspc/migcation/phac-aspc /publicat/ccdr-rmtc/12vol38/acs-dcc-1/assets/pdl/12vol 38 acs-dcc-1-eng.pdf.

National guideline for the treatment of bacterial vaginosis.ClinicalEffectiveness Group (Association ol Genitourinary Medicine and the Medical Society for the Study olVenereal Diseases).Sex Transm Infect

1999:75 (Suppl1):S6-S8.

The North American MenopauseSociety.Algorithm and mobile appfor menopausal symptom management andhormonal/non-hormonal therapy decision making:aclinical decision-support tool from The North

American Menopause Society. Menopause lnl2014;22:247-253.

Ouellet-Hellstrom R. Graham DJ. Stalfa JA elal.(FDA Office of Surveillance and Epidemiology.Silver Spring.MD).Combined Hormonal Conbacepbvcs (CHCs) and the Risk of Cardiovascular Oiscase Endpoints

[Internet].USFood and Drug Administration;|ci!ed 2020 Jun 22|.Available from:

hltps://www.fda.gov/files/drugs/published/Combined'Hoimonel’Conltaccptivc$'%23CKCs%29 and the-Risk-of'Cardiovasculat'Disease -Endpoints- report.pdf.

Paley PJ.Screening for the major malignancies affecting women:Current guidelines.Am J Obstet Gynecol 2001:184:1021-1030.

Rambout L.Hopkins L.Hutton B.et al.Prophylactic vaccination against human papillomavirus infection in women:A systematic review of randomized controlled trials.CMAJ 2007;177(5):469-479.

Ratner S.Ofri D.Menopause andhormone replacement therapy.West J Med 2001:175:32-34.

Reade CJ,McVey RM.Tone AA. et al.The fallopian tube as theorigin of high grade serous ovarian cancer:Review of a paradigm shift.J Obstet Gynaecol Can 2014;36:133-140.

Recalls and safely alerts.Health Canada safety review finds possible link between Fibristal and risk of liver injury [Internet],[place unknown]:Government of Canada:[updated 2019 Jan 11:cited 2020 Jun 22],

Available from:htlps://heallhycanadians.gc.ca/iecallalert-rappel-avis/licsc/2019/68806a-eng.php.

T

J

+

Activate Windows

Go to Settings to activate Windows.

GY60 Gynaecology TorontoNotes 2023

Reid R.SOGC ClinicalPractice Guidelines:Oral contraceptives and the risk of venous thromboembolism:An update.JObstet Gynaecol Can 2010:32:1192-1197.

Reid R,Abramson BL,Blake J.et al.SOGC Clinical Practice Guidelines:Managing menopause.J Obstet Gynaecol Can 2014;36(9):830-833.

Renaud M.le T. SOGC Joint Clinical Practice Guidelines.Epidemiology and investigations for suspected endometrial cancer.JObstet Gynaecol Can 2013;35:S1-9.

Rendi MH.Epithelial carcinoma olthe ovary,fallopian tube,and peritoneum:Histopathology.In:PostI. editor. UpToOate.[Internet!.Waltham. MA:UploDate: 2019 [cited 2020 Jun 9],Available from: https://

www.uptodatc.com/contcnts

'

epilhellal catcinoma-ol-lhc-ovary lalloplan-lubc and-petiloneum histoputhology ?scarch-Epithelial%20carcinoma\20ol%20lhe"i20ovary.'

k20lulloplan'

r>20tube,'

lb20and%20

peritoncum:%20Hlstopalhoiogytsource'search resultSselcctcd1itlc*M50Susagc type'

defaulttdisplay rank-1.

Rimsca ME.Counselling the adolescent about contraception.J Pediatr Rev 2003:24:162-170.

Ringel NE.Iglesia C.Commonbenign chronic vulvar disorders.AmEarn Physician.2O2O;1O2|9):550-7.

Royal College olObstetricians and Gynaecologists.Esmya (uliptistal acetate) - MHRA safely alert[Internet!

.[place unknown!

:Royal College of Obstetricians and Gynaecologists:[updated 2018 Aug 18;died 2020

Jun 22|.AvailableIrom: htlps://www.rcog.org.uk/en/quidelineS'researchsorviccs/guidclines/esmyaulipristal'acelate "mhta -safety-alert/.

Schllep KC. MumfordSt.Peterson CM.et 4.Pain typology andincident endometriosis. Hum Rcptod. 2015:30[10):2427-2438.

Seeger JO.Loughlin J.Eng PM.et al.Risk ol thromboembolism in women taking ethmyleslradiol/drospircnone and other oral contraceptives.Obstet Gynecol 200/;110:587-593.

Sen P.Barton SE.Genital herpes andits management.BMJ 2007:334:1048.

Setiawan Wf.Vang HP.Pike MC.et al.TypeIandIIendometrial cancers:Have they different risk factors? Am J ClinOncol 2013;31(20):2607-2618.

Sex & U [Internet!

.Ottawa:Society of Obstetricians and Gynaecologists of Canada;c2020[cited 2020 Jun 22|.AvailableIrom:https://www.seiandu.caf.

Sliaptcr AP.Gestational trophoblastic disease.Obstet Gyn Clin N Am 2001:28:806-817.

Shilton Jt Overview ol sexual dysfunction in women:Epidemiology,risk [actors,and evaluation.In:PostI.editor.UploDate.[Internet!.Waltham, MA: UploDate:2D20[cited 2020 Jun 22).Available from:https://

wviw.uptodale.com/contents,overview-olsexual-dysfunctionin-women-epidemiology-risk-factorsand- evaluation?search-Overview%20ol%20sexual%20dysfunction%20in'

!i.20women:

<

c20Epidemiology.%20

risk%20factors,

'‘c20and%20evaluationSsource-search.resultSselectedTitle-1-

-190Ausage_ type*defaultSdisplay.rank-1.

Shifren JL.Overview of sexual dysfunction inwomen:Management.In:Post!,editor.UploDate.[Internet!.Waltham.MA:UploDate;2019 [cited 2020Jun 22],Available from:https://www.uplodate.com/

contents/overviewof-seiual-dysfunclion-in-women-management?scarch-Overview%20ol%20seiual%20dysfunction

*

20in%20women:'»20Managementtsource-search result4sclectedTitlc-1"

150Ausage

type-delaultSdlsplay rank-1.

Shumaker SA.legault C,Kuletl.elal.Conjugatedequine estrogens andincidence olprobable dementia and mildcognitive impairment in postmenopausal women:Women’s Health Initiative memory study. JAMA

2004:291:2947-2958.

SimmsI,Stephenson JM.MallmsonH, etal.Risk factors associated withpelvic inflammatory disease.SexTransm Infect 2006;82(G):452-457.

Singh S.Best C.Dunn S,et al.SOGC Clinical Practice Guidelines:Abnormal uterine bleeding inpre menopausal women.J Obstet Gynaecol Can 2013:35|5):473-475.

Singh S.Best C.Dunn S. et al.No.292-Abnormal uterine bleeding in pre menopausal women.J Obstet Gynaecol Can 2018:40(5|:e391 e415.

Sobol JD. Approach to females withsymptoms ol vaginitis.In:Post1.editor.UploDate.[Internet!. Waltham.MA:UploDate:2020[cited 2020 Jun 22].Available Irom:https://www.uptodatc.com/contents/

approach to lemales-with-symptoms of-vaginitis?seatch-Approach%20to%20lemales%20with%20symptoms%20ol%20vaginitis.%20Asouice-search tcsullSselectedlille-H504usage Iype-delault4display

rank-1.

SOGC News Release.New recommendations Irom national ob/gyn society address Depo-Provera.bone loss. May 2006.Available from:http://www.sogc.org/media/pdl/advisories/dmpa-may2006 e.pdf.

Stuenkel CA.Davis SR.Compel A. et al. Treatment of symptomsof the menopause:AnEndocrine Society ClinicalPractice Guideline.J Clin Endocr Melab2015:100:3975.

Tang T.lord JM. Norman RJ.el al.Insulin sensitising drugs [metformin,rosiglilacone.pioglilaione.D chiro-inositot) for women with polycystic ovary syndrome,oligo amenorrhoca and subfertility. Cochrane

Database Syst Rev 2012:5:00003053.

TingulstadS.Hagen B. Sk|ddestad EE.etal.The risk ol malignancy index to evaluate potential ovarian cancers in local hospitals.Obstet Gynecol1999:93:448- 452.

Van Eyk N.Allen L.Giesbrecht E.elal.Pediatric vulvovaginal disorders:A diagnostic approach and review ol the literature.J Obstet Gynaecol Can 2009:31(9):850-862.

Wooltorton E.The Evra [ethinyl estradiol/norelgestrorain) contraceptive patch:Estrogen exposure concerns.CMAJ 2006:174:164-165.

Wooltorton E.Medroxyprogesterone acetate (Depo-Provera) and bone mineral density loss.CMAJ 2005:172:746.

Workowski KA. Bolan GA.Centers loi Disease Control andPrevention.Sexually transmitted diseases treatment guidelines.2015. MMWR Recomm Rep 2015:64:1.

Wright JO.fiorelll J,Schifl PB el al.Racial dispanties lor uterine corpus tumors:Changes inclinical characteristics and treatment over time.Cancer 2009:115:1276.

Yin H.Gui T.Comparative analyses olpostoperative complicationsand prognosisol different surgical procedures in stage II endometrial carcinoma treatment.OncoTargets Ther 2016:9:781- 786.

Yudin M.Money DM.Screening and management of bacterial vaginosis in pregnancy.JObstet Gynaecol Can 2017;39:184-191.

ri

L J

+

Activate Windows

Go to Settings to activate Windows.

Hematology

Reid Gallant, Syed Shahan Haider, and Nathan Kuehnc, chapter editors

Karolina Gaebe and Alyssa Li, associate editors

Wei Hang Dai and Camilla Giovino, EB\1 editors

Dr. Matthew Cheung, Dr. Lisa Chodirker, Dr. Helena Dhamko, Dr. Zachary Liedcrman, Dr. Michael

Scott, and Dr. Martina Trinkaus, staff editors

Hematology

Acronyms

Basics of Hematology.

CompleteBlood Count

Blood Film Interpretation

Bone Marrow Aspiration and Biopsy

Common Presenting Problems

Anemia

Erythrocytosis

Thrombocytopenia

Thrombocytosis

Pancytopenia

Neutrophilia

Neutropenia

Lymphocytosis

Lymphopenia

Eosinophilia

Agranulocytosis

Leukemoid Reaction

Approach to Lymphadenopathy.

Approach to Splenomegaly

Microcytic Anemia

Iron Metabolism

Iron Deficiency Anemia

Anemia of Chronic Disease

Sideroblastic Anemia

Lead Poisoning

Normocytic Anemia

Aplastic Anemia

Hemolytic Anemia

Thalassemia

p-Thalassemia Minor (Thalassemia Trait)

P-Thalassemia Major

P-Thalassemia Intermedia

a-Thalassemia

Sickle Cell Disease

Autoimmune Hemolytic Anemia

Microangiopathic Hemolytic Anemia/Thrombotic

Microangiopathy

Hereditary Spherocytosis

Hereditary Elliptocytosis

Glucose-6-Phosphate Dehydrogenase Deficiency

Macrocytic Anemia

Vitamin B12 Deficiency

Folate Deficiency

Hemostasis.

Stages of Hemostasis

Disorders of Primary Hemostasis

Immune Thrombocytopenia

Thrombotic Thrombocytopenic Purpura and Hemolytic Uremic

Syndrome

von Willebrand Disease

Disorders of Secondary Hemostasis

Hemophilia A (Factor VIII Deficiency)

Hemophilia B (Factor IX Deficiency)

Factor XI Deficiency

Liver Disease

Vitamin K Deficiency

Disseminated Intravascular Coagulation

HI Hypercoagulable Disorders

Venous Thromboembolism

Approach to Treatment of Venous Thromboembolism

Hematologic Malignancies and Related Disorders.

Myeloid Malignancies

Acute Myeloid Leukemia

Myelodysplastic Syndromes

Myeloproliferative Neoplasms

Chronic Myeloid Leukemia

Polycythemia Vera

Idiopathic Myelofibrosis

Essential Thrombocythemia

Lymphoid Malignancies

Acute Lymphoblastic Leukemia

Lymphomas

Hodgkin Lymphoma

Non-Hodgkin Lymphoma

Malignant Clonal Proliferations of Mature B-Cells.

Chronic Lymphocytic Leukemia

Multiple Myeloma

Monoclonal Gammopathyof Unknown Significance

Lymphoplasmacytic Lymphoma

Complications of Hematologic Malignancies

Hyperviscosity Syndrome

Tumour Lysis Syndrome

Blood Products and Transfusions

Blood Products

Red Blood Cells

Platelets

Coagulation Factors

Acute Blood Transfusion Reactions

Delayed Blood Transfusion Reactions

Common Medications

Antiplatelet Therapy

Anticoagulant Therapy

Chemotherapeutic and Biologic Agents Used in Oncology

Landmark Hematology Trials

References

H35

H2 ,H36

H2

,H39

,H39

H6

H42

H46

H47

H50 H12

H13

H14

H53

H54

H17

H18

H58

H61

H63

H25

H26

H28

r i

H32 L J

+

HI Hematology Toronto Notes 2023

Activate Windows

Go to Settings to activate Windows.

H2 Hematology Toronto Notes 2023

Acronyms

antibody

atrial fibrillation

DVT deep vein thrombosis

Epstcin- Barr virus

ethylenediamlnetetraacetic add IIP

erythropoietin

erythropoiesis-stimulating agent

erythrocyte sedimentation rate

essential thrombocythemia

fibrin degradation products

fine needle aspiration

frozen plasma

granulocyte-colony stimulating

factor

reduced glutathione

genitourinary

graft versus host disease

hemolytic anemia

hemoglobin

hepatitis B virus

hematocrit

hepatitis C virus

hemolysis,elevated liver enzymes, OCP

and low platelet count

heparin- induced thrombocytopenia PE

Hodgkin lymphoma

high molecular weight kininogen Ph

hemolytic uremic syndrome

inflammatory bowel disease

idiopathic myelofibrosis

immunomodulatory drugs

internationalnormalized ratio

intermittent pneumatic compression Pf

IPSS international prognostic scoring

system

immune thrombocytopenia

Janus kinase 2

PIT partial thromboplastin time

PUD peptic ulcer disease

PV polycythemia vera

RCMD refractory cytopenia with

multilineage dysplasia

RCMD RS refractory cytopenia with

multilineage dysplasia and ringed

Ab

AFrb EBV

AFLP acute fatty liver of pregnancy

atypical hemolytic uremic syndrome EPO

autoimmune hemolytic anemia ESA

acute lymphoblastic leukemia ESR

acute myeloid leukemia

absolute neutrophil count

activated protein C

acute promyelocytic leukemia FP

antiphospholipid antibodies

antiphospholipid antibody

EDTA

aHUS JAK:

LAD lymphadenopathy

LMWH low molecular weight heparin

MAHA/ microangiopathic hemolytic

TMA anemia/thrombotic microangiopathy sideroblasts

MCH mean corpuscular Hb

MCHC mean corpuscular Hb concentration SCD

MCV mean cotpuscularvolume

MDS myelodysplastic syndromes

myelofibrosis

MGUS monoclonal gammopathy of

unknown significance

multiple myeloma

MPN myeloproliferative neoplasm

MPV mean platelet volume

MUGA multi-gated acquisition

non-Hodgkin lymphoma

oral contraceptive pill

PCC prothrombin complex concentrates TIP

pulmonary embolism

progression-free survival

Philadelphia chromosome

proteasome inhibitors

prekalliktein

PMN polymorphonuclear neutrophil

paroxysmal nocturnal

AIHA

All

AML El

ANC FDP

APC FNA lit

'

,', RBC distribution width

sickle celldisease

stem cell transplantation

serum protein electrophoresis

soluble transferrin receptor

T-cell lymphoma

total iron binding capacity

tyrosine kinase inhibitor

T -cell large granular lymphocyte

tumour lysis syndrome

tissue plasminogen activator

thrombopoietin

thrombin time

thrombotic thrombocytopenic

API

APIA G-CSF SCT

APS SPEP

syndrome GSH MF sTfR

aPTT activated partial thromboplastin GU TCI

time GVHD TIBC

ARDS acute respiratory distress syndrome HA

ATIII antithrombin III

ATRA all-trans retinoic acid

bone marrow

CALR calreticulin

chimeric antigen receptor

Cll chronic lymphocytic leukemia

CMl chronic myeloid leukemia

CMV cytomegalovirus

CRP C-reactive protein

DAT direct antiglobulin test

ODAVP - desmopressin

DIC disseminated intravascular

coagulation

DLBCl diffuse large 8-cell lymphoma

DOAC direct oral anticoagulant

MV TKI

Hb T-lGl

HBV as

BM Hct tPA

HCV NHL TPO

CAR HELLP TT

HIT purpura

HL UFH unfractionated heparin

urine protein electrophoresis

venous thromboembolism

von Willebrand disease

von Willebrand factor

World Health Organization

radiation therapy

HMWK UPEP

HUS PI VIE

IBD PK VWD

IMF VWF

IMID PNH WHO

INR hemoglobinuria XRT

IPC prothrombin lime

Basics of Hematology

Hematopoietic Stem Cell

Erythrocyte:carries oxygen from lungs

to peripheral tissues

Reticulocyte:immature erythrocyte

Hb: protein contained in erythrocytes

which binds oxygen

Neutrophil: granulocyte integral in

innate immunity;main cell in acute

inflammation

Eosinophil:granulocyte involved

in response to parasites (especially

helminths) and allergic response

Basophil:granulocyte mainly involved in

allergy and parasitic infection

Lymphocyte:integral cell in adaptive

Immunity

Monocyte:involved in innate immunity:

can differentiate into macrophage or

dendritic cell

Platelet:mediator of primary hemostasis

Plasma:acellular,fluid component of

blood containing water and proteins

(including coagulation factors and

Immunoglobulins)

Serum:equivalent to plasma minus

coagulation factors

Myeloid piecursor Lymphoid precursor

Megakaryocyte/erythrocyte precursor

I I

Myeloblast Lymphoblast

Megakaryoblast Proerythroblast Monoblast

: Progranulocyte

Megakaryocyte Polychromatic

erythroblast

Monocyte

2

1

S

Basophil Eosinophil Neutrophil :

I

Erythrocyte Macrophage .1CJl

Platelets

o ?

-n

S

i

* o

s _

Granulocytes 0 r t

L J

Figure 1. Hematopoiesis

• over 101

'

blood cells arc produced daily

• sites ofhematopoiesis in adults: pelvis,sternum, vertebral bodies, and cranium

• lifespan of mature cells in blood

erythrocytes (90-120 d), neutrophils (~1 d), platelets (7-10 d),lymphocytes (varies- memory cells

pe rsist for years)

+

Activate Windows

Go to Settings to activate Windows.

H3 Hematology Toronto Notes 2023

• role of lymphoid organs

spleen: part of reticuloendothelial system, sequesters aged RBCs, removes opsonized cells, and

site of Ab production

thymus:site of T-cell maturation and involutes with age

• lymph nodes: sites of B- and T-cell activation (adaptive immune response)

Complete Blood Count

Table 1. Common Terms Found in the CBC

Test Definition Normal Values'

RBCCount Number of RBCs per volume of blood 3.5-5.0 x10l7L (female)

4.0-5.5 x 10RI (male)

115-155 9/1 (female)

125-170 g/L (male)

37-46% (female)

38-50% (male)

80100 ft

27-34 pg

315-355g/L

11.5-15.5%

23-90 x 1CP /L (0.5-1.5%)

<20 mm/h (female)

<10 mm/h (male)

3.5-10.5 X 103A

2 71 lOv.'

l

<0.7 x 1011

<0.10 *

1CP /L

<0.5x 109/1

1.0-4.0 x 101/1

0.1-1.0*

109 /1

130 380 x 109 /1

9.0-14.0 fl

Hb Amount olHbm the blood

Percentage of a given volume of whole blood occupied by packed

RBCs

Average RBC site

Average amount of Hb per RBCs

Average concentration of Hb inside RBCs

Percentage of variance in RBC size

Humber of reticulocytes per volume of blood

Rate at which RBCsseparate from the serum, becoming sediment in

the bottom of the test tube

Humber of WBCs per volume of blood

Segmented neutrophils

Band neutrophils

Basophils

Eosinophils

Lymphocytes

Monocytes

Humber of platelets pet volume of blood

Mean Platelet Volume (MPV ) Measurement ol plateletsize

Hct

MCV

MCH

MCHC

ROW

Reticulocyte Count

ESR

WBC Count

WBC Differential

Platelet Count

“All values apply to adults. Reference standards do not apply to all ethnic groups.

Approach to Interpreting a CBC

1 . consider values in the context of an individual'

s baseline:

up to 5% of population without disease may have values outside “normal" range

• an individual may display a clinically significant change from their baseline without violating

“normal"

reference range

2. is one cell line affected or are several?

• if all lines are low: pancytopenia (see Pancytopenia, HS )

if RBCs and platelets are low: consider a MAHA/TMA (see Microangiopathic Hemolytic Anemia/

thrombotic Microangiopathy, H23 ) or an autoimmune process (Evan’

s Syndrome)

• if single cell line affected: see Common Presenting Problems, H6

To estimate Hb based on the Hct,

multiply by 3

Clinical UseofRDW

. To distinguish the etiologies of

microcytosis:

• Iron deficiency:increased RDW

(anisocytosis) as cells are of varying

sizes in iron deficiency

• 3-thalassemia minor:normal RDV7

(also expect a high RBC count) as

cells are of similarsize because

the red cell abnormality is not

progressive

Blood Film Interpretation

RED BLOOD CELLS

Size

• microcytic (MCV <80 fL), normocvtic (MCV = 80-100 fL), macrocytic (MCV >100 fL)

• anisocytosis: RBCs with increased variability in size (increased RDW )

• iron deficiency anemia, HAs, Ml'

, blood transfusion, and MDS

Colour

• hypochromic: increase in size of central pallor (normal = less than 1/3 of RBC diameter)

iron deficiency anemia, anemia of chronic disease, and sideroblastic anemia

• polychromasia: suggests increased reticulocytes (pinkish-blue cells)

• increased RBC production by BM

Shape

• poikilocytosis: increased proportion of RBCs of abnormal shape

• iron deficiency anemia, hemoglobinopathies, ME, severe Bi:deficiency, MDS, and burns

i

_ J

+