Hello #medicine residents ๐๐ผ
What's that in the center of the image?
Yes, that's a SCHISTOCYTE !! It's nothing but a fragmented red cell ๐ด
In Greek, Schistos = Divided ๐ฌ๐ท
It's small, has irregular borders, and has NO central pallor like other red cells!!
#MedTwitter
What's that in the center of the image?
Yes, that's a SCHISTOCYTE !! It's nothing but a fragmented red cell ๐ด
In Greek, Schistos = Divided ๐ฌ๐ท
It's small, has irregular borders, and has NO central pallor like other red cells!!
#MedTwitter
What exactly does the presence of SCHISTOCYTES mean?
It means that the RBC is getting sheared off, it's walls are getting damaged and pieces of it are breaking off ๐ญ
This can't mean anything good, right ๐คทโโ๏ธ
#MedTwitter
It means that the RBC is getting sheared off, it's walls are getting damaged and pieces of it are breaking off ๐ญ
This can't mean anything good, right ๐คทโโ๏ธ
#MedTwitter
When does this happen?
Rapid blood flow through:
1๏ธโฃBad vessel
or
2๏ธโฃWhen blood hits against something that's not supposed to be in the body, e.g. prosthetic cardiac valves ๐คทโโ๏ธ
#MedTwitter
Rapid blood flow through:
1๏ธโฃBad vessel
or
2๏ธโฃWhen blood hits against something that's not supposed to be in the body, e.g. prosthetic cardiac valves ๐คทโโ๏ธ
#MedTwitter
Once we know this, the causes are easy to remember!!
1๏ธโฃ Bad vessel
a. TTP = โคต๏ธADAMTS-13 = Long vwf = platelet activation = microclots = RBC gets trapped and sheared = schistocytes
b. HUS
c. DIC = microclots = RBC gets trapped and sheared = schistocytes
#MedTwitter
1๏ธโฃ Bad vessel
a. TTP = โคต๏ธADAMTS-13 = Long vwf = platelet activation = microclots = RBC gets trapped and sheared = schistocytes
b. HUS
c. DIC = microclots = RBC gets trapped and sheared = schistocytes
#MedTwitter
d. Malignant Htn = Rapid blood flow = RBC fragmented = schistocytes
2๏ธโฃ Cardiac Valves (Aortic > Mitral)
RBC hits against a foreign surface at high velocity = gets sheared = schistocyte
If you see a schistocyte, you know something bad is going on !! Get help ๐ช๐ป
#MedTwitter
2๏ธโฃ Cardiac Valves (Aortic > Mitral)
RBC hits against a foreign surface at high velocity = gets sheared = schistocyte
If you see a schistocyte, you know something bad is going on !! Get help ๐ช๐ป
#MedTwitter
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