we always get taught to check for clubbing in lung disease but NO ONE ever explained why it happen. Thank you for clarifying the theory behind this finding, 'it makes so much sense' when you know what you are looking for and why!!!!
1) Megakaryocytes can be found in the spleen at Primary Myelofibrosis due to extramedullar hematopoiesis in advanced stage. 2) Underproduction = low Megakaryocytes and/or enlarged (folate/B12 deficiency) in bone marrow. Overdestruction = high number of Megakaryocytes in bone marrow to compensate by more platelet production. 3) Clonal thrombocytosis has morphologycaly abnormal nuclei of Megakaryocytes.
@@MedicosisPerfectionalis in my case. I think the hematoloque may have had a problem with the biopsy. The signs were the rare megakaryocytes and the possible dilution by blood of the sample. Is there any other possibility ? Incidentally, your lectures are superb. I wish you had been there when I was young.
Absolutely! I've searched and i believe he was referring to young patients with Down Syndrome, in whom the most common type is acute lymphoblastic leukemia and next is mieloblastic subtype M7.
For my own reference
Diseases:
* = Myeloproliferative neoplasms (MPNs)
1:37 - *Alcoholism* - (Low megakaryocytes -> Low platelets -> Bleeding / Petichiae)
1:58 - **Essential Thrombocytopenia* - (Clonal malignancy -> High megakaryocytes -> High platelets)
2:50 - **Polycythemia Vera* - (Clonal malignancy -> Increased proliferation of ALL cell lines -> High megakaryocytes -> High platelets)
4:35 - *Right-to-left shunts*, _e.g. Tetralogy of Fallot_ - (Megakaryocytes bypass pulmonary circulation and get trapped in sinusoids and secrete PDGF -> Clubbing + Hypertrophic osteoarthropathy + Periostitis)
9:39 - *Megaloblastic anemia* - (Low B12/folate -> Decreased DNA replication -> Large hematopoietic cells with open chromatin -> All lines giant)
11:33 - *Aplastic anemia* - (Poor bone marrow -> Decreased proliferation of ALL cell lines -> Low megakaryocytes -> Low platelets)
13:29 - **Primary myelofibrosis* - (Clonal malignancy -> High atypical megakaryocytes -> Monoclonal proliferation of fibroblasts in bone marrow -> Increased bone marrow fibrosis -> Initial panmyelosis with subsequent pancytopenia)
14:57 - *Myelodysplastic syndrome (MDS)* _AKA mini AML_ - (Defective maturation of all myeloid cell lines -> WBC hyperproliferation -> Low and abnormally sized megakaryocytes -> Low platelets)
17:18 - *MDS with 5q deletion (5q-syndrome)* - (Subtype of MDS with High megakaryocytes -> High platelets)
15:57 - **Myelofibrosis with myeloid metaplasia (MMM)* - (Clonal malignancy -> Dysplastic megakaryocytes)
18:21 - *Immune throbocytopenic purpura (ITP)* - (Immune mediated platelet destruction -> Low platelets -> Compensatory increase in TPO -> High megakaryocytes)
18:36 - *Thrombotic thrombocytopenic purpura (TTP) / Hemolytic uremic syndrome (HUS)* - (Large vWF multimers -> Excessive platelet aggregation -> Low platelets -> Compensatory increase in TPO -> High megakaryocytes)
19:55 - *Acute uncompensated deseminated intravascular coagulation (DIC)* - (Tissue factor released into circulation -> Widespread fibrin deposition -> Fibrin microthrombi -> Platelet (and coagulation factor) consumption -> Low platelets -> Compensatory increase in TPO -> High megakaryocytes)
20:39 - *Acute megakaryocytic Leukemia (AML)* - (High megakaryocytes -> Monoclonal proliferation of fibroblasts in bone marrow -> Increased bone marrow fibrosis)
20:54 - *Gray-platelet symdrome-like disorder* - (X-chromosome-linked mutation of GATA1 -> Absence of alpha granules in platelets -> Large agranular platelets + Fibrinogen (and other alpha granule proteins) accumulate in Bone marrow -> Bone marrow fibrosis)
Awesome 👏
thanks a lot. u r helping me too :)
we always get taught to check for clubbing in lung disease but NO ONE ever explained why it happen. Thank you for clarifying the theory behind this finding, 'it makes so much sense' when you know what you are looking for and why!!!!
I appreciate you!
1) Megakaryocytes can be found in the spleen at Primary Myelofibrosis due to extramedullar hematopoiesis in advanced stage.
2) Underproduction = low Megakaryocytes and/or enlarged (folate/B12 deficiency) in bone marrow.
Overdestruction = high number of Megakaryocytes in bone marrow to compensate by more platelet production.
3) Clonal thrombocytosis has morphologycaly abnormal nuclei of Megakaryocytes.
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A great video! Thank you ❤️
My pleasure 😇
can you add subtitles please?
Could u plz explain mds in a video if possible .... Also the point about hypercellularity yet pancytopenia
Myelodysplastic Syndrome (MDS) | Between The Normal and The Acute Leukemia ua-cam.com/video/tCh9zodUaII/v-deo.html
thank you thank you thank you thank you
My pleasure 😇
Why would a bone marrow biopsy show rare megakaryocytes and light hemodilution
In which case? Please remind me
@@MedicosisPerfectionalis in my case. I think the hematoloque may have had a problem with the biopsy. The signs were the rare megakaryocytes and the possible dilution by blood of the sample. Is there any other possibility ?
Incidentally, your lectures are superb. I wish you had been there when I was young.
Thanks, dear.
I really don’t know what that means, I am not a doctor.
I wish I could help!
@@MedicosisPerfectionalis OK. Thanks
@@MedicosisPerfectionaliswhat? You're not a doctor? Medicosis? Really?
Sir isn't M2 more common than M7?
Absolutely! I've searched and i believe he was referring to young patients with Down Syndrome, in whom the most common type is acute lymphoblastic leukemia and next is mieloblastic subtype M7.