Quick note
Anemia: oxygen-carrying problem
Use RBC size, reticulocytes, bilirubin/LDH/haptoglobin, platelets, and ANC to separate production, destruction, bleeding, and infection problems.
Exam 2 overview
Two systems, one clinical-reasoning approach
Anemia
Think oxygen delivery + cell line. First identify whether the problem is RBC production, blood loss, hemolysis, platelet loss, or neutrophil loss. Then match the lab pattern and immediate risk.
Endocrine
Think too much vs too little hormone, then ask what happens to fluid balance, metabolism, blood pressure, electrolytes, and neurologic status. Emergencies are recognized by instability rather than the diagnosis name alone.
Quick notes
These are the highest-yield patterns to recall before opening the full guides.
Quick note
Endocrine: direction matters
Track hormone direction, serum-vs-urine concentration, temperature/heart-rate patterns, and whether the patient is unstable before choosing the intervention.
Quick note
Priorities first
Airway compromise, shock, seizure/acute neurologic change, major hemorrhage, severe transfusion reaction, and dangerous dysrhythmia outrank teaching.
Quick note
Medication safety
Know what the drug replaces or blocks, the key adverse effect that changes priority, and the lab/assessment that shows the treatment is working.
Unit 5
Anemia
Decreased circulating oxygen, hematology patterns, blood products, transfusion reactions, nursing priorities, delegation, interdisciplinary care, and medication profiles.
- Iron deficiency: microcytic + hypochromic.
- B12: macrocytic/megaloblastic + neurologic findings.
- Folate: macrocytic/megaloblastic without the classic neurologic findings.
- Aplastic: pancytopenia + low reticulocytes + hypocellular marrow.
- Hemolysis: jaundice + reticulocytosis + high indirect bilirubin/LDH + low haptoglobin.
- Transfusion reaction: stop the transfusion first and assess.
Unit 6
Endocrine
Pituitary, DI/SIADH, thyroid dysfunction, adrenal disorders, surgery, diagnostics, emergencies, delegation, collaboration, and key medications.
- DI: dry—high urine output, dilute urine, higher serum Na/osmolality.
- SIADH: retained water—low serum Na/osmolality, concentrated urine.
- Hypothyroid: cold + slow; hyperthyroid: hot + fast.
- Myxedema coma: cold/slow/altered; thyroid storm: hot/fast/altered.
- Addison: cortisol/aldosterone deficiency; adrenal crisis can cause shock.
- Pheochromocytoma: alpha blockade before beta blockade.
Priority memory frame
1) Stabilize ABCs and perfusion. Stridor, respiratory failure, hemorrhage, shock, or a severe transfusion reaction comes first.
2) Protect the brain. Seizure, severe sodium disturbance, new confusion, stupor, or coma is an acute safety problem.
3) Treat the critical cause. Examples in the guides include blood-loss control, reaction protocols, IV glucocorticoid for adrenal crisis, DDAVP for central DI, and ordered thyroid-storm therapy.
4) Then teach and plan long term. Nutrition, medication adherence, activity, follow-up, delegation, and interdisciplinary care come after instability is addressed.