00._H_E_M_____B_O_O_K

HEMATOLOGY FOR

MIDDLE EAST STUDENTS

Dr. Anwar Sheikha MBChB, FRCP, FRCPI, FCAP, FRCPA, FRCPath., FACP Associate Professor of Hematology Head of the Hematology Department Senior Consultant Clinical Hematologist King Khalid University Medical College & Asir Central Hospital

Abha, Saudi Arabia

Contents:

Chapter 1

Blood Cell Morphology

Chapter 2

Anemias

Chapter 3

Leukemias

Chapter 4

Lymphomas

Chapter 5

Paraproteinemias

Chapter 6

Myeloproliferative Disorders

Chapter 7

Abnormalities of the White Blood Cells

Chapter 8

Bleeding Disorders

Chapter 9

Transfusion Medicine

Chapter 10

The Spleen

Chapter 11

Examination Case Studies

Chapter 12

Half a Thousand Hematology Exam Bank

2

Introduction “Blood is the essence of life”

‫الدم جوهر الحياة‬ After nearly two decades of teaching hematology in the Middle East, I managed to change the contents of my lectures from being a pure replica of a Western hematology book to one that is more of my local experience and better suited to native students. I felt that our students are more in need of local experience with blood diseases common to our region than AIDS-related hematological problems or pernicious anemia, which is so rare in this part of the world that I have had only seen three cases in my long professional life in the region. Working in the sole referral hospital of a hematology population approaching two million people and caring for almost all of the patients with blood diseases gave me a wealth of information and experience that I can comfortably share with my students. Out of that desire and with easy access to projection slides, computer and PowerPoint came the idea of collecting my lectures into easily accessible handouts. I have been revising them annually, add every new information I have been getting locally and from my international conference attendance and then print them out to be distributed to my students prior to each lecture. When the college started negating the benefits of handouts and stressed on directing students to resort to reference books, I had that extreme urge to collect all my lectures into this handy book. This book between your hands is the cream of my experience here and I feel responsible for every word and sentence of it. Hematology is basically taught in the medical college to pathology students, internal medicine students and as important ingredients in Gynecology & Obstetrics practice, Surgery and almost every other branch of medicine. I am not much of a proponent of this fragmentation but I understand that the issue is an inevitable consequence of blood being part of every system and specialty. It is also taught to other colleges like Dentistry, Pharmacy and Medical Sciences. Blood cells circulate everywhere in the body and every organ disease could present itself by some sort of blood changes. Blood diseases could also impose their effects on almost every system in the body and it is not uncommon for a patient to present to an orthopedic surgeon or a neurologist or a nephrologist or more frequently to a general pediatrician for what will turn out to be a leukemia or a myeloma. Nothing could make me happier more than remarks from my old time students, now colleagues, who inform me of using my handouts even in their postgraduate training and examinations. I hope that this modest effort continues to be an indispensable resource for students of hematology in this important part of the world. Before concluding this introduction, I would like to thank my wife, who is pursuing my path of doing pathology in the United States, and my kids Lana, Tara and Showan for beautifying my life in such a way that I had the desire, urge and time to author this modest book.

Anwar Sheikha, MBChB, FRCP, FRCPA, FRCPI, FCAP, FRCPath, FACP Associate Professor & Senior Consultant Clinical & Lab. Hematologist 3