Normal Processes (Step 1 Emphasis)

Embryonic development, fetal maturation (organogenesis), and perinatal changes

Organ structure and function

Cell/tissue structure and function

production and function of erythrocytes, including heme and hemoglobin synthesis; hemoglobin O2 and CO2 transport, transport proteins, erythropoietin

production and function of platelets

production and function of coagulation and fibrinolytic factors; hemostasis

Repair, regeneration, and changes associated with stage of life

Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis (Step 2 & 3 Emphasis)

Infectious and immunologic infectious disorders


viral: hemorrhagic fever (Ebola virus, Marburg virus); chikungunya; dengue fever

parasitic: malaria (Plasmodium spp); babesiosis (Babesia species)

primary infections of lymphoid tissue: lymphadenitis (viral, bacterial, fungal, parasitic); lymphangitis; buboes, bubonic plague (Yersinia pestis); cat scratch disease (Bartonella henselae)

immunologic and inflammatory disorders:

cryoglobinemia, essential mixed cryoglobinemia;

autoimmune hemolytic anemia;

paroxysmal nocturnal hemoglobinuria;

thrombotic thrombocytopenic purpura;

hemolytic uremic syndrome

Neoplasms: leukemia, acute (ALL, AML); leukemia, chronic (CLL, CML); lymphomas, Hodgkin disease, non-Hodgkin lymphoma, Burkitt lymphoma, T-cell lymphoma; multiple myeloma, dysproteinemias, monoclonal gammopathy of unknown significance (MGUS); myelofibrosis; myelodysplastic syndrome, myelodysplasias; other immunoproliferative neoplasms (eg, Waldenstrom macroglobulinemia)

Anemia, cytopenias, and polycythemia anemias decreased production: anemia of chronic disease

hemolysis: glucose-6-phosphate dehydrogenase deficiency; pyruvate kinase deficiency

disorders of hemoglobin, heme, or membrane: disorders of red cell membranes; hereditary spherocytosis, elliptocytosis; methemoglobinemia, congenital; sickle cell disease; sideroblastic anemia; thalassemias

other causes of anemia: blood loss, acute and chronic as a cause of anemia

cytopenias: aplastic anemia; leukopenia; neutropenia, cyclic neutropenia, agranulocytosis; pancytopenia; thrombocytopenia, quantitative; immune thrombocytopenic purpura (ITP)

cythemias: leukocytosis; polycythemia vera; secondary polycythemia

Coagulation disorders (hypocoagulable and hypercoagulable conditions) hypocoagulable: disseminated intravascular coagulation; hemophilia, congenital

factor VIII [hemophilia A] and IX [hemophilia B]; hypofibrinogenemia; von Willebrand disease; platelet dysfunction, qualitative

hypercoagulable: heparin-induced thrombocytopenia; other coagulopathies (eg, homocysteinemia, hypoplasminogenemia, antithrombin III, protein C/protein S deficiency, Factor V Leiden, anticardiolipin antibodies, lupus anticoagulant, prothrombin G20210A mutation)

reactions to blood components: ABO incompatibility/anaphylaxis; Rh incompatibility/anaphylaxis; hemolysis, delayed; transfusion reaction; transfusion contaminated with bacteria; transfusion-related acute lung injury (TRALI); anaphylactoid reaction (IgA deficiency)

Traumatic, mechanical, and vascular disorders:

mechanical injury to erythrocytes (eg, cardiac valve hemolysis);

disorders of the spleen;

splenic rupture/laceration;

splenic infarct;

splenic abscess;

effects/complications of splenectomy (eg, sepsis due to encapsulated bacteria);


Congenital disorders

Adverse effects of drugs on the hematologic and lymphoreticular systems:

antiplatelet drugs,

antithrombin drugs (eg, dabigatran);

chemotherapeutic agents; inhibitors of coagulation factors; methemoglobinemia, acquired; propylthiouracil; tumor lysis syndrome; warfarin