11-22 L3 Hypoproliferative Anemias

Question 1

Megoblastic anemias with nuerological changes is due to what?

Answer 1

• B12 def

Question 2

Megaloblastic anemias

what are common morphologic findings in the

• peripheral blood
• bone marrow

Answer 2

• Peripheral blood
  
  • pancytopenia
• Bone marrow
  
  • hypercellular

Question 3

define pernicious anemia

Answer 3

• autoimmune disorder associated with chronic atrophic gastritis
• decrease in intrinsic factor production

Question 4

pernicious anemia

• Type I
• Type II
• Type III

Answer 4

• Type I: block binding of B12 to intrinsic factor (most specific)
• Type II: B12-IF to the ileal receptor
• Type III: anti-parietal cell proton pump (most sensitive)

Question 5

anemia of folate deficiency vs B12 def

Answer 5

• folate def you dont get neurologic sequelae

Question 6

What is the most common worldwide nutritional deficiency?

Answer 6

IDA

Iron Def Anemia

Question 7

What is the difference b/t serum iron and TIBC

Answer 7

• serum iron: transferring bound to iron
  
  • measure Fe-Tf
• TIBC: serum transferrin concetntaoin
  
  • measure protein Tf

Question 8

All adult men and post-menopausal women with Fe def anemia must be evaluated for what?

Answer 8

• GI cancer
• or other bleeding lesion

Question 9

What is commonly seen with IDA

Answer 9

• Plummer vision syndrome (triad)
• Hypochromic microcytic anemia
• severe long standing IDA
  
  • Arophic changes to the tonuge
  • Esophageal webb
    *

Question 10

What is the most common form of anemia seen in hospitalized patients?

Answer 10

• Anemia of chronic disease
  
  • chronic infections (bac)
  • chronic immune def (
  • Neoplasms (cancer)

Question 11

How do you differentiate ACD vs IDA

Answer 11

• ACD (normocytic and normochromic)
  
  • increased storage iron in BM
  • high serum ferritin level
  • reduced serum Fe and TIBC
• IDA (microcytic and hypochromic)
  *

Question 12

Aplastic anemia

Answer 12

chrnic primary hematopoietic failure

rare inherited cases (fanconi anemia, telomerase)

Question 13

what are some causes of Aplastic anemia

Answer 13

• drugs
  
  • Myelotoxins
  • Nonmyelotic drugs
• whole body irradiation
• viral infections
  
  • Hepatitis, CMV, EBV, HIV
  • Parvovirus B19

Question 14

define Pure Red cell Aplasia

Answer 14

• marked eryhtroid hypoplasia with normal granulopoiesis and thrombopoiesis
• BM lack eryhtroid precursors

Question 15

What is an example of myelophthisic processes?

Answer 15

• leukoerythroblastosis
  
  • Immature RBCs
  • myeloid cells in the peripheral blood

Question 16

Diffuse Liver Disease

Answer 16

• caused by a ton of things
• due to toxic, infectious or cirrhotic causes
• **Results in : **marrow hypofunction
  
  • mainly affects RBC precursors, less commonly WBCs and megakaryocytes

Question 17

ACRF (anemia of chronic renal failure)

Answer 17

• severity of anemia is proportional to the severity of uremia
• Multifactorial basis
  
  • reduced red cell production (main cause)
  • Extracorpuscular defect induces chronic hemolysis
  • Iron def secondary to bleeding encountered in uremia