3.21.14* TBL

Question 1

Which of these mechanisms contribute to iron overload in patients with beta thalassemia minor?

a. increased uptake of dietary iron
b. reduced ferroportin activity
c. hemolysis
d. increased RBC iron
e. Decreased mobilization of iron stores

Answer 1

a. Hepsidin is downregulated because the body senses anemia. (p.38)

Question 2

How does aspirin lead to anemia?

Answer 2

a. bleeding by inhibiting platelets

b. irritating gastric mucosa

Question 3

Are these due to iron, b12 or folate deficiencies?

i. Koilonychia
ii. esophageal webbing
iii. abnormal gait
iv. lemon yellow complexion
v. angular chelitis

Answer 3

i. iron
ii. iron
iii. B12
iv. B12 and folate
v. iron

Question 4

What are the following are related to macrocytic, microcytic hypochromic, or normocytic hypochromic normochromic anemia:

i. aplastic anemia
ii. early blood loss
iii. iron deficiency anemia
iv. anemia of chronic disease
v. thalassemia
vi. sideroblastic anemia
vii. pernicious anemia
viii. folate deficiency
ix. liver disease

Answer 4

i. n
ii. n
iii. n -> mi
iv. n -> mi
v. mi
vi. mi
vii. ma
viii. ma
ix. ma

Question 5

macrocytosis can sometimes be caused by

Answer 5

reticulocytes

Question 6

29 y/o female with Hashimoto thyroiditis presents with SOB, fatigue and aundice for the past month. Recent thyroid testing was normal. Her SOB worsens with activity. She denies any chest pain, She also denies any abdominal pain or weight loss. A CBC drawn by her family physician reveals Hb of 6.2, Hct 19, MCV 102. Her WBC and platelet count are normal.

a. medication use
b. diet
c. hx of liver disease
d. hx of ice chewing
e. fever
f. occupation
g. Hx of donating blood

Answer 6

a, b, c,

Question 7

website

Answer 7

teachingcases.hematology.org/hemolytic/labData1.cfm

Question 8

nucleated RBCS are hyper- or hypo- proliferative?

Answer 8

hyper