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Pathoma > 5.2 Microcytic Anemias > Flashcards

5.2 Microcytic Anemias Flashcards

1
Q

What is the MCV in microcytic anemias?

A

Less than 80

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2
Q

What is the general problem in microcytic anemia?

A

Decreased production of Hb

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3
Q

What some of the causes of microcytic anemia?

A
  • Fe Deficiency
  • Anemia of Chronic Disease
  • Sideroblastic (defect of heme synthesis)
  • Thalassemia (deficiency of globin)
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4
Q

What is the most common type of anemia?

A

Fe Deficiency Anemia

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5
Q

Where does Fe absorption occur?

A

Duodenum

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6
Q

What is the Fe transport molecule?

A

Transferrin

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7
Q

What is the Fe storage molecule?

A

Ferritin

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8
Q

What is the common cause of Fe deficiency in an adult male?

A

Peptic Ulcer Disease

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9
Q

What is the common cause of Fe deficiency in an adult female?

A
  • Menorrhagia

- Pregnancy

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10
Q

What is the common cause of Fe deficiency in an elderly adult?

A

Colon polyps or carcinoma in the West and Hookworm in 3rd world countries.

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11
Q

What happens to the TIBC as ferritin decreases?

A

Increases

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12
Q

What are the size of the RBCs in early Fe deficiency?

A

Normocytic Anemia - RBCs are made normally, but less are made due to deficiency

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13
Q

What are the clinical features of Fe deficiency?

A
  • Anemia
  • Koilonychia
  • Pica
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14
Q

What will the value of the RDW be in Fe deficiency anemia?

A

Increased

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15
Q

What is free erythrocyte protoporphyrin?

A

Free protoporphyrin that is indicative of Fe deficiency anemia due to Fe being decreased but protoporphyrin levels being normal.

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16
Q

What is an associated syndrome with Fe deficiency anemia?

A

Plummer-Vinson Syndrome

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17
Q

How does Plummer-Vinson Syndrome present?

A

Presents with anemia, dysphagia and beefy red tongue

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18
Q

What is anemia of chronic disease associated with?

A
  • Chronic Inflammation

- Cancer

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19
Q

How does chronic disease lead to anemia?

A

Hepcidin sequesters Fe in storage site and limits Fe transfer from macrophages and it decreases EPO production.

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20
Q

What is the function of hepcidin?

A

Sequesters Fe to prevent access by bacteria - response to inflammation

21
Q

How can ACD present in its early phase?

A

Normocytic Anemia

22
Q

Sideroblastic Anemia

A

Anemia due to defective protoporphyrin synthesis

23
Q

What is the rate limiting enzyme in the formation of protoporphyrin?

A

ALAS - cofactor is Vitamin B6

24
Q

Where in the cells is Fe attached to protoporphyrin?

A

Mitochondria

25
Q

What are the cells seen in sideroblastic anemia?

A

Ring Sideroblasts - Fe is in the mitochondria

26
Q

What is the defect in congenital sideroblastic anemia?

A

Defect in ALAS enzyme

27
Q

What are some acquired causes of sidroblastic anemia?

A
  • Alcoholism
  • Lead Poisoning
  • Vitamin B6 Deficiency
28
Q

What drug can cause Vitamin B6 deficiency?

A

Isoniazid

29
Q

Thalassemia

A

Decreased synthesis of globin chains

30
Q

What is thalassemia protective against?

A

Plasmodium falciparum

31
Q

Components of HbF

A

alpha2 gamma2

32
Q

Components of HbA

A

alpha2 beta2

33
Q

Components of HbA2

A

alpha2 delta2

34
Q

What is the cause of alpha-thalassemia?

A

Due to a gene deletion - there are normally 4 alpha alleles on Ch16

35
Q

What happens with 1 alpha gene deletion?

A

Asymptomatic

36
Q

What happens with 2 alpha gene deletions?

A

Mild anemia with slightly increased RBC count

37
Q

Which deletion of 2 alpha genes is worse, cis or trans?

A

cis - it is due to an associated with an increased risk of severe thalassemia in offspring

38
Q

What group is the cis deletion of 2 alpha genes seen more often in?

A

Asians

39
Q

What group is the trans deletion of 2 alpha genes seen more often in?

A

Africans

40
Q

What happens with 3 alpha gene deletions?

A

Severe anemia with tetramers of HbH formed from beta chains that damage RBCs

41
Q

What happens with 4 alpha gene deletions?

A

Lethal in utero due to hydrops fetalis - gamma chains form tetramers called Hb Barts that damage RBCs

42
Q

What is the cause of beta-thalassemia?

A

Mutation of the beta genes on Ch11

43
Q

Beta Thalassemia Minor

A

1 normal beta and 1 beta +

  • Usually asymptomatic
44
Q

What cells are seen on smear of beta thalassemia minor?

A

Target Cells

45
Q

What is the key lab finding in beta thalassemia minor?

A

Increased HbA2

46
Q

Beta Thalassemia Major

A

2 beta 0

  • Most severe and presents with anemia several months after birth as HbF is temporarily protective
47
Q

What will be seen on x-ray of a patient with beta thalassemia major?

A

Crew Cut Appearance

48
Q

What will be seen on blood smear of beta thalassemia major?

A

Hypochromic Target Cells

49
Q

What is the key lab finding of beta thalassemia major?

A

Little to no HbA

Pathoma (119 decks)

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