9 Hematology 1 Flashcards

0
Q

Sideroblastic anemia

A

Inadequate/abnormal use of marrow iron–> polychromatic, stippled, targeted RBCs
Part of myelodysplastic syndrome, Hemoglobinopathies (esp thalassemia)
Dx: if microcytic, or high RDW
Labs: CBC w peripheral smear, iron, ferritin, bone marrow biopsy
*check for serum lead

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1
Q

Iron def anemia

A

Microcytic. Due to…
Absorption in stomach, duodenum, upper jejunum. Best as heme (meat), need gastric secretions, reduced by phytates/tannins/antacids/lead. Reduced by achorohydria, strophic gastritis, H pylori, SIBO, gastric bypass, celiac.
Stool occult blood, cbc w peripheral smear, serum iron, TIBC, ferritin

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2
Q

Anemia of Chronic Disease

A

causes: infections, inflammation, neoplastic dz, trauma, heart failure, DM, anemia of elderly, immune activation
cytokines: IL beta and TNFalpha
Labs: CBC w peripheral smear, iron, transferrin, trasnferrin receptor, serum ferritin

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3
Q

Hypoproliferative Anemia

A

low BM activity due to lack of EPO/inability to respond
renal dz due to low EPO
hypo/hyperthyroidism, panhypopituitarism, hyperparathyoidism
severe protein malnutrition
Labs: renal function, TSH, CBC w peripheral smear, BM biopsy

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4
Q

Aplastic/Hypoplastic Anemia

A

uncommon. pancytopenia of all cell lines.
genetic: Fanconi’s anemia, inability to clear gulatathione S transferase
acquired: chemical exposure, drugs, anticancer, pesticides
Pure red cell aplasia: infections, thymomas, immune sys injury
Labs: CBC w peripheral smear, iron, reticulocytes, BM biopsy

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5
Q

Myelophthisis

A

displacement of hemopoietic bone-marrow tissue into the peripheral blood, either by fibrosis, tumors or granulomas.. occurs with leukemia, lymphomas, myelofibrosis disorders

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6
Q

Myelophthisic Anemia

A

marrow replaced by tumor granuloma, lipid storage dz, fibrosis.
may see splenomegaly, bone pain
Labs: CBC w peripheral smear (anisocytosis, poikilocytosis), marrow biopsy

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7
Q

Macrocytic Anemia

A

causes: alcoholism, B12/folate def (“megaloblastic”), cytotoxic drugs, hypothyroid, liver dz
if severe: stocking glove neuropathy, dementia, glssitis, diarrhea, muscle wasting
Labs: CBC w periph smear, B12, folate. MCV>95, anisocytokis, poikilocytosis, Howell Jolly bodies, hypersegmented neutrophils–>neutopenia

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8
Q

Warm AIHA

A

most common, more in women, >37C
due to: spontaneous, viral infections, immune def, drugs, SLE, lymphoma, CLL
spleen
Dx: Coomb’s antiglobulin test

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9
Q

Cold AIHA

A

s antiglobulin test

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10
Q

Hereditary Spherocytosis

A

congenital RBC membrane defect. autosomal dominant. may be hepato/splenomegaly, cholelithiasis
Dx: spheroidal RBCs, anisocytosis, normal/low MCV, elevated MCHC, osmolytic fragility

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11
Q

Heriditary Ellipocytosis

A

congenital RBC membrane defect. rare, autosomal dominant.
may be hepato/splenomegaly, cholelithiasis
Dx: oval RBCs, anisocytosis, normal/low MCV, elevated MCHC, osmolytic fragility

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12
Q

Stomatocytosis

A
rare, RBC 
membrane disorder, increased fragility.
congential--severe, presents early
acquired--excess alcohol ingestion
RBCs have straight area of central pallor
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13
Q

Hypophosphatemia

A

low phosphate depletes RBC ATP–>rigid/fragile RBC

small, spheroid RBCs

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14
Q

G6P deficiency

A

Favism. x linked. Hemolysis if exposed to oxidants, sulfonamides, nitrofuran, Vit K, fava beans
sudden onset jaundice, pallor, dark urine. may be back pain, renal failure
Labs: Heinz bodies. bite cells, G6PD assay
self-limiting (usu)

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15
Q

Sickle Cell Anemia

A

she did her undg research on this…
chronic hemolytic anemia. heterozygous–>protection from malaria
SSx: painful bony crises, renal damage, punched out leg ulcers, splenic infarcts, severe anemia, splenomegaly
Labs: low RBCs, Hct, Hb, normocytic anemia, levated bilirubn, Hb electrophoresis (to tell bet hetero and homozygous)

16
Q

Hemoglobin C Disease

A

genetic, may be assoc w sickle cell dz

17
Q

Thalassemia

A

inherited defects in rate of syn, ineff erythrpoiesis, low RBC production
major=homozygous. Beta Thal Major most common
minor=hetero. milder disease
SSx: heart failure, failure to thrive, splenomegaly, jaundice, leg ulces, gall stones,
Labs: microcytic, hypochromic anemia, target cells, basophilic stippling, nucelated RBCs, anisocytosis, poikilocytosis, abnormal Hb electrophoresis

18
Q

Leukopenia

A

absolute decrease in WBCs. May be pancytopenic, or only one type

19
Q

Neutropenia

A

<200/mm3: rapidly fatal infections
Sxs: only w infection (cellulitis, liver abscesses, furunculosis)
Dx: CBC, PE to see which type of infection, history to determine cause

20
Q

Intrinsic Neutropenia

A

rare. defects in myeloid cells/precursors. congenital/idiopathic

21
Q

Secondary Neutropenia

A

drugs, BM infiltration (CA, myelofibrosis), splenomegaly, infections (viral infxns, HIV), alcoholism, SLE, folate/B12 def, leukemia, transfusions

22
Q

Lymphocytopenia

A

s, alcohol, malnutrition

Ssxs: recurrent infections, absent/1+ tonsils