ABC's of Anemia

Question 1

Reticulocytes

Answer 1

1 day old red blood cells still with a nuclei and synthesize proteins

Question 2

What are the symptoms of anemia?

Answer 2

Lightheadedness, syncope, dizziness
Dyspnea on exertion 
Easily fatigued 
Angina
Dementia

Question 3

If you view black stool what does that indicate about the internal bleeding?

Answer 3

Bleeding proximal to ligament of treitz

Melena

Question 4

If you view red stool what does that indicate about the internal bleeding?

Answer 4

Lower > upper GI tract

Hematochezia

Question 5

What amount of blood is assumed to be lost with occult stool? *

Answer 5

20-30 mL blood loss a day

Question 6

If your MCV (mean corpuscular volume) is 80-100 what does that mean?

Answer 6

Normocytic

Question 7

If your MCV is less than 80 what does that mean?

Answer 7

Microcytic

Hemoglobin problem

Question 8

If your MCV is 100 or higher what does that mean?

Answer 8

Macrocytic

Cell membrane problem

Question 9

If you have normocytic anemia and have acute blood loss what could be the cause?

Answer 9

Shifting fluids

Question 10

If an exam, you find normocytic cells and a hemoglobin level of 10 what is a possible diagnosis?

Answer 10

Anemia of chronic kidney disease (CKD)

Question 11

Say you find normocytic cells with a hemoglobin level of 10 and the anemia is due to chronic inflammatory disease, what could the diagnosis be due to? *

Answer 11

LUPUS
Inflammation - RA
Chronic infection - osteomyelitis, TB
Maliganancy

Question 12

If you have microcytic anemia with an MCV around 70-79 what should you think of? *

Answer 12

Iron deficiency or lead poisoning

Question 13

If you have microcytic anemia with an MCV less than 70 what should you think of?

Answer 13

Hemoglobinopathy

Question 14

What is the most likely scenario to see iron deficiency anemia?

Answer 14

Chronic blood loss

GI blood loss expected etiology

Question 15

If you have a pt with iron deficiency who is over 50, what do you need to rule out? *

Answer 15

Colon cancer

Question 16

In a lab exam, what factors would you look at the determine an iron deficiency?

Answer 16

Ferritin: Low 
Serum iron: Low 
Transferrin: inc 
Transferrin saturation %: low  
Total iron binding capacity (TIBC): high

Question 17

What disease process would give your pt iron deficiency with inflammation?

Answer 17

Colon cancer

Question 18

If a pt is found to have hemoglobinopathy you can assume they have;

Answer 18

Thalassemia

Question 19

If your pt has a hemoglobin between 7 - 10 with HgB A 0%, Hgb S 98%, Hgb F 2% with vaso-occulsive crisis combined with secondary issues like stroke, cholelithiasis and osteonecrosis o the femoral head we can assume this pt has; *

Answer 19

Sickle cell anemia

Question 20

What could be some causes of macrocytic anemia? *

Answer 20

Vitamin B12 deficiency

Folate deficiency

Question 21

If both B12 and folate are low it is called _____ and leads to _____. *

Answer 21

Megaloblastic anemia, pancytopenia

Question 22

What are some way to obtain an B12 deficiency? *

Answer 22

Lack of intake (alcohol abuse)

Lack of absorption (perniscious anemia - lack of intrinsic factor for binding or terminal ilem nonfunction or absent)

Question 23

How can you diagnose a B12 deficiency?

Answer 23

Multi-segmented PMN
Low levels B12
(If B12 normal, check homocystine and methylmalonic acid for elevation)

Question 24

How do you treat a vit B12 deficiency?

Answer 24

Intramuscular vit B12

1000 mg daily for 3 days, then once a month for 11 months then yearly

Question 25

How would someone obtain a folate (B9) deficiency?

Answer 25

Lack of intake due to alcohol

Question 26

How would a folate deficiency be diagnosed?

Answer 26

Low folate

RBC folate level low

Question 27

How do you treat a folate deficiency?

Answer 27

Folic acid 1 mg PO daily