ABC's of Anemia Flashcards
Reticulocytes
1 day old red blood cells still with a nuclei and synthesize proteins
What are the symptoms of anemia?
Lightheadedness, syncope, dizziness Dyspnea on exertion Easily fatigued Angina Dementia
If you view black stool what does that indicate about the internal bleeding?
Bleeding proximal to ligament of treitz
Melena
If you view red stool what does that indicate about the internal bleeding?
Lower > upper GI tract
Hematochezia
What amount of blood is assumed to be lost with occult stool? *
20-30 mL blood loss a day
If your MCV (mean corpuscular volume) is 80-100 what does that mean?
Normocytic
If your MCV is less than 80 what does that mean?
Microcytic
Hemoglobin problem
If your MCV is 100 or higher what does that mean?
Macrocytic
Cell membrane problem
If you have normocytic anemia and have acute blood loss what could be the cause?
Shifting fluids
If an exam, you find normocytic cells and a hemoglobin level of 10 what is a possible diagnosis?
Anemia of chronic kidney disease (CKD)
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? *
LUPUS
Inflammation - RA
Chronic infection - osteomyelitis, TB
Maliganancy
If you have microcytic anemia with an MCV around 70-79 what should you think of? *
Iron deficiency or lead poisoning
If you have microcytic anemia with an MCV less than 70 what should you think of?
Hemoglobinopathy
What is the most likely scenario to see iron deficiency anemia?
Chronic blood loss
GI blood loss expected etiology
If you have a pt with iron deficiency who is over 50, what do you need to rule out? *
Colon cancer
In a lab exam, what factors would you look at the determine an iron deficiency?
Ferritin: Low Serum iron: Low Transferrin: inc Transferrin saturation %: low Total iron binding capacity (TIBC): high
What disease process would give your pt iron deficiency with inflammation?
Colon cancer
If a pt is found to have hemoglobinopathy you can assume they have;
Thalassemia
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; *
Sickle cell anemia
What could be some causes of macrocytic anemia? *
Vitamin B12 deficiency
Folate deficiency
If both B12 and folate are low it is called _____ and leads to _____. *
Megaloblastic anemia, pancytopenia
What are some way to obtain an B12 deficiency? *
Lack of intake (alcohol abuse)
Lack of absorption (perniscious anemia - lack of intrinsic factor for binding or terminal ilem nonfunction or absent)
How can you diagnose a B12 deficiency?
Multi-segmented PMN
Low levels B12
(If B12 normal, check homocystine and methylmalonic acid for elevation)
How do you treat a vit B12 deficiency?
Intramuscular vit B12
1000 mg daily for 3 days, then once a month for 11 months then yearly
How would someone obtain a folate (B9) deficiency?
Lack of intake due to alcohol
How would a folate deficiency be diagnosed?
Low folate
RBC folate level low
How do you treat a folate deficiency?
Folic acid 1 mg PO daily
