ANEMIA Flashcards

1
Q

What type of anemia?

SICKLE CELL DISEASE

A

Normo Normo with increased reticulocytes

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2
Q

All aplastic anemia generally exhibit Normo-Normo type, except for ______ which may have a ______ type of anemia

A

Fanconi Anemia = macrocytic

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3
Q

Renal disease is what type of anemia

A

Normo Normo with normal or low reticulocytes

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4
Q

Inherited aplastic anemia makes up _____% of all aplastic anemia cases

A

15-20%

ACQUIRED APLASTIC ANEMIA is majority (80-85%)

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5
Q

_______Drug most frequently associated in ______ aplastic anemia

A

Chloramphenicol - acquired

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6
Q

Confirmatory test to detect PNH. This is also known as what disease?

A

Flow cytometry

Aka MARCHIAFAVA-MICHELI syndrome

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7
Q

Apart from fanconi anemia, what are 2 other associated conditions for inherited type of aplastic anemia

A
  1. Scwachman-Bodian-Diamond syndrome

2. Dyskeratosis congenita

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8
Q

DAF is also known as

A

CD 55

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9
Q

Deficiency in complement regulatory proteins is present in what condition? What are these CRP’s?

A

Paroxysmal nocturnal hemoglobinuria (PNH)

Deficient in DAF/CD-55 and MIRL/CD-59

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10
Q

CD-59 is also known as

A

MIRL- Membrane Inhibitor of Reactive lysis

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11
Q

3 general mechanisms of anemia

A
  1. Hemorrhage
  2. Hemolysis
  3. Low production of RBC
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12
Q

What is the first consideration when a patient has anemia?

A

Hemorrhage

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13
Q

Common site of significant bleeding occurs in the ______

A

Gastrointestinal tract

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14
Q

List the diseases associated with MICROCYTIC, HYPOCHROMIC anemia

A

TAILS

Thaassemia; Anemia of chronic inflammation; IDA; Lead poison; sideroblastic anemia

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15
Q

Tests for PNH

A
  1. Ham’s acidified serum
  2. Sugar water (sucrose hemolysis) test
  3. Flow cytometry
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16
Q

Physical abnormalities and cancer susceptibility may be associated with fanconi anemia. List those physical abnormalities

A
  1. Skeletal - thumb malformation, microcephaly, scoliosis
  2. Skin - hyper/hypopigmentation, cafe au lait
  3. Short stature
  4. Abnormality - eye, kidney, genital
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17
Q

MICROCYTIC anemia may result from insufficiency of _______ = insufficient erythropoeisis

A

Iron = abnormal iron studies

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18
Q

Acute leukemia results in ______ erythropoeisis

A

Insufficient

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19
Q

Renal disease results in _____ erythropoeisis

A

Insufficient

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20
Q

Early development of MICROCYTIC anemia shows ________; no obvious anemia developed

A

Low iron stores

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21
Q

Most common anemia

A

IDA

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22
Q

The most common pica is called _______; craving for _____

A

Pagophagia; ICE

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23
Q

Most common anemia seen in hospitalized patients

A

ACI

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24
Q

A cause for IDA is high demand for iron commonly seen among:

A

Pregnancy, adolescence, lactation

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25
Q

The difference between sideroblast and siderocyte. Since commonly they have iron granules

A

SideroBLAST = nucleated

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26
Q

This type of anemia occurs when there is low serum iron, yet very high iron stores

A

ACI = sideropenia

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27
Q

Acute phase reactants associated with ACI

A
  1. Lactoferrin
  2. Ferritin
  3. Hepcidin
28
Q

What type of anemia does ACI usually present, given the case is not so advanced

A

Normo-normo

Only when advanced state = MICROCYTIC, hypochromic

29
Q

Hallmark of the anemia that occurs when protoporphyrin production or incorporation of iron into it is prevented

A

Sideroblastic anemia = RINGED SIDEROBLAST

30
Q

In this anemia, iron becomes trapped in the mitochondria

A

Sideroblastic anemia (micro,hypo)

31
Q

Possible cause of IDA

A
  1. Menstruation (blood loss)
  2. High iron demand
  3. Nutritional deficiency
  4. GIT malignancy
  5. Hookworm
32
Q

Differentiation of MICROCYTIC, hypochromic anemias:

Give the iron study results (Serum iron, ferritin, TIBC) in ACI

A

Serum iron = low

Ferritin = high

TIBC = low

33
Q

Serum iron = low

Ferritin = low

TIBC = high

This is most likely what condition?

A

IDA

34
Q

Which 2 conditions have similar iron studies:

Serum iron = high

Ferritin = high

TIBC = normal

A

Sideroblastic anemia and thalassemia

Although for FEP: sideroblastic anemia has mixed result, unlike thalassemia is normal ; other conditions is high

35
Q

Serum iron result in adults ____ in kids _____ with LEAD POISONING

A

Adults = normal to high

Child = normal to low

36
Q

What is the TIBC and ferritin result in patients with lead poisoning, both child and adult?

A

TIBC = normal

Ferritin = normal

Note: iron is not affected in lead poisoning, only FEP result is high

37
Q

The most sensitive test for IDA

A

FERRITIN

Note: only IDA has a truly low iron store

38
Q

The first depletion when there is iron deficiency is low _____

A

Low iron stores (ferritin) = stage 1 IDA

39
Q

In frank IDA, which component is already affected?

A

Hemoglobin = functional iron depletion

40
Q

In stage 2 IDA, which is affected?

A

Iron in transit (serum iron becomes low = TIBC will increase )

41
Q

Stage 1 IDA is also known as _____ depletion

A

Storage iron depletion

42
Q

Lack of intrinsic factor may be due to what conditions (3)

A
  1. Gastrectomy - no stomach to produce IF
  2. H. Pylori infection - destroys parietal cell
  3. Pernicious anemia - antibodies to parietal cell & IF
43
Q

Renal dialysis may cause deficiency of ___

A

Folate

44
Q

What is pathognomonic for megaloblastic type of macrocytic, Normochromic anemia

A

Hypersegmented neutrophils

45
Q

Tapeworm infection (D. Latum) may cause what type of anemia?

A

Macrocytic, Normochromic anemia (vit b12 deficiency due to competition and intestinal obstruction)

46
Q

Give 3 conditions associated with presence of big RBC (non-megaloblastic)And this increase in cell size is due to ____

A

Liver disease - high cholesterol in rbc membrane (can’t clear out; no HDL)

Chronic alcoholism - directly affects BM, HSC differentiation

Bone marrow failure

Macrocytosis in non-megaloblastic anemia is due to presence of immature cells (big) and not due to impaired nuclear differentiation

47
Q

Shape of macrocytes present in non-megaloblastic anemia

A

Round

Oval in MEGALOBLASTIC

48
Q

Which among vit b12 and folate does its nutritional value decrease if food is overcooked

A

Heat label = folate

Ex: leafy veggies, liver, orange, beans, beef, fortified cereals, dairy

49
Q

______ may result if pregnant woman is deficient in folate

A

Neural tube defects (fetal nervous system) = spina bifida

50
Q

Which among VitB12 or folate is most frequent? And why is it infrequent in the other or who may be affected in such cases

A

Folate deficiency is more common

VitB12 may occur in STRICT VEGETARIANS

51
Q

Difference in the blood picture between deficiency in folate and vitamin b12

A

None. Indistinguishable

52
Q

Which component is important in DNA synthesis?

A

TTP - Thymidine triphosphate

53
Q

A synthetic form of vitamin b12 found in supplements

A

CYANOCOBALAMIN

54
Q

What replaces TTP when it is not formed due to deficiency in folate and/or VitB12?

A

Deoxyuridine triphosphate

55
Q

Why is vitamin b12 important in the successful synthesis of DNA?

A

Functions to transfer the methyl group (from methyl THF/ Folic acid) to produce TTP

56
Q

3 consequences if DEOXYURIDINE TRIPHOSPHATE replaces TTP

A
  1. Nuclear fragments
  2. Cell destruction
  3. Impaired cell division
57
Q

Neurological and neuropsychiatric symptoms are seen in ______

A

Vitamin b12 deficiency

58
Q

CBC picture both for folate and VitB12 deficiency

A
LOW = RBC, Hct, Hb, WBC, PLT
HIGH = MCV, MCH
59
Q

Total and B1 in folate and vit b12 deficiency is ______

A

HIGH

Also high: serum LACTATE DEHYDOGENASE

60
Q

What cells and other characteristics found in folate/VitB12 deficiency during MANUAL DIFFERENTIAL COUNT

A
  1. Anisocytosis
  2. Poikilocytosis = oval macrocytes
  3. RBC inclusion
  4. Hypersegmented neutrophils
61
Q

Total and indirect biliribin (serum) is a _______ type of test for folate/ vit b12 deficiency

A

SCREENING

62
Q

Metabolically active form of Vit.B12 is called ____

A

HoloTc - holotranscobalamin (VitB12+transcobalamin complex)

63
Q

____% of VitB12 is bound to transcobalamin 2

A

10-30%

Note: 75% bound to Transcobalamin 1, 3

64
Q

Minimum number of lobes to be classified as a Hypersegmented neutrophil. This is pathognomonic for?

A

6 lobes; megaloblastic anemia

65
Q

In folate deficiency, holoTc is _____ (high/low)

A

LOW - folate is not associated with holoTc (VitB12-transcobalamin complex)

66
Q

Serum homocysteine is HIGH in _____

A

Both folate and VitB12 deficiency

Note: its presence is due to either no source of methyl group since no folate OR no cofactor to stimulate the conversion of homocysteine to methionine

67
Q

What are other possible PBS findings in megaloblastic anemia

A

Teardrop cell

Basophilic stippling

Cabot ring

NRBC

Howell jolly body