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Hematology > Anemia > Flashcards

Anemia Flashcards

1
Q

Dx:

RBC				decreased
Hemoglobin	decreased
Hematocrit		decreased
MCV			normal	
MCH			normal
MCHC			normal
RDW			normal	
BUN				increased
Creatinine		increased
Urinalysis		+1 protein
EPO				decreased
A

Anemic
Normocytic
MCHC – Normochromic
Decreased EPO – Renal disease

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2
Q 
Dx:
RBC				decreased
Hemoglobin	decreased
Hematocrit		decreased
MCV			decreased
MCH			decreased
MCHC			decreased
RDW			elevated/normal
A

Anemia
Microcytic
Hypochromic (MCV)
(RDW) variation and size

Iron deficiency

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3
Q 
Dx:
RBC				decreased
Hemoglobin	decreased
Hematocrit		decreased
MCV			elevated
MCH			elevated
MCHC			normal
RDW			elevated
A

Anemia
Macrocytic
Normochromic
RDW –

Not enough for a dx
Most common – B12 deficiency

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4
Q 
Dx:
RBC: 				decreased
Hemoglobin:			decreased
Hematocrit:			decreased
MCV:				decreased
MCH:				decreased
MCHC:				decreased
RDW:				elevated
Ferritin:				decreased
Iron:					decreased
Transferrin saturation:	decreased
TIBC:				increased
A 
Anemia
Microcytic
Hypochromic
Variation in cell size 
Low iron stores
Iron deficiency
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4
Q 
Dx:
RBC: 				decreased
Hemoglobin:			decreased
Hematocrit:			decreased
MCV:				decreased
MCH:				decreased
MCHC:				decreased
RDW:				elevated
Ferritin:				decreased
Iron:					decreased
Transferrin saturation:	decreased
TIBC:				increased
A 
Anemia
Microcytic
Hypochromic
Variation in cell size 
Low iron stores
Iron deficiency
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5
Q 
Dx:
RBC:			decreased
Hemoglobin:		decreased
Hematocrit:		decreased
MCV:			normal
MCH:			normal
MCHC:			normal
RDW:			normal
Ferritin:			elevated
Iron:				normal 
TIBC:			decreased
A 
Anemia
Normocytic
Normochromic
Variation in cell size
Increased iron stores
Anemia of chronic disease
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6
Q 
Dx:
RBC:					decreased
Hemoglobin:			decreased
Hematocrit:			decreased
MCV:				normal
MCH:				normal
MCHC:				normal
RDW:				normal
Iron:					elevated
Transferring saturation: elevated
Ferritin:				elevated
TIBC:				decreased
Bilirubin:				elevated
Haptoglobin			decreased
Urinalysis:    positive for urobilinogen
A 
Anemia
Normocytic
Normochromic
No variation in cell size
Iron abundance
Hemolytic Anemia
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7
Q 
Dx:
RBC:		decreased
Hemoglobin:	decreased
Hematocrit:	decreased
MCV:		normal
MCH:		normal
MCHC:		normal
RDW:		normal
WBC:		decreased
Platelets:		decreased
A 
Anemia
Normocytic
Normochromic
No variation in cell size
Pancytopenia
Aplastic Anemia
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8
Q 
Dx:
RBC:		decreased
Hemoglobin:	decreased
Hematocrit:	decreased
MCV:		elevated
MCH:		elevated
MCHC:		normal
RDW:		elevated
Peripheral smear: 
ovalocytes and hypersegmented neutrophils 
Intrinsic Factor Antibody:	positive
A 
Anemia
Macrocytic
Normochromic
Variation in cell size
Megaloblastic
Pernicious anemia
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9
Q

Iron Deficiency Anemia:

Is serum iron or ferritin a better indicator of dx?

A

Ferritin: Most sensitive. Chief storage form of iron; directly proportional to iron stored in cells

Serum iron: Poor indicator, highly variable day to day/during the day

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10
Q

Anemia is classified as:

A

Increase RBC destruction
Decrease RBC production
Blood loss

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11
Q

Which questions are helpful when evaluating a patient for anemia?

A

Alcohol use
Diet
Menstrual hx
NSAID use

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12
Q

Which pattern best represents iron deficiency anemia?

Microcytic, hypochromic
Macrocytic normochromic
Macrocytic hyperchromic
Normocytic, normochromic

A

Microcytic, hypochromic

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13
Q

Which anemias are macrocytic, normochromic?

A

B12/folate deficiency

Pernicious anemia

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14
Q

Which anemias are microcytic, hypochromic?

A

Thalassemia
IDA
Sideroblastic

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15
Q

Which of the following is NOT a normocytic, normochromic anemia?

Hemolytic anemia
Iron deficiency anemia
Aplastic anemia

A

IDA

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16
Q

Which of the following laboratory tests is most sensitive and specific for determining the presence of anemia?

A

Hemoglobin

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17
Q

These are the two most common causes of anemia in the United States:

A

Anemia of chronic disease
and
Iron deficiency

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18
Q

What ddx is considered in an anemia patient with microcytosis and increased RDW?

A

IDA

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19
Q

What ddx is considered for an anemic patient with macrocytosis and increased RDW?

A

Liver disease
and
B12 or folate deficiency

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20
Q

Reticulocyte index is most useful for evaluating this type of anemia:

A

Normocytic, normochromic anemia

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21
Q

(T or F) A peripheral smear is helpful when anemia is discovered on a CBC.

A

Truuuuu chainz

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22
Q

Which form of iron is more bioavailable? Heme or non-heme?

A

Heme iron (meat based)

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23
Q

Which part of the GI tract is iron absorbed?

A

Duodenum

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24
Q

Which form of iron is absorbed through enterocytes?

A

Ferrous iron (Fe2+)

25
Q

What is the most common microcytic hypochromic anemia?

A

IDA

26
Q

Transferrin in produced in the:

A

Liver

27
Q

Total iron binding capacity (TIBC) measures:

A

All proteins available for binding mobile iron in the body

28
Q

(T or F) Severe stress can decrease serum iron levels

A

True

29
Q

(T or F) Serum iron is sensitive for detecting iron deficiency.

A

False

30
Q

What does serum iron testing evaluate?

A

Iron bound to transferrin

31
Q

What is the role of transferrin in iron metabolism?

A

Transports absorbed iron in plasma

32
Q

(T or F) Ferritin levels within normal range rule out iron deficiency.

A

False

33
Q

(T or F) Serum ferritin concentrations are typically directly correlated to iron storage.

A

True

34
Q

The majority of ferritin is stored in the:

A

Liver

35
Q

Which conditions are associated with decreased TIBC or transferrin?

A

Inflammatory diseases
Hypoproteinemia
Cirrhosis

36
Q

Which conditions are associated with increased TIBC or transferrin?

A

Estrogen therapy
Polycythemia
IDA

37
Q

(T or F) Ferritin acts as an acute phase reactant protein.

A

True

38
Q

In thalassemia, serum iron levels will be (increase/decreased)

A

Increased

39
Q

Intravascular hemolysis causes haptoglobin, a carrier for free hemoglobin to become (increased/decreased)

A

Decreased

40
Q

Which of the following markers is helpful in suspected acute hemolytic anemia?

Hematocrit
Serum iron
Haptoglobin
Ferritin

A

Haptoglobin

41
Q

B6 deficiency is associated with this type of anemia.

A

Microcytic, hypochromic

42
Q

Which pattern is associated with anemia of chronic disease?

Low serum iron and low ferritin
Low serum iron and high ferritin
High serum iron and high ferritin
High serum iron and low ferritin

A

Low serum iron and high ferritin

43
Q

Anemia of chronic disease is mediated by _________ and regulated by _________.

Cytokines; hepcidin
Erythropoietin; haptoglobin
Macrophages; hepcidin
Cytokines: haptoglobin

A

Cytokines; hepcidin

44
Q

Elevated hepcidin levels will have this effect on iron mobilization.

A

Block intestinal iron absorption
and
Block macrophage iron excretion

45
Q

Inflammation has this effect on hepcidin.

Upregulation
Downregulation
No effect

A

Upregulation

46
Q

Clinically, upregulation of soluble transferrin receptors suggests

Iron supplementation will be harmful to the patient

The patient will respond favorably to iron administration

The patient has enough iron and will not benefit from more

A

The patient will respond favorably to iron administration

47
Q

Aplastic anemia is characterized by which of the following?

Decreased serum iron
Increased serum iron
Polycythemia
Pancytopenia

A

Increased serum iron

Pancytopenia

48
Q

Which is the most common etiology for aplastic anemia?

Genetics
Radiation
Idiopathic
Environmental or chemical factors

A

Environmental or chemical factors

49
Q

Aplastic anemia is

A

Normocytic, normochromic

50
Q

G6PD is required for production of

A

NADPH
and
Reduced glutathione

51
Q

What are known or theorized oxidative stressors associated with GRPD deficiency hemolytic anemia?

A

Fava beans
Certain pharmaceuticals
High dose IV vitamin C

52
Q

Warm autoantibodies are typically this class of immunoglobulin

A

IgG

53
Q

Cold autoantibodies are typically this class of immunoglobulin.

A

IgM

54
Q

(T of F) Megaloblastic anemia is specific to B12 or folate deficiencies.

A

True

55
Q

Which of the following are true of megaloblastic anemia?

Synchronous maturation of RBCs

Impaired DNA synthesis

Delayed division of rapidly proliferating cells

Cellular gigantism

A

Impaired DNA synthesis

Delayed division of rapidly proliferating cells

Cellular gigantism

56
Q

(T or F) Pancytopenia may occur in severe cases of megaloblastic anemia

A

True

Lower than normal # of RBCs, WBCs, and platelets in the blood

57
Q

This anemia is associated with the finding of hypersegmented neutrophils on peripheral smear.

A

Megaloblastic anemia

58
Q

Which of the following is an outcome associated with B12 deficiency.

Heart disease

Hormonal imbalances

Irreversible neurological damage

Bleeding disorders

A

Irreversible neurological damage

59
Q

Pernicious anemia is due to

A

Autoimmunity against intrinsic factor and/or the parietal cells that produce it.

60
Q

(T or F) Hypothyroidism can cause macrocytosis.

A

True

Hematology (9 decks)

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