Anemia Flashcards
definition of anemia
low hgb, hct, or RBC count compared to normal age and gender controls ( >2 sd below mean)
anemia h/h for women
hgb < 12
hct < 36
h/h values for men
hbg < 13.5
hct < 41
average size (volume) of RBC
MCV
average hgb content in rbc
MCH
low mch on peripheral smear shows up as
hypochromia
variation in RBC size
rdw
low rdw means that
rbc are all around same size
high rdw means
lots of variation in rbc size
possible causes for anemia (5)
bone marrow suppression
iron deficient
B12/folate deficient
chronic dz
recurrent ifnxns
s/s of anemia
fatigue
tachycardia
angina
dyspnea
palpitations
bleeding
dizziness
tachypnea
weakness
syncope
hpi anemia clues
melena
abd pain
NSAIDs/OAC
hx ulcer
pica
hx abdominal surgery
gait problems
memory problems
etoh
moonshine
lead paint/pipes
g6pd, ssa, thalassemia
meds
transfusion
easy bruising
main pe test for anemia
fobt
skin manifestations of anemia
pallor of skin or conjunctiva
jaundice
petecchiae/ecchymoses
heent findings of anemia
glossitis
stomatitis
decreased vibratory sense
impaired proprioception
cardiac sx of anemia
tachycardia
new murmur
orthostatic hypotn
2 other pe findings of anemia
splenomegaly
LAD
microcytic anemia definition
mcv < 80
3 ex of microcytic anemia
ida
thalassemia
sideroblastic
sideroblastic anemia is mc associated w.
lead toxicity
also copper deficiency and zinc poisoning
mc cause of anemia worldwide
ida
ida should make you think
gi bleed
besides gi bleed, other causes for ida
pud
ca
nsaids
menstrual loss
what do you think when you see, cheilosis, smooth tongue, brittle nails, esophageal webs (plummer-vinson syndrome)
severe ida → hct < 25%
unique symptom of ida
pica
in ida, __ will be decreased (2)
and __ will be increased
decreased: ferritin, serum iron concentration
increased: TIBC
chains of hgb molecule
2 alpha
2 beta
thalassemia involves abnormal
hgb production
t/f: thalassemia can involve a OR b hgb proteins
T!
spectrum of dz in thalassemia
silent carrier → profound anemia
what do you think when you see: target cells, basophilic stippling, poikilocytes
smear findings for thalassemia
serum iron, ferritin, RBC count findings for thalassemia
normal to elevated
dx for thalassemia
electrophoresis
normocytic anemia definition
mcv 80-100
causes for normocytic anemia
acute blood loss
anemia of chronic dz/anemia of inflammation
chronic renal insufficiency
hemolysis
bone marrow suppression
endocrine dysfxn
endocrine causes of normocytic anemia (2)
hypothyroidism
hypopituitarism
3 conditions that commonly cause aocd
ckd
dm
chronic ai dz
pathophys of aocd
chronic inflammation → cytokine release → decreased rbc → decreased ebo → decreased iron absorption
classification of aocd
normochromic or normocytic
serum iron in aocd
decreased
tibc in aocd
normal - low
serum ferritin in aocb
normal - high
acute phase reactants in aocd
ferritin
esr
crp
in hemolytic anemia, __ is decreased
and __ is increased
RBC survival
cell lysis
hereditary causes of hemolytic anemia (4)
g6pd
ssa
hereditary spherocytosis
thalassemia
trauma/immune attack causes of hemolytic anemia (7)
TTP
HUS
DIC
valvular hemolysis
infxns
burns
hypersplenism
lab elevations in hemolytic anemia (2)
reticulocytes
indirect bilirubin
ldh
lab decreases in hemolytic anemia (2)
hgb
haptoglobin
what might smear for hemolytic anemia show
schistocytes
macrocytic anemia definition
mcv > 100
causes of macrocytic anemia (6)
etoh
folate deficiency
B12 deficiency
myelodysplastic syndromes (mds)
liver dz
reticulocytosis
drug-induced anemia
aml
what does mds stand for
myelodysplastic syndromes
what are mds
group of malignant hematopoietic stem cell disorders
dysplastic and ineffective blood cell production
mds increases risk for
acute luekemia
mds can be __
or __ (3)
de novo
chemo, environmental toxins, xrt
anemia PLUS low wbc makes you think (4)
aplastic anemia
bone marrow suppression
B12 deficiency
hypersplenism
anemia PLUS elevated wbc makes you think (3)
infxn
inflammation
hematologic malignancy
