Anemia

Question 1

Microcytic

Answer 1

MCV < 80

Question 2

Normocytic

Answer 2

MCV 80-96

Question 3

Macrocytic

Answer 3

MCV > 96

Question 4

Hypochromic

Answer 4

MCH Low

Question 5

Normochromic

Answer 5

MCH Normal (27-33)

Question 6

Macrochromic

Answer 6

MCH High

Question 7

Macrocytic Anemia causes

Answer 7

Vit B12 Deficiency
Alcoholism
Liver disease
DNA replication inhibitors (Methotrexate)

Question 8

Normocytic Anemia

Answer 8

Acute blood loss
Chronic bone disease
Bone marrow failure
Hemolysis

Question 9

Microcytic Anemia

Answer 9

Hem synthesis defect – iron deficiency, chronic disease
Globin synthesis – thalassemia, sideroblastic defect

Question 10

Sickle Cell (inherited)

Answer 10

• Pain is cardinal subjective symptom of sickle cell crisis, nausea, anorexia, lightheaded anxiety, SOB, palpitations.
• Patients should be instructed to avoid triggers (cold, heat, dehydration), maintain adequate hydration, correct hypoxia if needed.
• Acute treatment – aggressive IV or oral hydration, pain relief, PO Benadryl to control pruritis from opiate analgesics, Hydroxyurea, transfusions
  Normocytic, Normochromic

Question 11

Thalassemia

Answer 11

Microcytic, hypochromic,
RDW normal
* Minor = no treatment, avoid iron for incorrect dx.
* Major = Transfusion

Question 12

IDA (MOST COMMON)IDA (MOST COMMON)

Answer 12

Microcytic, hypochromic,
RDW high (longstanding will be normal)
* Signs - stomatitis, glossitis (burning tongue), brittle fingernails, platonychia, koilonychia, PICA.
* Instruct on diet rich in foods containing iron such as organ meats, red meat, dried peas and beans, dark veggies, whole grains.
* 150-200 mg/d elemental iron when deficient for 4-6 months.
* Serum ferritin – if you see changes in MCV, MCH, add it on to labs – single most powerful test for IDA