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CABS2: Hematology > Anemia > Flashcards

Anemia Flashcards

1
Q

what makes someone anemic

A

low iron
low b12
low folate
splenomegaly - hemolytic anemia
cancer
EPO - kidneys

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2
Q

what are the hormonal regulation for erythropoiesis

A

liver will make building blocks, stimulate
kidney
thyroid

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3
Q

what are the different types of anemias

A

poor production
blood loss
more EBCs being destroyed
combination

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4
Q

what does -cytic mean

A

cell size

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5
Q

what does -chromic mean

A

amount of hemoglobin

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6
Q

what is the presentation of anemia

A

depend on severity: may be asymptomatic
fatigue, weakness, pallor, palpitations, HA, exertional dyspnea, light headedness

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7
Q

what do the RBC indices help with

A

give information about size, weight, hemoglobin concerntation of the RBC
assists with classifying anemia

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8
Q

what is the MCV

A

mean corpuscular volume: average volume/size of one RBC

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9
Q

what is MCH

A

mean corpuscular hemoglobin: how much hemoglobin is within one RBC

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10
Q

what is MCHC

A

mean corpuscular hemoglobin concerntation: percentage of hemoglobin in one RBC

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11
Q

what is RDW

A

RBC distrubution width: indicates the variation in width of the RBCs

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12
Q

what is microcytic anemia

A

small RBC (defined as decreased MCV, seen on peripheral blood smear compared to other indicators)

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13
Q

what is the cause of microcytic anemia

A

iron deficinecy anemia
anemia of chronic disease
thalassemia

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14
Q

what is heme

A

a porphyrin ring that binds iron

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15
Q

what is globin

A

2 alpha gains and 2 beta chains (normal adult hemoglobins)

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16
Q

what is iron

A

binds oxygen to heme

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17
Q

what is iron deficiency anemia

A

iron binds to heme so that it can carry oxygen
low iron will cause small, pale RBCs
serum ferritin measure amount of total body stores of iron (<12mcg)

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18
Q

what is transferrin

A

a protein that assists with transport of the iron to where it needs to be - the blood, liver, spleen, marrow

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19
Q

what is seen on labs for iron deficiency anemia

A

low H&H
low MCV
Increased RBC distrubution width
low serum iron
low serum ferritin(most important test)
high total iron binding capacity (TIBC)
low transferrin iron percent saturation

20
Q

What is thalassemia

A

hereditary hemolytic anemia
autosomal recessive
mutation that results in problems iwth globin chain synthesis
microcytic anemia

21
Q

what is macrocytic anemias

A

big RBC (defined as increased MCV or seen on peripheral blood smear compared to other indicators) - may also see increased RDW
may be associated with increased reticulocytes

22
Q

what are the causes of macrocytic anemias

A

ETOH induced anemia
B12 deficiency anemia
Folate deficiency anemia
Hemolytic anemia

23
Q

what type of anemia may be associated with increased reticulocytes

A

macrocytic anemias

24
Q

where is folate absobed

A

in the duodenum

25
Q

what is folate needed for

A

DNA synthesis during erythropoiesis and helps with cellular maturation - if not enough will result in megaloblastic anemia

26
Q

if there is not enough folate, what type of anemia will result

A

megaloblastic anemia

27
Q

what type of anemia is folate anemia

A

macrocytic anemia

28
Q

where is folate typically produced

A

produced by bacteria within the gut flora

29
Q

what are folate deficiencies associated with

A

poor dietary intake, increase requirements (pregnancy), malabsorption, ETOH abuse and medications

30
Q

how are folate anemias diagnosed

A

elevated MCV
elevated RDW
low serum folate

31
Q

what is cobalamin

A

Vitamin B12

32
Q

what absorbes vitamin b12

A

through the parietal cells in the stomach
needs intrinsic factor for absorption
absorbed within the terminal ilium

33
Q

what is the purpose of B12

A

assists with maturation process, DNA synthesis and helps with folate synthesis

34
Q

what type of anemia is associated with B12 deficiency anemia

A

macrocytic anemia

35
Q

what are hallmark signs of B12 deficiency anemia

A

will have neurologic findings as well but folate deficiency will not

36
Q

what are the presentation of B12 deficiency

A

neuropathy (early)
dementia
Neuropsychiatric
Optic nerve atrophy

37
Q

what is normocytic anemias

A

normal RBCs just not enough

38
Q

what causes normocytic anemia

A

blood loss (acute)
anemia of chronic disease
hemolytic
aplastic anemia

39
Q

what is aplastic anemia

A

bone marrow failure resulting in pancytopenia
loss of hematopoietic stem cells within the marrow

40
Q

what is aplastic anemia associated with

A

autoimmune disease
direct injury to the hematopoietic stem cells
viral infections
clonal and genetic disorders

41
Q

what is sickle cell anemia

A

autosomal recessive disorder
results in hemoglobin S (s - sickle)
when there is decreased O2, dehydration, the HbS will change shape causing RBCs to “sickle”

42
Q

what causes sickle cell anemia to result in hemolytic anemia

A

the removal of the sickled cells

43
Q

what is sickle cell crisis

A

if healthy and well oxygenation - likely asymptomatic
if hypoxic, decreased pH, dehydration the abnormal B-globin chill will polymerize
leads to change in shape of RBC
unable to conform well within the vessels and can cause obstruction

44
Q

what is the duration of sickle cell crisis

A

typically lasts days to weeks

45
Q

what is associated with the pain in sickle cell crisis

A

vasoocculsive crisis (thrombotic crisis)

46
Q

what is sequestration crisis

A

especially in children, the sleep and liver can sequester large amounts of sickled cells and cause significant anemia

CABS2: Hematology (4 decks)

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