Anemia Flashcards
MCV decreased
Microcytic
MCV increased
Macrocytic
Anemia of decreased bone marrow activity
Hypoproliferative
Anemia of increased bone marrow activity
Hyperproliferative
Anisocytosis
Variation in size of RBCs
Poikilocytosis
Variation in shape of RBCs
Causes of non-megaloblastic macrocytic anemia
Hypothyroidism
Alcoholism
Reticulocytosis
Causes of megaloblastic macrocytic anemia
Vit B12 deficiency
Folate deficiency
Marrow in megaloblastic anemia
Hypercellular
Megaloblasts at all erythroid stages
Smear in megaloblastic anemia
Howell-Jowell bodies
Abnormal erythroblasts
Megaloblasts
Anemia that may be associated with autoimmune thyroiditis, autoimmune adrenalitis, or vitiligo
Pernicious anemia
Type I antibody in pernicious anemia
Blocks binding of Vit B12 to IF
Type II antibody in pernicious anemia
Blocks binding of B12/IF complex to IF receptor
Neurologic changes in vit B12 deficiency
Demyelination of dorsal and lateral tracts in spinal cord
Neurologic symptoms in vit B12 deficiency
Spastic paraparesis
Sensory ataxia
Severe paresthesia in LLs
Elevated levels of homocysteine and MMA
Vit B12 deficiency
Effect of elevated homocysteine levels
Atherosclerosis
Total body iron content in males and females
6 g in males
2.5 g in females
Role of hepcidin
Negative regulator of iron absorption
Role of transferrin
Transports iron to cells
Blood smear in iron deficiency anemia
Microcytic hypochromic anemia
Pencil cells
Decreased MCV, MCH, and MCHC
Bone marrow in iron deficiency anemia
Increase in erythroid progenitors - micronormoblasts
No stainable iron in macrophages
Stain for iron
Prussian blue
Clinical features of iron deficiency anemia
Pica
Koilonychia
Plummer-Vinson syndrome
Plummer-Vinson syndrome symptoms
Esophageal web
Microcytic anemia
Atrophic glossitis
Pathogenesis of anemia of chronic disease
Inflammatory mediators (IL-6)
Increased hepcidin production
Inhibition of ferroportin in macrophages
Reduced iron transfer from storage pool
Cause of sideroblastic anemia
Lead poisoning
Anemia associated with failure of hematopoiesis
Aplastic anemia
Two causes of aplastic anemia
Immune mediated suppression of marrow progenitors
Intrinsic abnormality of stem cells –> genetic damage
Another name for congenital aplastic anemia
Fanconi anemia
Physical features of Fanconi anemia
Hypoplasia of kidney and spleen
Microcephaly
Absent thumbs or radii
Hypo and hyperpigmentation
Affect of mutation in Fanconi anemia
16 different genes involved
Ubiquitination of FANCD2 protein
Defect in DNA repair
Role of FANCD2 protein
Protects cells against genetic damage –> DNA repair
Diagnostic test for Fanconi anemia
DEB/deipoxybutane test
Mechanism of DEB test
Increased chromosomal breakage after incubating lymphocytes with DNA cross-linking agent DEB
Drugs regularly associated with aplastic anemia
Busulfan
Melphalan
Anthracyclines
Autoimmune disease associated with aplastic anemia
SLE
Viruses associated with aplastic anemia
Hepatitis
EBV
Bone marrow in aplastic anemia
Dry tap
Hypocellular
Increased fat spaces
Clinical features of aplastic anemia
Gradual onset
No splenomegaly
Granulocytopenia - bacterial infections
Thrombocytopenia - bleeding
Characteristically absent in aplastic anemia
Splenomegaly
Syndrome where only erythroid progenitors are suppressed
Pure red cell aplasia (PRCA)
Histology in PRCA in parvo
Large pro-erythroblasts with vacuolated cytoplasm and pseudopedia
Congenital PRCA
Diamond-Blackfan anemia (DBA)
Inheritance of DBA
Sporadic autosomal dominant
Presentation in DBA
Infancy
Bone deformities
Growth failure
Macrocytic anemia
Craniofacial dysmorphism and thumb abnormalities
Autoimmune diseases associated with PRCA
SLE
RA
Solid tumors associated with PRCA
Thymoma
Breast
Viruses associated with PRCA
Parvovirus B19
HIV
HTLV
Bacterial infections associated with PRCA
TB
Streptococci
Cause of myelophthisic anemia
Infiltration of the bone by abnormal marrow (metastasis or granuloma)
Blood smear in myelophthisic anemia
Leuko-erythroblastic
Teardrop-shaped RBCs