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ANEMIA Flashcards

1
Q

RETICULOCYTES Normal%

A

2%

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2
Q

HEME

A

IRON that binds to prophoryin to form hemoglobin

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3
Q

GLOBIN

A

2 alpha + 2 beta chains

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4
Q

THALASEMIA

A

Changes in alpha or beta chain

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5
Q

NORMAL Hemoglobin in adults

A

A and D

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6
Q

HEMOLYSIS

A

Reticulocytes more than 2%

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7
Q

Things that increase ESR

A

A nemia
M yocardial infarction
I nflammation
I nfection

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8
Q

Above 100 ESR

A

Malignancy
Collagen
Multiple Myeloma
TB

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9
Q

LOW ESR

A

HYPOFIBRINOGENMIA
Polycythemia
SPHEROCYTOSIS
SICKLE CELL Anemia

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10
Q

To decide anemia

A

1) RBC less than 4.5
2) Hemoglobin less than 11
3) Size of RBC (macro,normally,microcytic)

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11
Q

NORMAL corpscular Hemoglobin

A

27-32

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12
Q

Normocytic

A

78%-98%

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13
Q

Macrocytic

A

> 100

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14
Q

Microcytic

A

<100

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15
Q

Blood film

A

RBC appearance

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16
Q

IRON Deficiency anemia Blood film

A

ANSICYTOSIS and POIKILOCYTISIS

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17
Q

HEMOLYTIC UREMIC SYNDROME

A

SCHISTOCYTE

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18
Q

DIC

A

SCHISTOCYTES

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19
Q

Anemia on etiology

A

Iron deficiency anemia
VITAMIN B12 DEFICIENCY
FOLIC ACID deficiency

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20
Q

ANEMIA on morphological changes

A

Micro cytic
Macro cytic
Normocytic

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21
Q

Microcytic

A

Sideroblastic anemia
Lead poison
Iron deficiency anemia
Thalassemia

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22
Q

Normocytic anemia

A

Bone marrow unable to form enough Rbcs
Acute blood loss
Hemolytic anemia
EXCEPT THALASSEMIA

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23
Q

MACROCYTIC ANEMIA

A

Megaloblastic Anemia
Non Megaloblastic anemia
Chronic liver disease
Hypothyroidism

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24
Q

How does body react to anemia?

A

Erythropoeitin increases to increase RBC production
Increase cardiac output
Increase plasma volume
Increase in lactic acid

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25
Q

CLINICAL PICTURE OF anemia

A

FATIGUE
WEAKNESS
increase cardiac output
DYSPNEA
Palpitation
Claudication pain

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26
Q

Signs of anemia

A

H eart failure but only if Hemoglobin 2 or 3
T achycardia
P allor

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27
Q

Pilonychia

A

IRON deficiency anemia

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28
Q

JAUNDICE/yellow lemon

A

HEMOLYTIC ANEMIA

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29
Q

SPHEROCYTOSIS

A

SPLEENOMEGALY/huge spleen

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30
Q

What increases iron absorption ?

A

Vitamin C

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31
Q

Decreases iron absorption

A

TANNIC ACID
MALBSORPTION (DUODENUM/JEJUNUM PROBLEMS)
phytate

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32
Q

IRON stored as

A

FERRITIN

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33
Q

CAUSES OF iron deficiency anemia

A

1) Decrease iron intake (malignancy,anorexia,old age)
2)increase iron requirement (pregnancy(hemodilution))
3)decreased absorption of iron(phytate/malabsorption)

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34
Q

For C section Hemoglobin has to be:

A

10

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35
Q

Most common reason for blood loss in Egypt

A

Oesophageal varices

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36
Q

Causes of Iron deficiency anemia

A

*Oesophageal varices (chronic liver disease hepatitis C&D
Bilharizia Chronicity)

*Multipara(bleeding from IUD)

*Intravascular hemolysis( Paroxysmal nocturnal hemoglobinuria)

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37
Q

CBC of Iron deficiency anemia

A

Microcytic
Hypochromic

38
Q

Finding of Iron deficiency anemia

A

Spooning of nails
Loss of hair

39
Q

In iron deficiency anemia if patient says they’ve been on treatment for one year but change isn’t seen:

A

WRONG TREAMENT

40
Q

Cases of Iron deficiency anemia

A

*ANKLYSTOMA PARASITE
*VAGINAL BLEEDING
*Esophageal varices
*ESOPHAGEAL WEB DUE To plant based syndrome (dysphagia)

41
Q

IRON DEFICIENCY Anemia LAB:

A

EVERYTHING decreases except total iron binding capacity

42
Q

Iron deficiency anemia on bone marrow:

A

HYPERPLASIA (DUE TO matured RBCS)

43
Q

Extra investigations for iron deficiency anemia:

A

*For esophageal varices=upper endoscopy

*Stool analysis= to see if there is occult blood in stool

*Investigation for anklyostoma

44
Q

Treatment of Iron deficiency anemia

A

ORAL +Parental + Intravenous+ Intramuscular

45
Q

Oral therapy for iron deficiency anemia

A

Iron sulphate or Ferrous sulphate

46
Q

IRON DEFIECIENCY TREATMENT FOR PREGNANT WOMAN:

A

Intravenous

47
Q

Iron deficiency anemia treatment for malabsorption:

A

INTRAVENOUS

48
Q

SIDE EFFECT OF INTRAMUSCULAR IRON

A

GLUTEAL ABSCESS & PAIN

49
Q

Blood transfusion not used in:

A

HEMOGLOBIN 8 OR 9

50
Q

To check for oral iron therapy efficiency

A

Wait for 3 months to check if hemoglobin has increased in grams

51
Q

If oral iron therapy has failed

A

We check reticulocytosis(from 4 days to 1 week after oral iron therapy)

52
Q

Side effect of intravenous injection

A

Anaphylactic shock

53
Q

Megaloblastic anemia

A

Folic acid and Vitamin B12 deficiency

54
Q

Megaloblastic anemia

A

Nucleus maturation arrest
Or
Asynchronicity between nucleus or cytoplasm

55
Q

NON AUTOIMMUNE CAUSE OF DECREASE IN INTRINSIC FACTOR ( Type 2 Megaloblastic anemia)

56
Q

Diseases where there is antibody against intrinsic factor:

A

PERINICOUS Anemia

57
Q

Pernicious anemia is seen in people with

A

VITILGO,
ADDISON,
AUTOIMMUNE Thyroid

58
Q

BONE MARROW Megaloblastic anemia

A

BIG RBCs from bone marrow
But absent Vitamin b12 and folic acid in both peripheral cell and bone marrow

59
Q

NON MEGALOBLASTIC anemia

A

*In chronic liver disease

*HEMOLYTIC crisis

*Hypothyroidism

They all lead to hemolysis

60
Q

Bone Marrow non megaloblastic anemia

A

Normal cells in bone marrow buy absent megaloblastic adherence peripherally

61
Q

NEUROLOGICAL SYMPTOMS of Perinicious anemia

A

SUBACUTE COMBINED DEGENERATION:

Peripheral Neuropathy

Posterior column affection (walking on cotton)

Hemiplegia

62
Q

GIT SYMPTOMS OF Perinicious anemia

A

Diarrhea
Angular stomatitis
Dyspepsia

63
Q

Perinicious anemia

A

VITAMIN b12 deficiency

64
Q

Investigation of Megaloblastic anemia

A

*Low Hemoglobin
*Low RBCs
*Mean Corpscular volume above 100(macrocytosis normochromia)
*Bone marrow megaloblastic appearance

65
Q

Drugs that lead to folic acid deficiency

A

Salicylic acid
Neomycin
Phenytoin
Methotrexate
Drugs of Rheumatoid arthritis/Systemic lupus Erythematosis

66
Q

FINDING THAT MAYBE PRESENT IN MEGALOBLASTIC ANEMIA

A

ANSCIYTOSIS

67
Q

Folic acid and Vitamin B are

A

Never measured

68
Q

If there are neurological manifestations

A

NEVER GIVE FOLIC ACID

69
Q

Treatment of megaloblastic anemia

A

FOLIC ACID FOR PREGNANT WOMAN
Vitb12 given to patient with diabetes IM/IV

70
Q

Parasitic causes of anemia

A

Anklyostoma
Diphyllobothrum latum
Malaria

71
Q

PANCYTOPENIA

A

APLASTIC ANEMIA (all blood cells are absent)

72
Q

Hypersplenism

A

Megaloblastic anemia+Systemic lupus

73
Q

Sideroblastic anemia

A

Iron twists around protophoryin giving sideroblastic appearance.

74
Q

Sideroblastic anemia may be associated with

75
Q

Sideroblastic anemia may be due to

A

Heme synthesis problem

76
Q

Sideroblastic anemia

A

May be carcinogenic

77
Q

Sideroblastic anemia= investigation

A

NORMOBLAST IN BONE MARROW

78
Q

SIDEROBLASTIC ANEMIA peripheral blood

A

Microcytic hypochromic anemia

79
Q

Things that increase in sideroblast

A

Iron in excess
Transferrin
Ferritin
Serum iron

80
Q

What remains normal in sideroblastic anemia

A

Iron binding capacity

81
Q

Fatal mistake in Thalasemia treatment

A

Giving iron

82
Q

Thalassemia is

A

Microcytic hypochromic

83
Q

ANEMIA OF CHRONIC LOSS (eg kidney/liver disease)

A

Ferritin high,iron low,iron binding capacity

84
Q

Causes of Pancytopenia/aplastic anemia

A

*Organophoshorus compound
*HIV
* Hepatitis B
*EpesteinBarrVirus

85
Q

In Inflammatory diseases such as Systemic lupus/rheumatoid,what increases?

A

FERRITIN/Acute phase reactant

86
Q

Why do we give iron even though Ferritin is high in COVID?

A

Because virus hides iron

87
Q

APLASTIC ANEMIA

A

Hemoglobin,white blood cells and platelets are low

88
Q

Cause of APLASTIC ANEMIA

A

Idiopathic
/fanconi/
unknown cause

89
Q

Complains of aplastic anemia

A

Pallor
Repeated infection
BLEEDING
IMMUNOCOMPROMISED

90
Q

Investigation of aplastic anemia

A

PANCYTOPENIA AND BONE MARROW TO KNOW CAUSE

91
Q

TREATMENT OF APLASTIC anemia

A

Blood transfusion
Androgen
Monoclonal antibody

92
Q

Acquired cause of aplastic anemia

A

Cytotoxic drugs and drugs that treat
rheumatoid arthritis +antithyroid drugs because they lead to agranulocytosis

ANEMIA (2 decks)

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