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Med School > Anemia > Flashcards

Anemia Flashcards

1
Q

Microcytic anemia reasons

A
  • defective heme
  • defective globin
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2
Q

Normocytic anemia reasons

A
  • underproduction
  • overdestruction (intravascular and extravascular)
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3
Q

Macrocytic anemia reasons

A
  • megaloblastic
  • nonmegaloblastic
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4
Q

Defective heme anemias

A
  • iron deficiency
  • sideroblastic anemia
  • anemia of chronic disease
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5
Q

Defective globin anemias

A

a and b thalassemia

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6
Q

Underproduction anemias

A
  • parvovirus B19
  • aplastic anemias
  • myelophthistic anemia
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7
Q

Intravascular anemias

A
  • paroxysmal nocturnal hemoglobinurea
  • G6PD deficiency
  • microangiopathic hemolytic anemia
  • malaria
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8
Q

Extravascular anemias

A
  • hereditary spherocytosis
  • sickle cell anemia
  • hemoglobin C
  • immune hemolytic anemia
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9
Q

Megaloblastic anemias

A
  • folate deficiency
  • B12 deficiency
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10
Q

Non-megablastic anemias

A
  • alcoholism
  • liver disease
  • drugs like 5-FU
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11
Q

Iron deficiency

A
  • decreased serum iron, increased TIBC, decreased serum ferritin, decreased % saturation, increased RDW, increased FEP
  • causes:
    - vegetarian/ low iron diet (malnutrition)
    - issues with duodenal absorption (ferroportin abnormalities)
    - peptic ulcer disease
    - menorrhagia
    - gastrectomy
  • Plummer-Vinson Syndrome–> esophageal web
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12
Q

Sideroblastic anemia

A
  • increased ferritin, decreased TIBC, increased serum iron, increased % saturation
  • iron overload
  • protoporphyrin deficiency (enzymes: ALAS+B6, ALAD, ferrochetelase)
  • causes:
    - congenital
    - vitamin B6 deficient
    - alcoholism
    - lead poisoning (ALAD)
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13
Q

Anemia of chronic disease

A
  • increased ferritin, decreased TIBC, decreased serum iron, decreased % saturation, increased FEP
  • suppresses EPO production
  • sequestered hepcidin
  • treat with EPO or underlying autoimmunity
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14
Q

Alpha thalassemia

A
  • 2 knockout–> cis is worse than trans deletion
  • 3 knockout–> severe anemia (HbH)
  • 4 knockout–> hydrops fetalis (Hemoglobin Barts)
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15
Q

Beta thalassemia

A
  • B minor–> asymptomatic
  • B major–> severe anemia
    - ineffective erythropoiesis
    - aplastic crisis with parvovirus
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16
Q

Parvovirus B19

A
  • temporarily halts erythropoiesis
  • supportive tx
17
Q

Aplastic anemia

A
  • damage to hematopoietic stem cells
  • pancytopenia
  • empty bone marrow
  • tx: transfusion, EPO/ GM-CSF/ G-CSF, immunosuppresion, BM transplant
18
Q

Myelophthistic anemia

A
  • pathologic process that replaces bone marrow
    - tumors and myelofibrosis
  • teardrop cells
  • nucleated RBCs in periphery
19
Q

Paroxysmal Nocturnal Hemoglobinurea

A
  • acquired deficiency of GPI (no DAF or MIRL to fight off complement)
  • affects myeloid stem cells
  • hemoglobinemia
  • hemoglobinurea
  • hemosiderinurea
  • thrombosis of hepatic v., portal v.
  • can cause iron deficiency anemia and AML
  • treat with eclizumab
20
Q

G6PD deficiency

A
  • reduced G6PD half-life, leads to oxidative stress
  • bite cells and Heinz bodies
  • hemoglobinuria and back pain
21
Q

Malaria

A
  • infection of RBCs and liver
  • anaphylic mosquito
  • cyclical fevers
22
Q

Hereditary spherocytosis

A
  • defect of spectrin and ankrin
    - cytoskeleton binding proteins
  • consumed by spleen
  • parvovirus can cause aplastic crisis
  • treat with splenectomy–> Howell-Jolly bodies
23
Q

Sickle cell anemia

A
  • end up with >90% HbS
  • precipitated by:
    - hypoxemia
    - dehydration
    - acidosis
  • membrane damage
  • autosplenectomy
  • acute chest syndrome
  • treat with hydroxyurea to increase HbF
24
Q

Hemoglobin C

A
  • mutation in beta chain Hb
  • lysine substitution
  • characteristic crystals
25
Q

Immune Hemolytic Anemia

A

Warm agluttinin
- IgG mediated
- spherocytes produced
- tied to SLE, CLL, some drugs
- treat with steroids, IVIG, splenectomy

Cold agluttinin
- IgM mediated
- distal extremities in cold weather
- tied to mycoplasma and mono, Raynaud’s

26
Q

Folate deficiency

A
  • decreased serum folates, increased hemocysteine, normal MMA
  • poor diet
  • increased demand
  • folate antagonists (methotrexate)
27
Q

B12 deficiency

A
  • decreased B12, increased homocysteine, increased MMA
  • vegan diet
  • pernicious anemia
    - autoimmune destruction of parietal cells
  • pancreatic insuffiency
  • Crohn’s disease
  • ileum damage

Med School (4 decks)

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