Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Hema > ANEMIA > Flashcards

ANEMIA Flashcards

1
Q

is defined as a decrease in erythrocytes and hemoglobin, resulting in decreased oxygen delivery to the tissues Impoverished condition of the blood caused by reduction in RBC, Hgb or both. It is considered to be present if the Hgb conc. of the Hct is below the lower limit of the__% reference interval for the individual’s age, sex and geographic location.
• Can be classified morphologically using RBC indices (______) or etiology/cause
• Anemia is suspected when the hemoglobin level is <___ g/dL in men or <___ g/dL in women

A

Anemia

95

MCV, MCH, MCHC

12
11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

total production of RBCs production of RBCs that reach the measured using M:E ratio, fecal circulation of peripheral blood measured by urobilinogen and plasma iron; the RBC turnover utilization of iron, entire lifespan done

A

Total Erythropoiesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

production of RBCs that reach the measured using M:E ratio, fecal circulation of peripheral blood measured by urobilinogen and plasma iron; the RBC turnover utilization of iron, entire lifespan done reticulocyte count and RBC lifespan

A

Effective Erythropoiesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CAUSE OF ANEMIA
1. Decrease RBC___
2. Increase RBC___

A

production

destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

GENERAL SIGNS AND SYMPTOMS
LFDFVPH

A
  1. Low Hgb conc, & blood volume
  2. Fatigue
  3. Dyspnea on exertion
  4. Faintness
  5. Vertigo
  6. Palpitation
  7. Headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

COMMON SIGNS AND SYMPTOMS
PRLSSS

A
  1. Pallor
  2. Rapid bounding pulse
  3. Low blood pressure
  4. Slight fever
  5. Some dependent edema
  6. Systolic murmurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MACROCYTIC NORMOCHROMIC

MCV is greater than __ fl. MCHC is normal
• MCHC is more accurate than MCH

A

•96

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MACRO/ NORMO

A. MEGALOBLASTIC ANEMIA
• Erythroblast in bone marrow shows abnormality and delayed maturation
Causes:
1. Vitamin B12 deficiency –___\ anemia
2. Folic acid deficiency – ____ anemia
3. Abnormalities of Vit B12 or folate metabolism
4. Inherited disorders of DNA synthesis
5. Drug-induced disorders of DNA synthesis

A

pernicious

nutritional megaloblastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

WHAT LAB FINDINGS

Red cells are macrocytic - MCV is greater than 95 fl. and often as high as 120-140 fl.
2. Macrocytes are typically oval shape.
3. Reticulocytes count is low in relation to the degree of anemia.
4. Total white cell count and platelet counts may be moderately reduced, especially in severely anemic patients.

A

MEGALOBLASTIC ANEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PERIPHERAL SMEAR WHAT ANEMIA

Show normal red blood cells in morphology despite the drop of Hgb, Het and RBC count.
2. Increased bone marrow activity (increased of Reticulocyte count), w/o increased red cell or hgb breakdown.
• •
After menstruation, retics might increase. Normal: 0-1/field

A

MEGALOBLASTIC ANEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Macrocytosis – many big RBCs
• Bone marrow shows normoblastic
Causes:
1. Accelerated erythropoiesis
2. Increased membrane surface area
3. Obscure causes (hypoplastic & aplastic anemias)
4. Alcohol
5. Liver disease
6. Cytotoxic drugs (e.g.: metronidazole – drug for amebiasis)

A

NON MEGALOBLASTIC ANEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MCV is less than 80 fl MCHC less than 30%
Causes:
1. Iron deficiency
2. Disorder of globin synthesis as in thalassemia
3. Disorders or porphyrin & heme synthesis as in sideroblastic anemia
4. Other disorders of iron metabolism

A

MICROCYTIC HYPOCHROMIC ANEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Aniso- and poikilocytosis
• The red blood cells are microcytic since many are smaller
than the nucleus of the lymphocyte
• The erythrocytes are hypochromic with an increased
central pallor
• Elliptocytic and pencil-shaped forms are present.

A

MICROCYTIC HYPOCHROMIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

• MCV is
Causes:
1. Recent blood loss
2. Overexpansion of plasma volume as in pregnancy
3. Hemolytic diseases
4. Hypoplastic bone marrow (aplastic anemia)
5. Infiltrated bone marrow (leukemia)
6. Endocrine abnormality
7. Chronic disorders
8. Renal disorders TIBC
9. Liver diseases

A

NORMOCYTIC NORMOCHROMIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

INC RETICS

Very acutely, with hypovolemia, may have normal
blood counts, will become anemic with volume
replenishment

A

ACUTE BLOOD LOSS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

INC RETICS

Increased reticulocyte production cannot keep pace
with loss of RBCs peripherally.
• Response to specific therapy in nutritional anemias

A

HEMOLYTIC ANEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

LAB FINDING WHAT ANEMIA
1. Plasma volume and red cell volume - reduced in proportionate amount.
2. Hct is normal.
3. Platelet count is reduced.
4. Plasma fibrinogen level is reduced.
5. Neutrophilic leukocytosis is present.
6. Normocytes and normochromic cells are present.

A

NORMOCYTIC NORMOCHROMIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

WHAT ARE THE ANEMIA UNDER DEC RBC PRODUCTION AND INC RBC DESTRUCTION

MACROCYTIC NORMOCHROMIC
-MEGALOBLASTIC ANEMIA
- NON MEGALOBLASTIC ANEMIA

MICROCYTIC HYPOCHROMIC

NORMOCYTIC NORMOCHROMIC

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CAUSES

  1. Anemia due to Impaired Red Cell Production
  2. Anemia due to blood loss – Post Hemorrhagic Anemia 3. Anemia due to Accelerated Red Cell Destruction – Hemolytic Anemia
A

IMPAIRED OR DEFECTIVE PRODUCTION ANEMIAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

WHAT ARE UNDER IMPAIRED OR DEFECTIVE PRODUCTION ANEMIAS

A

IDA
ACD
SIDERIBLASTIC ANEMIA
THALASSEMIA
LEAD POISONING
PORPHYRIAS
MEGALOBLASTIC ANEMIAS
APLASTIC ANEMIA
MYELOPHTHISIC (Bone marrow replacement) ANEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Most common form of anemia • Microcytic/hypochromic anemia

Serum iron, ferritin, hemoglobin/hematocrit, RBC indices, retics count - LOW

RDW and TIBC - HIGH

A

IDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Inability to use available normal RBCs
• Impaired release of storage iron associated with increased
HEPCIDIN levels
• Normocytic/normochromic anemia, or slightly
microcytic/hypochromic anemia
• Associated with persistent infections, chronic
inflammatory disorders

ESR, FERRITIN ___
SERUN IRON and TIBC ____

A

ANEMIA OF CHRONIC DISEASE

INC
DEC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Caused by blocks on the protoporphyrin pathway resulting in defective hemoglobin synthesis and iron overload
• Excess iron accumulates in the mitochondrial region of immature erythrocytes (ringed sideroblasts)
• Two RBC populations (dimorphic) are seen • Microcytic/hypochromic anemia

FERRITIN AND SERUM IRON ___
TIBC ____

A

SIDEROBLASTIC ANEMIA
DEC

INC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

• an inherited blood disorder that causes your body to have less hemoglobin than normal

A

THALASSEMIA

25
Q

Multiple blocks in the protoporphyrin pathway

Normocytic/normochromic anemia with characteristic course basophilic stippling

A

LEAD POISONING

26
Q

Group of inherited disorders characterized by a block in the protoporphyrin pathway
Heme precursors before the block accumulate in the tissues, and large amounts are excreted in urine/feces Photosensitivity, abdominal pain, CNS disorders Hematologic findings are insignificant

A

PORPHYRIAS

27
Q

Defective DNA synthesis causes abnormal nuclear maturation; RNA synthesis is normal, so the cytoplasm is not affected
Nucleus matures slower than the cytoplasm (asynchronism)
Caused by either Vitamin B12 deficiency or folic acid deficiency
Macrocytic/normochromic anemia

A

MEGALOBLASTIC ANEMIAS

28
Q

Bone marrow failure
Decrease in hemoglobin/hematocrit and reticulocytes Normocytic/Normochromic anemia

A

APLASTIC ANEMIA

29
Q

Hypoproliferative anemia caused by replacement of bone marrow hematopoietic cells by malignant cells or fibrotic tissue
Normocytic/normochromic anemia

A

I. MYELOPHTHISIC (BONE MARROW REPLACEMENT) ANEMIA

30
Q

ANEMIA DUE TO BLOOD LOSS - POST HEMORRHAGIC ANEMIA

A

ACUTE AND CHRONIC

31
Q

if blood is lost over a short period of time in amount sufficient to cause anemia.

LAB
decrease of hgb, hct and RBC count
increase of bone marrow activity, without increase red cell or hgb breakdown.

PERIPHERAL BLOOD SMEAR
• shows normal red cells
• elevated reticulocyte count

A

ACUTE POSTHEMORRHAGIC ANEMIA

32
Q

if blood is lost in small amount over an extended period of time, both the clinical and hematologic features that characterize acute posthemorrhagic anemia are lacking

LAB FINDINGS

WBC count is normal or slightly decreased
platelet count is increased

PERIPHERAL BLOOD SMEAR

reticulocyte count may be normal or slightly increased
• red blood cells at first normochromic and normocytic and gradually the newly formed red cells become microcytic and hypochromic

A

CHRONIC POST HEMORRHAGIC ANEMIA

33
Q

Sudden loss of blood resulting from trauma or other severe forms of injury
• Normocytic/normochromic anemia

A

ACUTE BLOOD LOSS

34
Q

Gradual, long-term loss of blood
• Normocytic/normochromic anemia
(initially)
• Microcytic/hypochromic (caused by gradual loss of iron)

A

CHRONIC BLOOD LOSS

35
Q

ANEMIA DUE TO ACCELERATED DESTRUCTION OF RBC

Hemolytic anemia - may be due to:
A.____, hemolytic anemias - defect of red cell itself, usually hereditary & grouped as membrane, metabolic or hemoglobin defects.
B.___ hemolytic anemias - a factor outside the red cell & acting upon it. Almost always acquired.

A

Intrinsic

Extrinsic

36
Q

INTRINSIC HEMOLYTIC ANEMIAS: HEMOLYTIC ANEMIA DUE TO MEMBRANE DISORDERS

HEREDITARY

SPHEPSAR

A
  1. HEREDITARY SPHEROCYTOSIS (CONGENITAL HEMOLYTIC JAUNDICE OR ANEMIA)
  2. PAROXYSMAL NOCTURNAL HEMOGLOBINURIA/MACHIAFAVA-MICHELI SYNDROME
  3. HEREDITARY ELLIPTOCYTOSIS/OVALOCYTOSIS
  4. HEREDITARY PYROPOIKILOCYTOSIS
  5. HEREDITARY STOMATOCYTOSIS (HYDROCYTOSIS)
  6. HEREDITARY ACANTHOCYTOSIS (ABETALIPOPROTEINEMIA)
  7. RHNULL DISEASE
37
Q

inherited as a non-sex-linked dominant trait
• most common in North Europeans
• spherocytes die prematurely
• SPLENOMEGALY
LABORATORY FINDINGS OF HEREDITARY SPHEROCYTOSIS:
• Osmotic Fragility Test is increased.
• Reticulocytes are usually 5-20%
• Direct Coomb’s (antiglobulin test is negative).
• MCV is normal; MCHC is often increased.
• WBC, platelet counts are normal except during periods of
hemolysis.
• Total bilirubin is elevated.
PERIPHERAL SMEARS:
• blood film shows microspherocytes

A

HEREDITARY SPHEROCYTOSIS (CONGENITAL HEMOLYTIC JAUNDICE OR ANEMIA)

38
Q

chronic intravascular hemolysis
• nocturnal hemoglobinuria occurs during sleep or after
awakening
• pH of plasma is low due to red cells • ACIDOSIS

LAB FINDINGS

positive sucrose hemolysis test or Ham’s acidified serum test or sugar water test.
• WBC count and platelet count are often low.
• Hemosiderinuria is a feature.

PERIPHERAL SMEARS

Reticulocyte count is elevated.
• Normocytic –normochromic anemia is present.

A

PAROXYSMAL NOCTURNAL HEMOGLOBINURIA/MACHIAFAVA-MICHELI SYNDROME

39
Q

associated w/ severe hemolytic anemia in infants

defect involves the impaired association of spectrin dimers resulting in free, unconnected dimers.
• Dominant inheritance

LAB FINDINGS

Osmotic fragility test is increased.
• Autohemolysis of red cells is present

PERIPHERAL BLOOD SMEAR

non-hypochromic elliptoytes are abundant on blood films.
• Reticulocytes and NRBC are normal in shape.

A

HEREDITARY ELLIPTOCYTOSIS/OVALOCYTOSIS

40
Q

rare, moderately severe congenital hemolytic anemia
• inherited as recessive autosomal traits
• occurs in blacks
PERIPHERAL SMEARS:
• microcytosis, striking micropoikilocytosis & fragmentation

A

HEREDITARY PYROPOIKILOCYTOSIS

41
Q

rare congenital anemia
• inherited as recessive autosomal trait caused by inc. Na &
dec. K due to increased permeability of membrane
• 10-30% red cells appear as mouth like

LAB FINDINGS

Osmotic Fragility Test is increased.
• Reticulocyte may be normal or elevated.

PBS

10-30% red cells appear as mouth like linear pallor instead of the normal central round pale area.
• 10-50% of red cells appear as a stomatocytes

A

HEREDITARY STOMATOCYTOSIS (HYDROCYTOSIS)

42
Q

caused by absence of beta-lipoprotein
• associated w/ plasma lipid abnormalities
• low total lipid, cholesterol & phospholipids
• autohemolysis occurs
• Reticulocyte count ranges from normal to increased
• Presence of mild anemia
• EDTA: usual anticoagulant used

A

HEREDITARY ACANTHOCYTOSIS (ABETALIPOPROTEINEMIA)

43
Q

inherited due to gene suppression or presence of silent Rh gene (Xo)
membrane abnormalities due to absence of all Rh-Hr antigens on the red cells.

LAB FINDINGS

High Reticulocyte count • autohemolysis & Osmotic
Fragility are increased

PBS

mild,chronic normocytic normochromic hemolytic anemia
smear shows stomatocytes & spherocytes

A

RHNULL DISEASE

44
Q

inherited
represents an imbalance in the membrane
phospholipids in the red cells
anemia may increase due to infection or under condition of stress.

PERIPHERAL SMEARS:
• causes mild anemia w/ morphologically normal
• Cells

A

HIGH PHOSPHATIDYLCHOLINE HEMOLYTIC ANEMIA

45
Q

HEMOLYTIC ANEMIA DUE TO METABOLIC DISORDERS

A
  1. G6PD DEFICIENCY
  2. PYRUVATE KINASE DEFICIENCY
  3. PYRIMIDINE-5-NUCLEOTIDASE (PN) DEFICIENCY
  4. GLUCOSE PHOSPHATE ISOMERASE DEFICIENCY
  5. TRIOSEPHOSPHATE ISOMERASE, HEXOKINASE AND DIPHOSPHOGLYCERATE MUTASE DEFICIENCY
  6. GLUTATHIONE SYNTHASE, GLUTATHIONE PEROXIDASE AND GLUTATHIONE REDUCTASE DEFICIENCIES
46
Q

inherited sex-linked
• complex heterogeneous disorder w/c is ubiquitous
• most common defect seen in enzyme deficient hemolytic
anemia
• Type A, Type B & Favism
o Type A: seen in___; clinically mild hemolytic
condition
o Type B: seen in_____
; more susceptible to
sever oxidant hemolysis than type A
o Type B worse than Type A
o___\: most delicate & life threatening that occurs 1
hour after eating fava beans
LABORATORY TESTS:
• Methyl violet or crystal violet stains
• Dye Reduction test
• Ascorbate Cyanide test
• Fluorescent Spot test
• Quantitative Assay of G6PD

A

G6PD
blacks

Mediterraneans

Favism

47
Q

the most common red cell enzyme deficiency involving the Embden-Meyerhof glycolytic pathway
• inherited disorder,
• PK converted to phosphophenolpyruvate to pyruvate in the
EMP w/ the production of ATP
• rbc loses its flexibility due to decrease ATP
• mild to moderately hemolytic anemia w/ splenomegaly

PBS

no notable red cell abnormalities until after splenomegaly
• ecchinocytes
• irregularly contracted red cells
• crenated red cells may be prominent

LAB FINDINGS

Reticulocyte count is elevated
• Fluorescent test – positive
• Quantitative assay of PK

A

PYRUVATE KINASE DEFICIENY

48
Q

inherited
• caused by an abnormality in nucleotide metabolism
• acquired occurs in lead poisoning & responsible for the
• • •
Anemia of chronic inflammation Iron deficiency anemia Unexplained anemia
• Vitamin b12 deficiency • Sideroblastic anemia • Thalassemia
basophilic stippling

LAB

Reticulocytosis is observed
Positive in the demonstration of decreased Nucleosidase activities

PBS

There are marked basophilic stipplings in red cells

A

PYRIMIDINE-5-NUCLEOTIDASE (PN) DEFICIENCY

49
Q

this causes an abnormality in anaerobic
glycolysis causes a moderately severe anemia

LAB

Reticulocyte count may be significantly increased

PBS

red cells show anisocytosis and Poikilocytosis

A

GLUCOSE PHOSPHATE ISOMERASE DEFICIENCY

50
Q

are other enzyme deficiencies that involve anaerobic glycolysis.

A

TRIOSEPHOSPHATE ISOMERASE, HEXOKINASE AND DIPHOSPHOGLYCERATE MUTASE DEFICIENCY
14

51
Q

also show hemolytic anemia - these enzymes are required in the HMP like G-6-PD, hemolysis increase due to oxidant drug exposure or infection.

A

GLUTATHIONE SYNTHASE, GLUTATHIONE PEROXIDASE AND GLUTATHIONE REDUCTASE DEFICIENCIES

52
Q

EXTRINSIC HEMOLYTIC ANEMIA CAUSES

A

Causes:
1. Chemical agents – drugs and chemicals
2. Physical agents – heat, trauma
3. Vegetable and animal poisons
4. Infectious agents – malarial parasite, bacteria
5. Presence of autoantibodies, isoantibodies or drug-related antibodies causes

53
Q

Hemoglobin less than 13g/dl in males and less than 12g/dl in females

FACTORS CONTRIBUTING

Decreased bone marrow function
• Decline in physical activity
• Nutritional deficiencies
• Cardiovascular disease
• Chronic inflammatory disorders

HYPOPROLIFERATION

Secondary to iron deficiency
• Vitamin b12 or folate deficiency
• Renal failure
• Hypothyroidism
• Chronic inflammation
• Endocrine disease

MOST COMMON AMONG ELDERLY

Anemia of chronic inflammation Iron deficiency anemia Unexplained anemia

INEFFECTIVE ERTHROPOIESIS

Vitamin b12 deficiency • Sideroblastic anemia • Thalassemia

A

ANEMIA AND THE ELDERLY

54
Q

Lab evaluation: CBC, retic count, peripheral blood film review, chemistry panel, iron studies, vit b12 and folate levels, free erythrocyte porphyrin
o Hypoproliferative anemia
o Most common form of anemia in the hospitalized geriatric population
Impaired erythropoietin-dependent erythrocytosis – involved in the pathogenesis of this diseas

A

ANEMIA AND THE ELDERLY

55
Q

Affects both erythrocytes and metabolic pathways of iron- dependent tissue enzymes
Results from conditions leading to chronic gastrointestinal blood loss, including long term use of nonsteroidal inflammatory medications, gastritis, peptic ulcer disease, gastropharyngeal reflux disease and angiodysplasia

A

IRON DEFIENCY ANEMIA

56
Q

Sideroblastic anemia – impaired heme synthesis and abnormal globin synthesis
Megaloblastic anemia – defective DNA synthesis; results in ineffective erythropoiesis (deficiency of vitamin B12 and folate)

A

INEFFECTIVE ERYHTROPOIESIS

57
Q

Megaloblastic anemia in 5 -10% of elderly

Attributed to inadequate intestinal absorption of found bound vitamin B12 and pernicious anemia
• Loss of gastric acid – bacterial growth: Helicobacter pylori

A

VITAMIN B12 deficiency

58
Q

Develops from inadequate dietary intake
• Alcoholic elderly are more prone because alcohol interferes
with folate absorption

A

FOLATE DEFICIENCY

59
Q

Shortened RBC survival time
• Drug induced haemolytic anemia – high doses of
antibiotics, non steroidal inflammatory drugs, quinidine,
phenacetin, etc.
• Also results from collagen vascular disease, infections,
chronic lymphocytic leukemia
• Major types:
o Caused by immunologic mechanisms o Due to intrinsic effects
o Resulting from extrinsic factors

A

HEMOLYTIC ANEMIA

Hema (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions