Anemia Flashcards
Normal Hgb
12-16
Normal Hct
37-54
normal TIBC
250-450
Normal Iron
50-150
Normal MCV
80-100
Normal MCH
26-34
Normal MCHC
32-36
What are the causes of microcytic anemia
Iron deficiency and thalessemias
Types of macrocytic anemias
Vitamin b or folate and megaloblastic anemias
Normocytic anemias
Chronic disease or hemolysis
What are the causes, S/S, Lab values, and Tx of iron deficiency Anemia
Causes: blood loss, low intake, impaired absorption
S/s: Dyspnea, fatigue, hypotension, pallor, dehydration, PICA
Labs: Low hgb, low MCH, Low MCV, low iron, high RDW, low ferritin, high TIBC
Treatment: oral iron which can cause flatus and constipation
What is B thalessemia, 2 forms, labs, and management
Decreased production of normal hgb where B chain is reduced or absent
Minor: One copy of B thalessemia
Major: Produces no normal B thalessemia, typically does not survive the first few months of life
Labs: MCV, MCHC, HGB low, decreased alpha/beta production, iron and TIBC normal
Tx: no treatment, severe condition needs lifelong transfusions
Folic acid deficiency s/s, labs, and treatment
s/s: glossitis
Labs: elevated MCV, MCH normal, folate decreased
Tx: Po folic acid intake
Pernicious anemia s/s, labs, and treatment
S/s: glossitis, palpitations, dizziness, anorexia, positive neuro findings
Labs: Hgb low, MCV increased, anti-IF high , b12 low
Tx: cyanocobalamin
Sickle Cell Disease triggers, s/s of Crisis, and treatment
Complication
Triggers: hypoxia, dehydration, stress, infection
Crisis s/s: Aching joint pain, weakness, dyspnea
Treatment: IVF, dilaudid, O2
Complication: Acute chest syndrome: chest pain, tachypnea, cough, pulm crisis
Hemolytic anemia labs
Low H and H, low haptoglobin, elevated retic, elevated LDH, positive schistocytes
What are the microcytic anemias
Iron deficiency, and thalessemias
Macrocytic anemias
B12 folate deficiency, alcoholism, liver failure
Normocytic anemias
Chronic disease, sickle cell, blood loss, and hemolysis
What is the most common type of anemia
Iron deficiency
Causes of iron deficiency anemia
Blood loss and low iron intake
PICA
Unusual food cravings such as ice or clay and is seen in iron deficiency anemia
Who typically has thalessemias
Asians with anemia think thalessemia
S/s of thalessemia
Generally well appearing
Heterozygous vs Homozygous beta thalessemias
Heterozygous is Minor
Homozygous is Major
Who is most likely to have folic acid deficiency anemia
Homeless, eating disorders, substance abuse
S/S of folic acid deficiency
Glossitis
Aphthous ulcers
NO NEURO SIGNS
What are people with b12 deficiency lacking
Intrinsic factor
How does the s/s of b12 differ from folate
B12 has NEURO symptoms: Parastesias, positive Romberg, postive babinski
How long does a B12 deficiency patient need cyanocobalamin?
Life long
What is a VWF patient lacking that makes them anemic
VWF and factor VIII
Treatment of VWF
Desmopressin, VWF and factor VIII concentrate
Where do neoplasms initiate in leukemias
Hematopoietic cells in the bone marrow
What is the most acute type of leukemia
AML
Pancytopenia with circulation blasts is a hallmark of which leukemia/
ALL
What is the mot common leukemia in adults
CLL
Philadelphia chromosome is the hallmark of which leukemia
CML
What is 5 FU
Chemo
What medication can decrease the risk of TLS in chemo
Allopurinol
Differ stage 1-4 in lymphoma staging
I: a single lymph
II: Multiple lymph on one side of the diaphragm
III: Spleen and lymph on both sides of the diaphragm
IV: Liver or bone marrow
Differentiate Non-Hodgkin’s and Hodgkin’s lymphoma
NH: Lymphadenopathy more common in 50 years old
H: more common in young males, cervical adenopathy that spreads in predictable pattern, Reed stern berg cells
Non-Hodgkin and Hodgkin lymphoma tx
Radiation and chemo BMT
What is Idiopathic thrombocytopenia purpura
Autoimmune destruction of platelets, usually chronic
What are the first symptoms of ITP in adults
Kidney and gum bleeding
Treatment of ITP
Not necessary until Plts< 20,000
High dose corticosteroids
IVIG
PLT transfusion
What should people with folate deficiencies avoid consuming
Red wine or alcohol
DIC treatment
Treat underlying condition
Platelets, FFP, cryo