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Heme-Onc > Anemia > Flashcards

Anemia Flashcards

1
Q

why does anemia occur?

A

hemoglobin in blood is too low to fulfill oxygen demands in the body

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2
Q

what is the normal hematocrit relationship to hemoglobin?

A

hematocrit usually 3x hemoglobin concentration

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3
Q

tells variation in RBC widths/sizes

A

Red Cell Distribution Width (RDW)

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4
Q

measure of average RBC size

A

Mean Cell Volume (MCV)

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5
Q

average hemoglobin concentration per RBC; measure of color

A

mean corpuscular hemoglobin concentration (MCHC)

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6
Q

average amount of hemoglobin per RBC (weight)

A

mean corpuscular hemoglobin (MCH)

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7
Q

immature RBCs; higher values means increased production of RBCs

A

reticulocytes

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8
Q

measurement of circulating iron; bound and unbound

A

serum iron

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9
Q

measurement of a circulating iron storage protein; increase indicates increase in body iron stores

A

serum ferritin

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10
Q

measurement of circulation transport protein for iron; increases as iron body stores are depleted

A

total iron binding capacity (TIBC)

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11
Q

disorder described as large, structurally abnormal, immature RBCs (megaloblasts)

A

B12 deficiency

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12
Q

patient presents with neurological dysfunction like paresthesia, loss of vibratory sense, ataxia, weakness, and change in mental status. They also present with glossitis, cheilosis, diarrhea, and anorexia. Dx?
Treatment?

A

B12 deficiency

IM vitamin B12 (cyanocobalamin)

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13
Q

associated with hyper-segmented neutrophils, large/oval RBCs, increased RDW, and poikilocytosis. Also associated with increased MMA and homocysteine.

A

B12 deficiency

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14
Q

what 2 diagnostics and results confirm the diagnosis of B12 deficiency?

A

elevated MMA (methylmalonic acid) and homocysteine

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15
Q

megaloblastic anemia that results in slower nuclear development with large cytoplasm and decreased RBC life.

A

folate deficiency

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16
Q

what is the most common cause of folate deficiency?

A

inadequate dietary intake

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17
Q

patient presents with anemia findings, glossitis, cheilosis, diarrhea, and anorexia. Labs show elevated MCV, hypersegmented neutrophils, and normal B12. Dx?
Treatment?

A

folate deficiency

folic acid

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18
Q

what can folate deficiency in pregnancy lead to? what should pregnant patient’s take to avoid it?

A

neural tube defects

prenatal vitamins

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19
Q

what is the most common cause of anemia worldwide?

A

iron deficiency anemia

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20
Q

what is the most common cause of iron deficiency anemia?

A

blood loss

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21
Q

a patient presents with anemia findings, glossitis/cheilosis, smooth tongue, rough skin, and koilonychia. Dx?

A

iron deficiency anemia

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22
Q

what is the treatment for iron deficiency anemia?

A

ferrous sulfate q other day
continue for 4-6 mo after Hgb is normal

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23
Q

how should ferrous sulfate be taken? (2)

A

do not give with food
take 2 hours before antacids

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24
Q

deficient or absent synthesis of alpha globin chains

A

alpha thalassemia

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25
Q

what is alpha thalassemia in which no normal alpha-globin gene is present?
what does it lead to?

A

hemoglobin barts

stillborn fetus

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26
Q

what is alpha thalassemia in which there is 1 alpha-globin gene present?

what is the treatment?

A

hemoglobin H disease

chronic transfusions

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27
Q

what is alpha thalassemia in which
2 normal alpha-globin gene are present?

A

alpha-thalassemia minor

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28
Q

patient presents without symptoms but labs show microcytic mild anemia. Dx?

A

alpha-thalassemia minor

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29
Q

what is alpha thalassemia in which 3 normal alpha-globin genes are present and the patient presents clinically and hematologically normal?

A

alpha-thalassemia minima/silent carrier

30
Q

deficient or absent synthesis of beta-globin chains

A

beta thalassemia

31
Q

patient presents with severe microcystic hemolytic anemia; they have hepatosplenomegaly, bony deformities, osteopenia, and fractures requiring regular transfusions. Dx?

A

transfusion dependent beta thalassemia

32
Q

patient presents with microcytic hemolytic anemia; they have hepatosplenomegaly, bony deformities, osteopenia, and fractures. Dx?

A

non-transfusion dependent beta thalassemia

33
Q

how does a patient with beta-thalassemia minor/trait present? (2)

A

mild microcytic anemia
clinically normal

34
Q

CBC shows target cells, acanthocytes, poikilocytosis, basophilic stippling, nucleated RBCs; microcytosis, normal iron levels, and patient has does not have normal family history. Dx?

A

thalassemia

35
Q

treatment for thalassemia? (2)

A

genetic counseling
refer to hematologist

36
Q

what is the treatment of choice for beta-thalassemia major?

A

bone marrow transplant

37
Q

anemia due to inability to incorporate iron into heme; iron accumulates

A

sideroblastic anemia

38
Q

what is a cause of sideroblastic anemia?

A

lead poisoning

39
Q

patient presents as pale, with abdominal pain, fatigue, learning disabilities, seizures, foot/wrist drop. They also have a lead line on their gums. Dx?

A

sideroblastic anemia (lead poisoning)

40
Q

CBC shows low MCV, low MCH, basophilic stippling, increased serum lead levels, increased serum iron, and normal/decreased TIBC. Dx?

A

sideroblastic anemia

41
Q

what will an xray of long bones in a patient show if they have sideroblastic anemia?

A

lead lines

42
Q

what makes the definitive diagnosis of sideroblastic anemia? what does it show?

A

examination of bone marrow

prussian blue iron stain with ringed sideroblasts

43
Q

what is the management for sideroblastic anemia caused by lead poisoning? (4)

A

remove lead
chelation therapy
+/- transfusion
referral to hematology /toxicology

44
Q

occurs due to a block in release of iron from macrophages; cytokine inhibition of erythropoietin occurs.

A

anemia of chronic disease

45
Q

what is the most common cell size in anemia of chronic disease?

A

mild normochromic normocytic

46
Q

what is the management for anemia of chronic disease? (2)

A

treat underlying disease
erythropoietin

47
Q

excessive stimulation of RBCs in anemia of chronic disease is associated with what? (2)

A

MI
CVA

48
Q

due to bone marrow failure and pancytopenia, most likely due to immune injury of multipotent hematopoietic stem cells

A

aplastic anemia

49
Q

a patient presents with anemia findings, neutropenia, mucosal/skin bleeding due to thrombocytopenia, and purpura and petechiae. Dx?

A

aplastic anemia

50
Q

what is the diagnostic for aplastic anemia?
what will it show?

A

bone marrow biopsy

hypocellular marrow

51
Q

what is the treatment for aplastic anemia? (2)

A

hematopoietic cell transplant (stem cell)
intensive immunosuppressive therapy

52
Q

X-linked recessive disorder that leads to RBC oxidative injury and hemolysis

A

glucose-6-phosphate dehydrogenase deficiency (G6PD)

53
Q

patient presents with jaundice, dark urine, and abdominal/low back pain. Dx?

A

G6PD deficiency

54
Q

CBC with peripheral blood smear reveals low H/H, elevated reticulocyte count, bite/blister cells, and heinz bodies (denatured hemoglobin in RBCs). There are also elevated unconjugated bilirubin and hemoglobinuria. Dx?

A

G6PD deficiency

55
Q

what is the screening and diagnostic to diagnose G6PD deficiency?

A

NADP

56
Q

what is the treatment for G6PD deficiency? (3)

A

self limiting
avoid drugs/offending foods

blood transfusion for severe cases

57
Q

autosomal dominant disease; disorder of the RBC membrane that decreases in surface to volume ratio, leading to spherical shape of the cell that becomes trapped in the spleen

A

hereditary spherocytosis

58
Q

patient presents with anemia findings, jaundice, splenomegaly, and gallstones. Dx?

A

hereditary spherocytosis

59
Q

CBC reveals decreased H/H, increased reticulocytes, increased MCHC and peripheral smear shows spherocytes (sphere-shaped RBCs). Indirect bilirubin and LDH are both increased. Dx?

A

hereditary spherocytosis

60
Q

management for hereditary spherocytosis? (3)

A

refer to hematologist
folic acid
+/- splenectomy

61
Q

autosomal recessive disorder of hemoglobin S gene; both copies of the beta-hemoglobin gene are Hbs

A

sickle cell anemia

62
Q

when does sickle cell anemia appear?

A

around 6 months

63
Q

patient presents with skin ulcers, retinopathy, ischemic necrosis of bones, renal/ hepatic dysfunction, and priapism. Dx?

A

sickle cell infarction

64
Q

what is the primary cause of hospitalization in sickle cell anemia?

A

acute vaso-occlusive crisis

65
Q

patient presents with fever, dyspnea, hypoxia, chest pain, abdominal pain/swelling, and priapism. Dx?

A

sickle cell anemia crisis

66
Q

CBC reveals hematocrit that is NOT 3x higher than hemoglobin, increased reticulocytes, sickled cells, howell-jolly bodies, and target cells. There is also increased indirect bilirubin and hemoglobinuria. Dx?

A

sickle cell anemia

67
Q

how to diagnose sickle cell anemia?

A

Hgb electrophoresis
increased hemoglobin S and F

68
Q

prevention for sickle cell anemia complications? (4)

A

daily vitamin
penicillin until 5 yrs old
hydroxyurea
+/- folic acid

69
Q

treatment for sickle cell anemia complications? (3)

A

pain meds
oxygen
transfusions

70
Q

what are 2 curative treatment for sickle cell anemia?

A

hematopoietic stem cell transplant
gene editing/therapy transplant

Heme-Onc (3 decks)

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