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Hematology/Immunology Part 1 > Anemia > Flashcards

Anemia Flashcards

1
Q

What is the physiological definition of anemia?

A

Hemoglobin level too low to meet cellular oxygen demands.

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2
Q

What factors determine hemoglobin values?

A

Age, gender, race, degree of sexual maturation, altitude, heredity.

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3
Q

What do RBC indices describe?

A

Size, shape, hemoglobin content of RBCs, and uniformity of RBC population.

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4
Q

What does a low Mean Corpuscular Hemoglobin (MCH) indicate?

A

Hypochromia.

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5
Q

What does a high Red Cell Distribution Width (RDW) signify?

A

Underlying condition, such as anemia, autoimmune conditions, and liver or kidney disease.

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6
Q

What are the pathophysiologic mechanisms of anemia?

A

Decreased production, acute blood loss, increased destruction (hemolysis).

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7
Q

What are the types of anemia based on erythrocyte size?

A

Microcytic, normocytic, macrocytic.

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8
Q

What are the causes of microcytic anemia?

A

Iron deficiency, sideroblastic, thalassemia, anemia of chronic disease.

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9
Q

What are the causes of macrocytic anemia?

A

B12, folate deficiency.

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10
Q

What are the causes of normocytic anemia?

A

Chronic disease, aplastic.

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11
Q

What are the types of increased RBC destruction?

A

Hemolysis (acquired or congenital).

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12
Q

What are the protective mechanisms against too much iron?

A

Highly regulated iron absorption, iron tightly bound to proteins.

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13
Q

What are the symptoms of iron deficiency anemia?

A

Weakness, fatigue, SOB, pallor, dizziness, irritability, decreased exercise tolerance, pica.

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14
Q

What is the most specific and reliable indicator of iron deficiency?

A

Ferritin levels

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15
Q

How should iron studies be interpreted?

A

In combination with RBC indices, peripheral smear, and history

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16
Q

What are the lab indicators of iron deficiency anemia?

A

High TIBC, low serum iron, low transferrin saturation, low ferritin.

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17
Q

What is the primary treatment for iron deficiency anemia?

A

Oral iron therapy

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18
Q

What are common side effects of oral iron therapy?

A

Nausea, constipation, diarrhea

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19
Q

What is a characteristic feature of sideroblastic anemia?

A

Iron retained in mitochondria

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20
Q

What is the function of Vitamin B12?

A

Methionine synthesis and formation of succinyl coenzyme A

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21
Q

What results from folate or Vitamin B12 deficiency?

A

Megaloblastic anemia

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22
Q

What are clinical findings of Vitamin B12 deficiency?

A

Neurological abnormalities

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23
Q

What lab findings are associated with folate and Vitamin B12 deficiency?

A

Macrocytosis, Howell-Jolly bodies, hypersegmentation of neutrophils

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24
Q

What are common causes of folic acid deficiency?

A

Decreased intake, excessive alcohol consumption, intestinal malabsorption

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25
Q

What is the treatment for Vitamin B12 deficiency?

A

Daily oral supplement or monthly IM injection

26
Q

What induces the production of hepcidin in anemia of chronic disease?

A

Inflammatory cytokines

27
Q

What is the hallmark of aplastic anemia?

A

Hypocellularity and hypoplasia of all cell lines in bone marrow

28
Q

What is the most common cause of acquired aplastic anemia?

A

Autoimmune T cell-mediated destruction

29
Q

What is the most common cause of acquired aplastic anemia?

A

T cell mediated autoimmune response

30
Q

What are the primary symptoms of thrombocytopenia?

A

Easy bleeding/bruising and epistaxis

31
Q

What diagnostic test is required for confirming aplastic anemia?

A

Bone marrow biopsy and aspirate

32
Q

What is a highly effective treatment for autoimmune aplastic anemia?

A

Immunotherapy

33
Q

What is the most common cause of death in aplastic anemia?

A

Infection

34
Q

What characterizes hemolytic anemia?

A

Increased destruction of erythrocytes

35
Q

What are the two main types of hemolysis?

A

Intravascular and extravascular

36
Q

What is the most common cause of non-immune hemolytic anemia?

A

Hereditary spherocytosis

37
Q

What is the primary treatment consideration for hereditary spherocytosis?

A

Splenectomy, weighing risk/benefit.

38
Q

What lab marker is elevated due to non-specific cell damage in hemolytic anemia?

A

LDH

39
Q

What does a positive direct Coombs test indicate?

A

Immune etiology

40
Q

What is the clinical presentation of Thalassemia Minor?

A

Clinically normal with mild microcytic anemia, usually asymptomatic.

41
Q

What characterizes Hemoglobin H disease?

A

Presence of hemolysis, jaundice, and splenomegaly.

42
Q

What is the outcome of Hydrops Fetalis?

A

Incompatible with life due to no alpha chains.

43
Q

What is the most common cause of α-Thalassemia?

A

Point mutations leading to reduced or absent β-chain synthesis.

44
Q

What are the complications of untreated β-Thalassemia Major?

A

Severe anemia, bony deformities, iron overload, and early death from cardiac failure.

45
Q

How is β-Thalassemia Intermedia different from β-Thalassemia Major?

A

Less severe anemia, diagnosed later, and survival into adulthood.

46
Q

What is the clinical significance of β-Thalassemia Minor?

A

Asymptomatic carriers with mild microcytic anemia and normal life expectancy.

47
Q

What are the treatment options for Thalassemias?

A

Genetic counseling, supportive care, transfusions, iron chelation, stem cell transplant, and gene therapy.

48
Q

What genetic mutation causes Hemoglobin S?

A

Mutation in the β-globin gene leading to polymerization of Hgb-S.

49
Q

What are the chronic complications of Sickle Cell Disease?

A

Chronic hemolytic anemia, jaundice, organ damage, and increased risk of infections.

50
Q

What is a common neurological event in sickle cell disease that can be clinically apparent?

A

Stroke

51
Q

What triggers Vaso-occlusive Pain Crisis in Sickle Cell Disease?

A

Often unknown, but can include skin cooling, infection, stress, and dehydration.

52
Q

What is the significance of Acute Chest Syndrome in Sickle Cell Disease?

A

Frequent cause of death and second most common reason for hospitalization.

53
Q

What are some common symptoms of a stroke in sickle cell disease?

A

Hemiparesis, aphasia, dysphagia, seizures, headache, cranial nerve palsy, stupor, coma

54
Q

How is Acute Chest Syndrome managed?

A

Empiric antibiotics, transfusion, supportive care, and bronchodilators.

55
Q

What imaging techniques are used for diagnosing a stroke in sickle cell patients?

A

MRI, MRA, CT without contrast

56
Q

What is the primary treatment for stroke in sickle cell disease?

A

Transfusion

57
Q

What screening tool is used for stroke risk in sickle cell disease?

A

Transcranial Doppler Ultrasound

58
Q

What are the key components of managing sickle cell disease?

A

Early identification, family education, preventive measures, screening, prophylactic penicillin, immunization, treatment of acute complications, disease-modifying agents, chronic transfusion, hydroxyurea, stem cell transplantation, gene therapy

59
Q

When is transfusion indicated in sickle cell disease?

A

Acute stroke or TIA, acute chest syndrome, priapism, splenic sequestration, pre-operative, symptomatic anemia, aplastic crisis, abnormal transcranial doppler

60
Q

When is transfusion not indicated in sickle cell disease?

A

Pain crisis, anemia

Hematology/Immunology Part 1 (12 decks)

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