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MDTI > Anemia > Flashcards

Anemia Flashcards

1
Q

blood smear

A

placing a drop of blood on a slide and using another slide to spread it into a thin, even layer that can be stained

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2
Q

centrifuged peripheral blood

A

RBCs on bottom, plasma up top

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3
Q

what area of the blood smear do you focus on?

A

the feathered edge

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4
Q

what is the color of a blood smear indicative of?

A

hematocrit

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5
Q

ideal characteristics of a blood smear

A

RBCs not touching, central pallor present in most RBCs, not too widely spread apart or distorted

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6
Q

hematocrit

A

ratio of the volume of RBCs to that of whole blood. typically around 3x [Hb]

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7
Q

MCV (mean red cel volume)

A

the average volume of a red cell in your specimen

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8
Q

(RDW) red cell distribution width

A

measure of the variation of the RBC volume in you specimen. standard deviation of the volume over the mean

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9
Q

what do we use as a visual reference range for MCV

A

the size of a lymphocyte nucleus

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10
Q

microcytosis definition

A

low MCV <80.

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11
Q

hypochromasia

A

increased central pallor >1/3 diameter of RBC. usually associated with a low hemoglobin and microcytosis.

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12
Q

macrocytosis definition

A

high MCV >100.

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13
Q

what does an increased reticulocyte (purplish blue) indicate?

A

bone marrow is responding to a stimulus to create more red blood cells. measure of marrow’s ability to respond to anemia/hypoxia

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14
Q

anemia definition

A

a decrease in the number of red blood cells or less than the normal quantity of hemoglobin in the blood. insufficient RBC mass to deliver adequate O2 to tissues

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15
Q

two causes of anemia

A

decreased erythropoesis, or increased bleeding/RBC destruction

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16
Q

after seeing reduced hematocrit levels, what do you look for?

A

MCV to determine (micro/normo/macrocytic anemia)

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17
Q

how can you distinguish between destructive/productive problem of anemia?

A

reticulocyte count: high (destructive/blood loss issue), low (production issue)

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18
Q

MCV count for microcytic anemia

A

<80

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19
Q

MCV count for normocytic anemia

A

80-99

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20
Q

MCV count for macrocytic anemia

A

> 100

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21
Q

4 causes of microcytic anemia

A

iron deficiency anemia, anemia of chronic inflammation/chronic disease, thalssemia, sideroblastic anemia

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22
Q

iron deficiency anemia

A

form of microcytic, hypochromic anemia. most common nutritional deficiency in the world, toddler, adolescent women, older adults at risk

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23
Q

patient presentation with iron deficiency anemia

A

low hemoglobin, low MCV, high RDW. Elliptocytes also present.

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24
Q

thalassemia

A

problem with hemoglobin synthesis due to abnormalities in synthesis of globin chains (alpha, beta). causes microcytic hypo chromic anemia.

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25
Q

patient presentation with thalassemia

A

VERY low MCV. presence of target cells

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26
Q

hemolytic anemia

A

one of the classes of normocytic anemia

27
Q

hereditary spherocytosis

A

defect in RBC cytoskeleton. normochromic, normocytic hemolytic anemia. high reticulocyte count (polychromasia). undergo increased hemolysis in spleen, shorter lifespan

28
Q

spherocyte

A

RBCs that have lost membrane and take on a spherical shape. lack central pallor.

29
Q

common causes of macrocytic anemia

A

megaloblastic anemia, liver disease, alcohol

30
Q

megaloblastic anemia

A

vitamin B12 or folate deficiency that leads to ineffective erthryopoesis due to defects in DNA synthesis.

31
Q

patient presentation with megaloblastic anemia

A

large RBCs and hyper segmented neutrophils

32
Q

life span of RBCs

A

120 days

33
Q

role of G6PD in RBC

A

protection from oxidative damage (maintains NADPH for glutathione)

34
Q

where are senescent RBCs destroyed?

A

spleen

35
Q

advantage of sigmoid O2-Hb dissociation curve?

A

releases O2 at low partial pressure (deoxygenated tissues) and binds O2 at high partial pressure (lungs)

36
Q

what right shifts O2-Hb curve?

A

decreased pH, increased CO2, increased temperature, increased 2,3-DPG (all leading to reduced oxygen affinity/increased oxygen unloading)

37
Q

what left shifts O2-Hb curve?

A

increased pH, decreased CO2, decreased temperature, decreased 2,3-DPG, CO poisoning (all leading to increased affinity/decreased unloading)

38
Q

cytokine most important for erythroblast formation from stem cell?

A

EPO

39
Q

where is EPO made?

A

kidney

40
Q

what induces kidney to secrete EPO?

A

hypoxia, anemia (reduced levels of oxygen in tissues)

via HIF-1

41
Q

how does EPO induce erythroblast formation?

A

stimulates erythroid cells in bone marrow to proliferate

42
Q

what CBC values are low in anemia?

A

RBC count, Hemoglobin levels, Hematocrit

43
Q

5 possible causes of anemia

A

kidney disease (decreased EPO), EPO unable to stimulate marrow, bone marrow disorder, blood loss, decreased red cell survival

44
Q

how to mechanistically classify of anemia

A

reticulocyte levels

45
Q

how to morphologically classify of anemia

A

MCV

46
Q

low reticulocyte count

A

marrow isn’t active or marrow disorder or decreased EPO (<1ish%)

47
Q

high reticulocyte count

A

marrow is healthy and compensating as in hemolysis or bleeding (>1ish%)

48
Q

corrected reticulate count

A

takes into account actual number being made rather than percentage. corrects for anemia

49
Q

formula for corrected reticulocyte count

A

%reticulocytes* (actual hematocrit/45)

50
Q

causes of decreased RBC production

A

iron/B12/folate deficiencies (no building blocks), anemia from chronic disease (can’t use iron), renal disease (EPO deficiency), aplastic anemia/toxins/immune mediated (lack of RBC precursors)

51
Q

causes of intracorpuscular RBC destruction

A

abnormal membrane, enzyme deficiency, abnormal Hb, thalassemia

52
Q

causes of extra corpuscular RBC destruction

A

immune hemolytic anemia, RBC fragmentation, infection (malaria)

53
Q

reticulocyte count after acute bleeding

A

will take 2-7 days to increase

54
Q

reticulocyte count after occult bleeding

A

initially elevated but over time, with loss of iron, levels decrease from normal

55
Q

mild anemia Hb levels

A

10-12

56
Q

moderate anemia Hb levels

A

8-10

57
Q

severe anemia Hb levels

A

<8

58
Q

signs and symptoms of anemia related to low oxygen delivery

A

fatigue, decreased exercise tolerance, light headedness, skin/conjunctiva/nail bed pallor

59
Q

signs and symptoms of anemia related to cardiovascular response

A

rapid, bounding pulse >100. dyspnea, heart failure

60
Q

signs and symptoms of anemia due to iron deficiency

A

spoon like nail changes, pica

61
Q

symptom of anemia due to hemolysis

A

jaundice

62
Q

hypovolemia

A

low blood volume, usually due to trauma and rapid loss of blood –> acute anemia

63
Q

signs and symptoms of hypovolemia

A

SHOCK: pale/damp skin, low blood pressure on standing, weak pulse, confusion/coma, decreased urine output

MDTI (42 decks)

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