Anemia Flashcards
What are low hematocrit lab values to indicate anemia?
males <41%, females <36%
What are low hemoglobin lab values to indicate anemia?
males <13.5, females <12
What type of anemia is characterized by brittle fingernails, calf cramps, pagophagia (craving ice) and pica (craving non-food substances) and can sometimes be seen with yellow eyes?
iron-deficient anemia
What are some risk factors that can make someone at risk for iron-deficiency anemia?
females, pregnancies, bariatric surgery, Celiac disease
What causes iron-deficiency anemia?
defective heme synthesis from lack of iron– could be blood loss, decreased iron intake, malabsorption
Is iron-deficiency anemia micro or macrocytic?
microcytic
What do these lab values indicate:
CRC<2% (low reticulocyte count)
MCV<80 (microcytic)
RDW>15 (high)
TIBC>68 (elevated)
% transferrin saturation low
hypochromic RBCs >6% (high)
Ferritin < 10-15 (low)?
iron-deficient anemia
How do you treat iron-deficient anemia orally?
determine reason, and with oral preparations (ferrous sulfate, gluconate) and administer with Vitamin C to promote absorption
Consider transfusions if compromise or acute hemorrhage
How do you treat iron-deficient anemia parenterally?
HMV or LMV iron dextran which has a high rate of anaphylaxis, ferric gluconate or iron sucrose (less likely but may need to repeat) or ferumoxytol and ferric carboxymaltose (good, but $$$)
What type of anemia is normocytic and caused by impaired EPO production and has decreased RBC survival, impaired mobilization of iron from malignancy, and is seen in chronic conditions?
chronic disease anemia
What do these lab values indicate:
CRC <2%
MCV 80-100
low everything: Hgb, Fe, TIBC, EPO, possibly increased ferritin, renal failure?
chronic disease anemia
What type of anemia is indicated by ataxia, learning disabilities, peripheral neuropathy, intermittent abdominal pain, vomiting, loss of appetite, constipation, and commonly in children?
lead poisoning anemia, also called plumbism
What does these diagnostic results indicate:
* basophilic stippling of RBCs
* elevated blood lead level
* lead lines at metaphyseal plates on CT?
lead poisoning anemia
How can you treat lead poisoning anemia?
removal of source of lead and edetate disodium chelation
What type of anemia is distinguished through its X-linked ALA synthase gene or vitamin B6 deficiency and ringed sideroblasts in bone marrow with basophilic stippling that has a CDC <2% and MCV<80 and potentially high iron levels?
sideroblastic anemia
What type of overarching type of anemia can be displayed through yellowing eyes, jaundice, and dark urine?
hemolytic anemia
What do these lab values indicate:
CRC >2%
Coombs test/DAT +
increased LDH
low haptoglobin
hemolytic anemia
What is a type of hemolytic anemia that is X-linked, can be extra or intravascular, and can be triggered by medications, infections, fava beans and can be episodic?
G6PD deficiency anemia
How can you distinguish G6PD anemia from other hemolytic anemias?
bite cells + checking G6PD activity/genetic testing
What is a type of hemolytic anemia that is characterized by dark urine and splenomegally and is common in Northern Europeans/americans and with those that have family history as an autosomal dominant trait?
hereditary spherocytosis
What do these labs indicate:
CRC >2%
elevated MCHC
DAT/Coombs negative
peripheral smear = circular, hyperchromic rounded RBCs?
hereditary spherocytosis
How can you treat hereditary spherocytosis?
mild-moderate; folic acid
severe: splenectomy
What type of anemia is distinguished through taking years to develop with neurologic symptoms like symmetrical paresthesia, ataxia, spasticity, memory loss, burning sensation of tongue?
B12 deficiency anemia
What can gastric surgery, ETOH use, liver disease, PPIs and maybe vegans put someone at risk for?
B12 deficiency anemia
What do these lab values indicate:
CRC<2%
MCV>100
B12<150
folic acid>145
homocysteine high
MMA high
cobalamin low
folate - normal?
B12 deficiency anemia
What’s the #1 cause of B12 deficiency?
pernicious anemia
How do you treat B12 deficiency?
IM B12 injections in large doses or lower oral doses
What type of anemia is distinguished with pancytopenia, sore tongue, cheilitis, steatorrhea, and NO neurological symptoms but can be associated with alcoholism, malabsorption, or certain drugs that interfere with metabolism?
folate deficiency
What do these labs indicate:
CRC<2%
MCV>100
LDH - high
bilirubin - high
homocysteine - high
MMA - normal
folate - low?
folate deficiency
What does hypersegmented neutrophils indicate on a peripheral smear?
B12 or folate deficiency
What’s one of the first signs of anemia on a vital signs list?
high HR, tachycardia
