Anemia

Question 1

What are low hematocrit lab values to indicate anemia?

Answer 1

males <41%, females <36%

Question 2

What are low hemoglobin lab values to indicate anemia?

Answer 2

males <13.5, females <12

Question 3

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?

Answer 3

iron-deficient anemia

Question 4

What are some risk factors that can make someone at risk for iron-deficiency anemia?

Answer 4

females, pregnancies, bariatric surgery, Celiac disease

Question 5

What causes iron-deficiency anemia?

Answer 5

defective heme synthesis from lack of iron– could be blood loss, decreased iron intake, malabsorption

Question 6

Is iron-deficiency anemia micro or macrocytic?

Answer 6

microcytic

Question 7

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)?

Answer 7

iron-deficient anemia

Question 8

How do you treat iron-deficient anemia orally?

Answer 8

determine reason, and with oral preparations (ferrous sulfate, gluconate) and administer with Vitamin C to promote absorption

Consider transfusions if compromise or acute hemorrhage

Question 9

How do you treat iron-deficient anemia parenterally?

Answer 9

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 $$$)

Question 10

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?

Answer 10

chronic disease anemia

Question 11

What do these lab values indicate:
CRC <2%
MCV 80-100
low everything: Hgb, Fe, TIBC, EPO, possibly increased ferritin, renal failure?

Answer 11

chronic disease anemia

Question 12

What type of anemia is indicated by ataxia, learning disabilities, peripheral neuropathy, intermittent abdominal pain, vomiting, loss of appetite, constipation, and commonly in children?

Answer 12

lead poisoning anemia, also called plumbism

Question 13

What does these diagnostic results indicate:
* basophilic stippling of RBCs
* elevated blood lead level
* lead lines at metaphyseal plates on CT?

Answer 13

lead poisoning anemia

Question 14

How can you treat lead poisoning anemia?

Answer 14

removal of source of lead and edetate disodium chelation

Question 15

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?

Answer 15

sideroblastic anemia

Question 16

What type of overarching type of anemia can be displayed through yellowing eyes, jaundice, and dark urine?

Answer 16

hemolytic anemia

Question 17

What do these lab values indicate:
CRC >2%
Coombs test/DAT +
increased LDH
low haptoglobin

Answer 17

hemolytic anemia

Question 18

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?

Answer 18

G6PD deficiency anemia

Question 19

How can you distinguish G6PD anemia from other hemolytic anemias?

Answer 19

bite cells + checking G6PD activity/genetic testing

Question 20

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?

Answer 20

hereditary spherocytosis

Question 21

What do these labs indicate:
CRC >2%
elevated MCHC
DAT/Coombs negative
peripheral smear = circular, hyperchromic rounded RBCs?

Answer 21

hereditary spherocytosis

Question 22

How can you treat hereditary spherocytosis?

Answer 22

mild-moderate; folic acid
severe: splenectomy

Question 23

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?

Answer 23

B12 deficiency anemia

Question 24

What can gastric surgery, ETOH use, liver disease, PPIs and maybe vegans put someone at risk for?

Answer 24

B12 deficiency anemia

Question 25

What do these lab values indicate:
CRC<2%
MCV>100
B12<150
folic acid>145
homocysteine high
MMA high
cobalamin low
folate - normal?

Answer 25

B12 deficiency anemia

Question 26

What’s the #1 cause of B12 deficiency?

Answer 26

pernicious anemia

Question 27

How do you treat B12 deficiency?

Answer 27

IM B12 injections in large doses or lower oral doses

Question 28

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?

Answer 28

folate deficiency

Question 29

What do these labs indicate:
CRC<2%
MCV>100
LDH - high
bilirubin - high
homocysteine - high
MMA - normal
folate - low?

Answer 29

folate deficiency

Question 30

What does hypersegmented neutrophils indicate on a peripheral smear?

Answer 30

B12 or folate deficiency

Question 31

What’s one of the first signs of anemia on a vital signs list?

Answer 31

high HR, tachycardia