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HEMATOLOGY 1 > ANEMIA > Flashcards

ANEMIA Flashcards

1
Q

Anemia definition

A

Decrease below normal of RBCs, hemoglobin, or hematocrit.

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2
Q

Normocytic, Normochromic Anemia

A

MCV and MCHC are both normal.

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3
Q

Normocytic, normochromic Conditions with normal or decreased Reticulocyte Count

A

Aplastic anemia, Kidney disease, Acute blood loss.

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4
Q

Normocytic, normochromic Conditions with increased Reticulocyte Count

A

(ENZYMES and Hemolytic anemias)

PNH, Paroxysmal Cold Hemoglobinuria, Sickle Cell Disease, Enzyme deficiencies: G6PD deficiency, PK deficiency, Other hemolytic anemias.

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5
Q

Rare, potentially deadly bone marrow failure syndrome

A

Aplastic anemia.

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6
Q

Aplastic anemia features

A

Pancytopenia (↓ RBCs, WBCs, platelets), Reticulocytopenia, Bone marrow hypocellularity, Depletion of hematopoietic stem cells.

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7
Q

Paroxysmal Cold Hemoglobinuria

A

Autoimmune hemolytic anemia with Donath Landsteiner antibody (autoanti-P).

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8
Q

Approximately 80 to 85% of aplastic anemia cases

A

Acquired Aplastic Anemia.

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9
Q

Acquired Aplastic Anemia categories

A

1) Idiopathic acquired aplastic anemia (no known cause), 2) Secondary acquired aplastic anemia (associated with identified causes like chemicals, viruses, and drugs).

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10
Q

Common causes of Secondary acquired aplastic anemia

A

Chemicals (e.g., insecticides, benzene), Viruses (e.g., Epstein-Barr virus), Drugs (e.g., chloramphenicol).

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11
Q

Drug most frequently implicated in acquired aplastic anemia

A

Chloramphenicol.

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12
Q

Approximately 15% to 20% of aplastic anemia cases

A

Inherited Aplastic Anemia.

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13
Q

Inherited Aplastic Anemia diseases

A

1) Dyskeratosis congenita, 2) Shwachman-Bodian-Diamond syndrome, 3) Fanconi Anemia (FA).

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14
Q

Most common inherited aplastic anemia, a chromosome instability disorder

A

Fanconi Anemia (FA).

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15
Q

Fanconi Anemia features

A

Aplastic anemia, cancer susceptibility, and physical abnormalities (e.g., skeletal abnormalities, skin pigmentation changes, short stature, abnormalities of the eyes, kidneys, and genitals).

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16
Q

Fanconi Anemia physical abnormalities

A

Skeletal abnormalities (thumb malformations, microcephaly, scoliosis), Skin pigmentation changes (hyperpigmentation, hypopigmentation, café-au-lait lesions), Short stature.

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17
Q

Fanconi Anemia vs Fanconi Syndrome

A

Fanconi Syndrome is a defect in proximal CT.

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18
Q

Paroxysmal Nocturnal Hemoglobinuria (PNH) A.K.A

A

Marchiafava-Micheli Syndrome.

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19
Q

Paroxysmal Nocturnal Hemoglobinuria (PNH) cause

A

Deficiency of complement regulatory proteins: DAF (decay-accelerating factor, CD55), MIRL (membrane inhibitor of reactive lysis, CD59).

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20
Q

Test for PNH

A

Ham’s Acidified Serum Test, Sugar Water Test (sucrose hemolysis test); Flow cytometry using FLAER (confirmatory for PNH).

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21
Q

FLAER in PNH

A

Fluorescein labelled proacrolysin variants.

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22
Q

Microcytic, Hypochromic Anemias

A

Small cells with increased central pallor (MCV and MCHC both LOW).

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23
Q

Microcytic anemia cause

A

Insufficient iron for normal erythropoiesis.

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24
Q

Microcytic anemia diagnosis

A

Abnormal iron studies.

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25
Q

Early microcytic anemia development

A

Reduced iron stores, no obvious anemia.

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26
Q

Associated conditions of microcytic hypochromic anemia (C T A I L S)

A

(Chronic blood loss, Thalassemia, Anemia of chronic inflammation, Iron deficiency anemia, Lead poisoning, Sideroblastic anemia).

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27
Q

Anemia of chronic inflammation (ACI) original name

A

Anemia of chronic disease (ACD).

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28
Q

Most common anemia among hospitalized patients

A

Anemia of chronic inflammation (ACI).

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29
Q

Conditions associated with ACI

A

Chronic infections (e.g., tuberculosis), Chronic inflammatory conditions (e.g., rheumatoid arthritis), Tumors.

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30
Q

Central feature of ACI

A

Sideropenia (↓ serum iron) despite abundant iron stores.

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31
Q

PBS in ACI

A

Usually normocytic, normochromic; advanced stages: microcytic, hypochromic.

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32
Q

Acute phase reactants (APRs) in ACI

A

Hepcidin, Ferritin, Lactoferrin.

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33
Q

Hepcidin function

A

Master regulatory hormone for systemic iron metabolism; inactivates ferroportin (iron transport from tissues to blood).

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34
Q

Sideroblastic anemia development

A

Prevented protoporphyrin production or the incorporation of iron into protoporphyrin.

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35
Q

Sideroblast definition

A

Nucleated RBC precursor with cytoplasmic iron granules.

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36
Q

Siderocyte definition

A

Anucleate RBC with iron granules.

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37
Q

Iron in sideroblastic anemia

A

Trapped in mitochondria, cannot be fully utilized in Hb synthesis.

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38
Q

Hallmark of sideroblastic anemia

A

Ring sideroblasts (mitochondria loaded with iron).

39
Q

Peripheral blood picture in sideroblastic anemia

A

Dimorphic (normochromic and hypochromic RBCs).

40
Q

Most common anemia

A

Iron deficiency anemia (IDA).

41
Q

Possible causes of IDA

A

Blood loss (menstruating women), Nutritional deficiency (infants), ↑iron demand (pregnancy, lactation, adolescence), Malignancies of gastrointestinal tract, Hookworm infections.

42
Q

Clinical features of IDA

A

Fatigue, weakness, irritability, headache, palpitations, loss of concentration, shortness of breath, brittle hair, pallor, koilonchia (spooning of fingernails), glossitis, angular cheilosis, pica (non-food cravings, especially ice).

43
Q

TIBC (Total Iron Binding Capacity)

A

Indirectly measures transferrin concentration by its ability to bind iron.

44
Q

Serum Ferritin Test

A

Reveals body’s tissue iron stores; good indicator of iron storage status; useful in diagnosing iron deficiency.

45
Q

Used to measure serum ferritin

A

Radioimmunoassay.

46
Q

Stage 1 of Iron Deficiency

A

Storage Iron Depletion.

47
Q

Stage 1 Characteristics

A

Normal Hemoglobin, Serum Iron, and TIBC; Decreased Serum Ferritin.

48
Q

Stage 2 of Iron Deficiency

A

Transport Iron Depletion.

49
Q

Stage 2 Characteristics

A

Normal Hemoglobin, Decreased Serum Iron, Serum Ferritin; Increased TIBC.

50
Q

Stage 3 of Iron Deficiency

A

Functional Iron Depletion (Frank Iron Deficiency Anemia)

51
Q

Stage 3 Characteristics

A

Decreased Hemoglobin, Serum Iron, and Serum Ferritin; Increased TIBC

52
Q

Serum Iron and Serum Ferritin: High; TIBC and FEP: Normal

A

Thalassemia

53
Q

Serum Iron and TIBC: Low; Serum Ferritin and FEP: High

A

Anemia of Chronic Inflammation (ACI)

54
Q

Serum Iron and Serum Ferritin: Low; TIBC and FEP: High

A

Iron Deficiency Anemia (IDA)

55
Q

Normal to High Serum Iron (Adults); Normal to Low (Children); TIBC: Normal; Serum Ferritin: Normal; FEP: High

A

Lead Poisoning

56
Q

Serum Iron and Serum Ferritin: High; TIBC: Normal; FEP: Mixed (High and Low)

A

Sideroblastic Anemia

57
Q

MACROCYTIC

A

NORMOCHROMIC ANEMIAS Characterized by

58
Q

Types of Megaloblastic Anemias

A

Vitamin B12 Deficiency, Folate Deficiency

59
Q

Vitamin B12 Deficiency Causes

A

Inadequate intake, Increased need (e.g., pregnancy, lactation, growth), Competition (e.g., D. latum infection), Lack of Intrinsic Factor (e.g., gastrectomy, H. pylori infection, Pernicious Anemia)

60
Q

Pernicious Anemia Features

A

Antibodies against Parietal Cells, Antibodies against Intrinsic Factor (IF)

61
Q

Parietal Cells

A

Found in the stomach; produce HCl and Intrinsic Factor (IF)

62
Q

Required factor for Vitamin B12 absorption

A

Intrinsic Factor

63
Q

Folate Deficiency Causes

A

Inadequate intake, Increased need, Renal dialysis

64
Q

Anemia associated with liver disease

A

chronic alcoholism

65
Q

Megaloblastic Anemia neutrophils

A

Hypersegmented (> 6 segments)

66
Q

Hypersegmented Neutrophils in Nonmegaloblastic Anemia

A

Absent

67
Q

Normal Neutrophils

A

Have 3 to 5 nuclear lobes

68
Q

Macrocyte Shape in Megaloblastic Anemia

A

Oval

69
Q

Macrocyte Shape in Nonmegaloblastic Anemia

A

Round

70
Q

Megaloblasts in Bone Marrow (Megaloblastic Anemia)

A

Present

71
Q

Megaloblasts in Bone Marrow (Nonmegaloblastic Anemia)

A

Absent

72
Q

Root Cause of Megaloblastic Anemia

A

Impaired DNA synthesis

73
Q

Vitamin B12 is the cofactor for ____ in DNA Synthesis

A

Thymidine Triphosphate (TTP)

74
Q

Vitamin B12 Alternative Name

A

Cobalamin

75
Q

General term for any form of folic acid

A

Folate

76
Q

Synthetic form of Vitamin B12 found in supplements

A

Cyanocobalamin

77
Q

Naturally occurring form of Vitamin B12

A

obtainable from food or supplements

78
Q

Symptoms in Folate or Vitamin B12 Deficiency

A

Fatigue, weakness, shortness of breath, glossitis, gastritis, nausea or constipation

79
Q

Symptoms in Vitamin B12 Deficiency

A

Memory loss, numbness, tingling in toes and fingers, loss of balance, vibratory sense loss in lower limbs, Personality changes, psychosis

80
Q

Vegan Diet and Type of Anemia

A

Prone to Vitamin B12 Deficiency Megaloblastic Anemia

81
Q

Sources of Vitamin B12

A

Liver, meat, oysters, clams, fish, eggs, cheese, dairy products

82
Q

Effect of Cooking on Vitamin B12

A

Not destroyed by cooking

83
Q

Sources of Folate

A

Leafy green vegetables, dried beans, liver, beef, fortified cereals, broccoli, dairy, whole grains, oranges

84
Q

Effect of Cooking on Folate

A

Folates are heat labile, overcooking can reduce nutritional value

85
Q

Laboratory tests used to diagnose Vitamin B12 and Folate deficiency Screening tests

A

Complete blood count (Hemogram), Manual differential count, Absolute reticulocyte count, Serum total and indirect bilirubin, Serum lactate dehydrogenase

86
Q

Laboratory findings in Vitamin B12 and Folate deficiency

A

Decreased Hb, Hct, RBCs, WBCs, PLTs; Increased MCH

87
Q

Specific diagnostic tests for Vitamin B12 and Folate deficiency

A

Serum B12, serum folate, RBC folate, serum methylmalonic acid, serum/plasma homocysteine, holotranscobalamin assay

88
Q

Other findings in megaloblastic anemia

A

Teardrop cells, nucleated RBCs, Howell-Jolly bodies, basophilic stippling, Cabot rings

89
Q

Hypersegmented neutrophils

A

Pathognomonic for megaloblastic anemia

90
Q

Vitamin B12 absorption and transport

A

Vitamin B12 binds to intrinsic factor (IF) in the stomach, then binds to transcobalamin in the enterocyte, forming holotranscobalamin (holoTC), the metabolically active form of Vitamin B12

91
Q

Anemias caused by decreased RBC production

A

Aplastic anemia, Megaloblastic anemia, Iron deficiency anemia, Thalassemia, Anemia of chronic renal failure, Anemia of endocrine disorders, Anemia of chronic inflammation (ACI), Anemia associated with marrow infiltration, Sideroblastic anemia

92
Q

Anemias caused by increased RBC destruction (intracorpuscular abnormalities)

A

Membrane defect: hereditary spherocytosis, hereditary elliptocytosis, pyropoikilocytosis; Enzyme deficiency: G-6-PD, pyruvate kinase, porphyria; Globin abnormality: hemoglobinopathies (Hb SS, CC, SC); Paroxysmal nocturnal hemoglobinuria

93
Q

Anemias caused by increased RBC destruction (extracorpuscular abnormalities)

A

Mechanical: microangiopathic hemolytic anemia, etc.; Infection: malaria, Bartonella, Ehrlichia, Babesia; Chemical and physical agents: drugs, toxins, burns; Antibody-mediated: acquired hemolytic anemia due to warm-reacting antibodies

94
Q

Anemia due to blood loss

A

Hemorrhage

HEMATOLOGY 1 (27 decks)

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