Anemia Flashcards
Blood disorders
Leukocytosis
Leukopenia
Polycythemia
Anemia
Thrombocytopenia
Throbocytosis
Red blood cells
Live 120 days
If low normal bone marrow increases production-also if noted deceased O2
Reason for decrease: anemia, Hodgkin disease, multiple myeloma, leukemia, lupus; Addisons, RA
Reasons for increase: polycythemia, dehydration, acute poisoning, severe diarrhea, IPF
Hematocrit
Males 40-54%
Females 37-47%
Newborns 50-62%
Increased reasons: polycythemia, dehydration, shock, high altitude living
Decreased reasons: anemia, cirrhosis, leukemia, hyperthyroid, acute blood loss, hemolysis
Hemoglobin
Males 13.5-17.5
Females 12-16
Newborns 14-20
More important than HCT
Increased reason: polycythemia, CHF, burns, high altitude, COPD, meds like gentamicin and methyldopa
Decreased reasons: anemia, hyperthyroid, cirrhosis, dehydration, hemorrhage, hemolytic reaction, pregnancy, Hodgkin lymphoma, leukemia, lupus
Mean corpuscular volume
MCV less than 87-MICROCYTIC
87-103 NORMOCYTIC
Greater than 100-103 MARCOCYTIC
Hypo chromic
Amount of hemoglobin is low at the center of RBC appears pale and large
Basophilic stippling
Fine granules enclosed in the cell seen in lewd poisoning or serious blood disorders like pernicious anemia or leukemia
Polychromasia
Cells do not take in acid stain
Numerous in acute blood loss anemia or hemolytic anemia
Malarial stippling
Fine granular appearance of RBC that are harboring the parasite of tertiary malaria
Nucleated RBC
Severe anemia
Howell jolly bodies
Nuclear remnants which appear after splenectomy and in people with hemolytic and megaloblastic anemia
Poikilocytosis
Abnormal variation and irregularities in shape; seen in severe anemia (target cell, spherocytes, sickle cell, shistocytes)
Target cells
Thinner than normal
Due to liver disease, thalassemia, post splenectomy, iron deficiency, HGB C and S
Spherocytes
Cells are smaller and round
Seen after transfusion
Sickle cell
Hemolytic anemia, sickle cell trait, sickle cell disease
Crescent shaped cell
Schistocytes
Fragmented bizarre looking RBC shapes
DIC, burns, vasculitis, artificial heart valve, glomerulonephritis
Platelets
High- cancer; CML, CGL, polycythemia, cirrrhosis, chronic pancreatitis, high altitude, splenectomy, post hemorrhagic anemia, iron deficiency, RA, winter, cardiac disease TB
Low- hemolytic anemia, chemotherapy, pernicious anemia, aplastic anemia, hypersplenism, ITP, HIV, post transfusion, DIC, DDT exposure
Less than 20,000 petechial rash, ecchymosis, spontaneous bleeding
Microcytic anemia
Causes- iron deficiency anemia, anemia of chronic disease, sideroblastic anemia (drugs and toxins etoh, isoniazid, lead), thalassemia, hemoglobulinopathies
NORMOCYTIC anemia
Acute post hemorrhagic anemia
Hemolytic anemia
Anemia from impaired bone marrow -aplastic anemia, myelofibrosis, renal disease, liver disease, malnutrition, anemia of chronic disease
Macrocytic Anemia
Causes
-B12 deficiency -vegetarianism, intrinsic factor deficiency (achlorhydria, PPI use, bariatric surgery), sprue, parasite, chronic pancreatic disease, pregnancy, cancer, hypothyroidism, enzyme deficiency leading to lack of transcobalamin 2
-folate deficiency- lack of vegetables, etoh, steatorrhea, anticonvulsant, OCP, pregnancy, cancer, HD, drugs-methotrexate, triamterene, sulfas
Labs
Iron
Folate
Ferritin
CBC
Reticulo count
B12
Occult stool
Transferrin saturation
TIBC
Smear
Coombs or urine bilirubin
Meds
Ferrous sulfate ** 325 mg TID
Ferrous fumarate 200 mg TID
Ferrous gluconate 600 mg TID
Epoetin alpha 50-100 U/Kg three times a week
Sherri’s blood work shows a decreased MCV and decreased MCHC what should you order next
Serum iron, TIBC, serum ferritin
Stu age 49 has slightly reduced H/H what is your next action after you ask him about his diet
Perform a fecal occult blood test
