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Hematology > Anemia 2 > Flashcards

Anemia 2 Flashcards

1
Q

What level of Hb defines anemia in adults (men, women, pregnant women)?

A

Men

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2
Q

What is the most common cause of B12 deficiency? Folate?

A
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3
Q

How long does it take for B12 deficiency to present? Folate?

A
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4
Q

What is the treatment for B12 deficiency? Folate?

A
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5
Q

What is the chemical released by the kidneys that stimulate bone marrow production of RBCs?

A

EPO

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6
Q

What are the three measures that define anemia?

A

Low Hb
Low Hct
Low RBC

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7
Q

High hb = ?

A

Polycythemia

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8
Q

HIgh HCT = ?

A

Polycythemia

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9
Q

High RBC count = ?

A

Thalassemia

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10
Q

What is the equation for the absolute reticulocyte count?

A

(RBC count)*(% reticulocytes) /100

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11
Q

Under what number can reticulocytosis be excluded (for the reticulocyte count)?

A
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12
Q

What are the three ways in which we classifty anemias?

A

Onset (acute vs chronic)
Pathophysiology
Morphology

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13
Q

What are the two different categories of pathophysology for anemia?

A

Hyporoliferative

Proliferative

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14
Q

What is the usual cause of macrocytic anemia?

A

Defect in the maturation of RBCs

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15
Q

Normocytic anemia is usually caused by what?

A

Decreased production or increased destruction

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16
Q

Micro or macrocytic anemia: iron deficiency?

A

Micro

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17
Q

Micro or macrocytic anemia: anemia of chronic disease

A

micro

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18
Q

Micro or macrocytic anemia: thalessemias?

A

Micro

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19
Q

Micro or macrocytic anemia: siderblastic anemia?

A

Micro

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20
Q

Micro or macrocytic anemia: B12 deficiency

A

Macro

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21
Q

Micro or macrocytic anemia: folic acid deficiency

A

Macro

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22
Q

Micro or macrocytic anemia: drug related?

A

macro

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23
Q

Micro or macrocytic anemia: hypothyroidism

A

Normo

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24
Q

Micro or macrocytic anemia: liver disease

A

Normo

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25
Q

Micro or macrocytic anemia: alcoholism

A

normo

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26
Q

Micro or macrocytic anemia: myelodysplastic syndrome

A

Normo

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27
Q

What are the three general causes of intrinsic hemolytic anemia?

A

Membrane defects
Enzymatic defects
Hemoglobinopathies

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28
Q

What are the three general causes of extrinsic hemolytic anemias?

A

Autoimmune
Splenomegaly
Infections

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29
Q

What is the PMN findings for megaloblastic anemias?

A

Hypersegmented neutrophils

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30
Q

What are the sources for B12? Folate?

A 
B12 = meat
Folate = green leafy vegetables
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31
Q

Where is B12 absorbed? Folate?

A 
B12 = ileuem
Folate = proximal jejunum
32
Q

What are the daily requirements for B12?

A

1-3 mcg

33
Q

What are the daily requirements of folate?

A

50-100 mcg

34
Q

How long does it take to become folate deficient? B12?

A 
Folate = 3-4 months
B12 = 3-4 years
35
Q

Which has a more rapid onset: B12 deficiency d/t malabsorption or dietary deficieny

A

Malabsorption

36
Q

What are the two reactions that B12 is necessary in?

A

Methionine synthesis

Conversion of methylmalonic acid to succinyl-CoA

37
Q

What intestinal disease is known to lead to B12 deficiency?

A

Crohn’s

38
Q

What are the two drugs that can lead to B12 deficiency?

A

Metformin

PPIs

39
Q

B12 deficiency that presents a few weeks after birth = ?

A

Congential transcobalamin deficiency

40
Q

B12 deficiency that presents at birth?

A

Congenital methylmalonic acidemia

41
Q

Why are parethesias common in B12 deficiencies?

A

Demyelination

42
Q

True or false: babinski’s sign may be present with B12 deficiency

A

True

43
Q

What happens to the reticulocyte count with B12 deficiencies?

A

Lower

44
Q

What are the histological characteristics of PMNs in b12 deficiencies?

A

Hypersegmented (may lobes)

45
Q

What is the treatment for B12 deficiency?

A

B12 1000mcg IM/SQ weekly, then monthly

46
Q

What mineral must be monitored carefully during the treatment for B12 deficiency?

A

K (hypokalemia)

47
Q

How long does it take Hb levels to return to normal following treatment with B12?

A

2 months

48
Q

What causes the paresthesias with B12 deficiency?

A

Demyelination of the dorsal colums/ML pathways

49
Q

Pts who have undergone what surgical procedure require B12 supplementation?

A

Gastrectomy

50
Q

What is the most common cause of pernicous anemia?

A

Autoimmune attack against parietal cells

51
Q

What are the tests for pernicous anemia now-a-days?

A

Parietal cell / IF antibody test

52
Q

What would you expect gastric serum levels to be in a patient with pernicious anemia? Serum pepsinogen levels?

A

Gastrin high

Pepsinogen low

53
Q

What would a biopsy of a stomch of a pt with pernicious anemia show?

A

Death of parietal cells, repalced with mucus cells

54
Q

Borderline B12 levels is accompanied by what lab values in a pt with subclinical B12 deficiency?

A

Elevated Homocysteine /methylmalonic acid levels

55
Q

What is the most common cause of folate deficiency anemia?

A

Inadequate dietary intake

56
Q

Folate deficiency signs/symptoms are the same as B12, except for what?

A

B12 has neurological symptoms, while Folate does not

57
Q

What are the signifiant lab findings with folate deficiency?

A

Low Hb

Low serum RBC/folate level

58
Q

What is the methylmalonic acid level in pts with folate deficiency?

A

Normal

59
Q

What is the treatment for folate deficiency?

A

1-5 mg/day oral folate

60
Q

How long does it take for folate to reach normal levels?

A

8 weeks

61
Q

What are the homocysteine levels in folate deficiency?

A

High

62
Q

What are the two autoimmune causes of aplastic anemia?

A

idiopathic

SLE

63
Q

What is the congenital cause of aplastic anemia?

A

Defected in telomere length maintenance

64
Q

What are the toxins that can cause aplastic anemia? (3)

A

Benzene
Toluene
Insecticides

65
Q

What is the virus that can cause aplastic anemia in the post-viral state?

A

Hepatitis

66
Q

What treatment can cause aplastic anemia?

A

Chemotherapy

67
Q

What are the CBC findings with aplastic anemia?

A

Panytopenia

68
Q

What are the signs/symptoms of aplastic anemia? (4)

A

Immune suppression
Fatigue
Petechiae
HSM

69
Q

True or false: LA / bone pain can be symptoms of aplastic anemia

A

False– think osteosarcoma if these are present

70
Q

True or false: reticulocytoenia is always present with aplastic anemia

A

True

71
Q

What is the test that you should always order for patients with aplastic anemia?

A

Bone marrow biopsy

72
Q

What is the treatment for mild aplastic anemia? Severe?

A

Symptomatic treatment for mild

Bone marrow transplant for severe

73
Q

What are the methylmalonic acid levels in B12 deficiency? Folate deficiency?

A 
b12 = high
Foalte = low
74
Q

What are the serum folate levels in folate deficiency? B12/

A 
B12 = normal
Folate = low
75
Q

What are the CBC findings for aplastic anemia?

A

Pancytopenia

Hematology (32 decks)

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