Anemia

Question 1

Anemia general symptoms

Answer 1

Weakness, HA, sensitivity to cold, exertional dyspnea, fatigue

Question 2

Acute anemia sx

Answer 2

Tachycardic, orthostatic hypotension, fainteness, pain, cold extremities

Question 3

Vitamin B deficiency symptoms

Answer 3

Neurologic: Paresthesia, abnormal reflexes, ataxia, confusion, numbness, vertigo, decreased vibration sense (posterior column and spinocerebellar pathway both involved in vibration sense)

Question 4

Anemia general signs

Answer 4

jaundice, petechiae, ecchymosis, loss of skin tone, pallor

Question 5

Anemia labs

Answer 5

CBC w/indices
retic count
peripheral smear
stool sample for occult blood

Question 6

What is included in a CBC

Answer 6

RBC, WBC, hgb, hct, platelets and MPV

Question 7

What is included in RBC indicies

Answer 7

MCV, MCH, MCHC

Question 8

Normal Hgb levels

Answer 8

F: 12-14 M:14-16

Question 9

Normal Hct level

Answer 9

F: 37-475 M: 40-50%

Hct is usually 3x hgb

Question 10

Microcytic/hypochromic anemias (MCV <80)

Answer 10

Iron deficiency, anemia of chronic dz(late), thalessemia and sickle cell

Question 11

Normocytic/normochromic MCV 80-100

Answer 11

Anemia of chronic dz(early), renal failure, autoimmune hemolytic

Question 12

Macrocytic/hyperchromic MCV>100

Answer 12

B12 and folate deficiency

Question 13

Cause of IDA

Answer 13

menstruation, preg,

GI bleeds

Question 14

Causes of Vit B deficiency

Answer 14

Malabsorption MC, pernicious anemia, Crohn’s dz (ileum), surgical resection

Question 15

Causes of Folate deficiency

Answer 15

Malnutrition, ETOHism

Question 16

Causes of anemia of chronic dz

Answer 16

malignancy, renal failure, arthritis

Question 17

causes of hemolytic anemia

Answer 17

increased destruction of RBC

Question 18

MC cause of anemia

Answer 18

IDA

Question 19

IDA dx

Answer 19

Microcytic, hypochromic
Low serum iron, ferritin, and transferrin
Increased TIBC
No compensatory reticulocytosis

Question 20

what is Ferritin

Answer 20

storage protein for iron

Question 21

what is transferrin

Answer 21

protein that binds to iron and transports it throughout the body

Question 22

What is TIBC

Answer 22

measures how well iron moves through the body

Question 23

IDA tx

Answer 23

Oral or parenteral Iron
Ferrous sulfate 325 mg po tid
hgb should increase by one week, normalize by 6 weeks, microcytosis may take months to resolve

Question 24

Anemia of chronic dz findings

Answer 24

normocytic, normochromic
High ferritin
normal or low TIBC
low transferin
low retic

Question 25

Anemia of chronic dz tx

Answer 25

treat chronic dz, erythropoieten

Question 26

Vit B12 deficiency findings

Answer 26

``` Macrocytic Hypersegmented PMNs smooth red tongue neurologic issues low serum B12 ```

Question 27

Vit B12 tx

Answer 27

Parenteral or oral B12 | 1-2mg PO qd

Question 28

Folated deficiency findings

Answer 28

``` Macrocytic hypersegmented PMNs Smooth red tongue NO NEURO ISSUES normal B12 low serum folate ```

Question 29

Hemolytic anemia findings

Answer 29

HIgh reticulocyte count (means either hemolysis, blood loss, or decreased EPO) warm or cold antibody normochromic, normocytic spherocytes (antibodies coat RBC,no central pallor) and schistocytes (fragmented RBC, being ripped apart) on smear Direct coombs test pos

Question 30

Folate deficiency tx

Answer 30

oral folic acid 1-5 mg qd x 4months

Question 31

what is direct coombs test

Answer 31

detects antibodies attached to a pts RBC