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Clin Med 1 > Anemia > Flashcards

Anemia Flashcards

0
Q

normal HGB and HCT in men

A

HGB 14-18 g/dl

HCT 40-50%

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1
Q

normal HGB and HCT for women

A

HGB 12-16 g/dl

HCT 35-45%

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2
Q

causes of decreased RBC production (4)

A

iron deficiency
B12 deficiency
folate deficiency
chronic disease

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3
Q

3 big etiologies of anemia

A

decreased RBC production
increased RBC destruction
Blood loss

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4
Q

causes of anemia due to blood loss

A

menstrual
GI bleeding
trauma

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5
Q

hypochromic, microcytic anemias (3)

A

iron deficiency anemia
thalassemias
sideroblastic anemia

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6
Q

normochromic, normocytic anemia (3)

A

hypothyroidism
liver disease
chronic disease

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7
Q

macrocytic/megaloblastic anemia causes

A

folate &/or B12 deficiency

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8
Q

causes of iron deficiency anemia

A

menses
pregnancy
GI blood loss
decreased iron absorption

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9
Q

iron deficiency anemia on a smear

A

biconcave appearance, central pallor on RBCs

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10
Q

iron deficiency anemia test results (4)

A

decreased serum ferritin
decreased serum Fe
elevated TIBC
** Elevated RDW

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11
Q

alpha 2 thalassemia presents as

A

mild hypochromic, microcytic anemia

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12
Q

alpha 3 thalassemia presents as

A

hemolytic anemia w/ splenomegaly

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13
Q

Beta thalassemia presents as

A

asymptomatic, hypochromic, microcytic anemia

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14
Q

lab findings for thalassemia

A

decreased MCV
Smear: poikilocytosis, target cells, nucleated RBCs
Normal RDW

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15
Q

good DDX finding for iron deficiency anemia

A

Elevated RDW

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16
Q

thalassemia tx (3)

A

transfusions to keep HGB > 9 g/dl
possible splenectomy
iron chelation therapy needed due to transfusion

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17
Q

how is anemia of chronic disease diagnosed?

A

exclusion, hx

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18
Q

an acquired disorder of hematopoetic stem cells, resulting in refractory anemia

A

MDS

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19
Q

refractory anemia due to drugs, lead toxicity, malignancy, inflammation, infection

A

sideroblastic anemia

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20
Q

variable MCV
anisocytosis & poikilocytosis
ringed sideroblasts may be present

A

sideroblastic anemia

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21
Q

elevated reticulocyte count w/ no other findings indicates

A

prior/recent hemorrhage, recent hemolysis

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22
Q

MCV > 100 =

A

macrocytic anemias

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23
Q

etiology/process of macrocytic anemia

A

defective DNA synthesis –> larger RBCs

24
Q

additional symptoms of macrocytic anemia

A

glossitis, jaundice, splenomegaly, neuro***

25
Q

macrocytic anemia smear’s most significant finding

A

hypersegmented neutrophils

26
Q

Labs for Macrocytic Anemia (4)

A

serum B12
Schilling Test
IF antibodies
serum methylmalonic acid & homocysteine levels

27
Q

autoantibodies against intrinsic factor

A

pernicious anemia- results in B12 deficiency

28
Q

Lab ddx between B12 and folic acid deficiency

A

B12: elevated serum methylmalonic acid and homocysteine levels
Folate: elevated homocysteine but normal methylmalonic acid levels

29
Q

tx for folic acid deficiency

A

replacement therapy

Treat B12 as well

30
Q

how do elevated reticulocytes look on a smear?

A

blue

31
Q

elevated reticulocyte count, nucleated RBCs and schistocytes on smear, elevated plasma Hb —> ?

A

hemolytic anemia

32
Q

how to differentiate between intravascular and extravascular hemolytic anemia (lab test)

A

serum haptoglobin decreased in intravascular hemolysis

33
Q

causes of intravascular hemolysis

A

fragmentation syndromes: traumatic (macroangiopathic) from prosthetic heart valve; fibrin strands in vessels (microangiopathic)
G6PD deficiency

34
Q

causes of extravascular hemolysis (4)

A

hereditary spherocytosis
sickle cell
hemolytic anemia (drug induced or autoimmune)
incompatible blood transfusion

35
Q

RBCs w/ decreased surface area, poorly deformable. RBCs get trapped in splenic sinusoids & are phagocytized by macrophages

A

hereditary spherocytosis

36
Q

hereditary spherocytosis etiology

A

autosomal dominant

37
Q

lab findings for hereditary spherocytosis (2)

A

osmotic fragility test for cell wall defects

lack of central pallor on RBC smear

38
Q

hereditary spherocytosis tx (2)

A

splenectomy, give pnuemococcal vaccine

39
Q

primary presentation of back, rib, limb pain

A

sickle cell anemia

40
Q

cause of sickle cell pain

A

vaso-occlusive ischemia

41
Q

complications of sickle cell (4)

A

osteonecrosis of femoral/humeral heads
functional asplenism due to infarcts
leg ulcers
bilirubin gallstones due to chronic hemolysis

42
Q

1st and 2nd line lab tests for sickle cell

A

Sickledex (1st line)

Hb electrophoresis

43
Q

sickle cell characteristic finding on peripheral smear

A

Howell-Jolly bodies: residual nuclear material

44
Q

precipitating factors of sickle cell (4)

A

dehydration
hypoxia
altitude
intense exercise

45
Q

sickle cell tx (2)

A

Pain crises: analgesics, fluids, oxygen

Hydroxyurea to decrease occurrence of crises

46
Q

antibodies bind to RBCs, damage cell membrane –> hemolysis –> phagocytized –> destroyed in the spleen

A

autoimmune hemolytic anemia

47
Q

smear findings for autoimmune hemolytic anemia? (4)

A

reticulocytosis
polychromasia
spherocytosis
nucleated red cell

48
Q

on smear: reticulocytosis, polychromasia, spherocytosis, nucleated red cells

A

autoimmune hemolytic anemia

49
Q

autoimmune hemolytic anemia tx (4)

A

treat underlying autoimmune cause
corticosteroids for short term
splenectomy
folic acid supplementation

50
Q

anemia characterized by an abnormal iron metabolism

A

sideroblastic anemia

51
Q

normal retic count range

A

0.5-2.5%

52
Q

normal MCV range

A

80-100 fl

53
Q

length of iron deficiency tx

A

at least 6 mo- replenish stores

54
Q

decreased serum ferritin, decreased serum Fe, increased TIBC

A

iron deficiency

55
Q

normal serum ferritin, normal TIBC

A

unlikely iron deficiency

56
Q

decreased Fe, decreased TIBC, normal ferritin

A

anemia of chronic disease

57
Q

increased ferritin, increased serum Fe, normal TIBC

A

Thalassemia

Clin Med 1 (18 decks)

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