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Semiology > Anemia > Flashcards

Anemia Flashcards

1
Q

Micro cystic anemia

A

Sideroblastic
Thalassemia
Iron deficiency

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2
Q

Macrocyctic anemia

A

Biermer anemia

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3
Q

Normochromic normocytic

A

Normal MCV. MCHC
– anemias of chronic disease
– hemolytic anemias (those characterized by accelerated destruction of rbc)
– anemia of acute hemorrhage
– aplastic anemias (characterized by disappearance of rbc precursors from the marrow)

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4
Q

Low MCHC MCVC

A

Hypochromic microcytic
– iron deficiency anemia
- sec. to gatsrointestinal bleeding, other hemorrhage
– thalassemias

– anemia of chronic disease (rarely)

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5
Q

Normal MCHC high MCV

A

Normochromic macrocytic anemia – vitamin b12 deficiency – folate deficiency

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6
Q

Clinical classification of anemia

A
  • Mild: 8-11 g/dl, Ht: 30-39%
  • Moderate:6-8, 22-30
  • Severe:<6, <22
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7
Q

Normochromic anemia

A

Post hemorrhage

Hemolytic

Simple chronic

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8
Q

Manifestations in anemic sdr.

A
  • weakness, tiredness, dyspnea, postural dizziness
  • Paresthesia- vitamin B12 deficiency
  • Exacerbations of pre-existing cardiac manifestations (due to a hyperdynamic state as a compensatory mechanism)
  • Depending upon the form:
  • Acute anemia after bleeding- severe manif.
    -Chronic: less severe
  • Pallor, jaundice
    -Pallor of the palmar creases suggests that the haemoglobin level is less than 7mg/L
    Jaundice: in hemolytic anemia
  • koilonychia- dry, brittle, ridged, spoon-shaped nails, due to severe iron deficiency anemia
  • Adenopathy- in infections, cancer Tachycardia
  • Systolic murmur:
  • Splenomegaly-hemolytic anemia
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9
Q

Lab test

A

complete blood count
Peripheral blood smear
Reticulocyte count
Bone marrow biopsy
Ferritin,
folate,
vitamine B12

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10
Q

IRON DEFICIENCY ANEMIA

A

Diet- vegetarians
Hemorrhage: gastrointestinal tract, urinary tract; ! “HIDDEN”- HEMOCCULT TEST Malabsorption: atrophic gastritis

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11
Q

irn defficiency anemia

A

General:

  • fatigue,
  • tachycardia,
  • dispnea,
  • pallor

Specific:

  • Plummer-Vinson syndrome: dysfagia, stomatitis, glossitis
  • Splenomegaly:
  • koilonykia
  • perverted appetite
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12
Q

biermer anemia cause

A

Pernicious anemia is a chronic illness caused by impaired absorption of vitamin B-12 because of a lack of intrinsic factor in gastric secretions.

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13
Q

biermer clinical

A
  • General manif.
  • G-i.: anorexia, weight loss, nausea; smooth tongue with atrophic papillae- HUNTER glossitis
  • Neurological: paresthesias, weakness, unsteady gait; loss of proprioception- myelin degeneration !! may be present in the absence of anemia
  • splenomegaly: 20% Yellowish pallor- increased turnover of bilirubin
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14
Q

Etiology hemolytic anemia

A

Hereditary disorders include erythrocyte membrane and enzymatic defects and hemoglobin abnormalities: Hereditary spherocytosis, Sickle cell anemia

Acquired hemolytic conditions: immune disorders, toxic chemicals and drugs, antiviral agents (ribavirin), Infections

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15
Q

in patients with severe anemia

A
  • Tachycardia,
  • dyspnea,
  • angina,
  • weakness
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16
Q

dark urine

A

Hemglbinuria patients with intravascular hemolysis

17
Q

if anemia is severe or if the onset is rapid.

A

Angina and evidence of cardiac decompensation

18
Q

fever,

neurological signs,

renal failure,

petechiae, and hemolysis because of the widespread occlusion of small vessels.

A

thrombotic thrombocytopenic purpura (TTP)

19
Q

leg ulcers caused by decreased red cell deformity and endothelial changes can be assciated with

A

Sickle cell anemia and other hemolytic

20
Q

Acute leukemias

A
  • hemorrhage,
  • anemia,
  • infection, or infiltration of organs
21
Q

Acute lymphoblastic leukemia

A
  • bone pain,
  • fever,
  • mediastinal syndr.,
  • hepato-splenomegaly
22
Q

myelogenous leukemia

A
  • may infiltrate tissues, causing many significant complications including
  • central nervous system involvement,
  • pulmonary dysfunction,
  • skin and gingival infiltration.
  • -splenmegaly
  • -Adenpathy
23
Q

chronic myelogenous leukemia

A
  • splenomegaly,
  • weight loss,
  • malaise,
  • bleeding, or thrombosis
24
Q

non hodgkin lymphoma

A
  • Adenopathies
  • splenomegaly
  • extranodal involvement
  • Gi tract
  • skin
  • Genitourinary
  • bone marrow sinuses
  • thyroid
  • CNS

CT scan of neck abdomen pelcies
to detect:

  • heppatosplenomegaly
  • enlarged lymphnodes
25
Q

Hodgkin lymphoma

A

most common symptom:

  • cervical and suraclavicular laymphadenoathy
  • 2/3 have mediastenal involvement

Localized symptom: -painless adenopathy

Respiratory:cough or chest pian (mediastenal involvement)

26
Q

Hodgekin lymhoma B symptoms (systemic)

A
  • fever >38 °C for 3 consecutie days
  • Unexplained weight loss of 10% or more within the previous 6 months
  • drenching night sweat
27
Q

hodgekin lymphoma stages

A

–Stage I - Involvement of a single lymph node region or of a single extralymphatic organ or site
–Stage II - Involvement of 2 or more lymph node regions on the same side of the diaphragm or localized involvement of an extralymphatic organ or site and 1 or more lymph node regions on the same side of the diaphragm
–Stage III - Involvement of lymph node regions on both sides of the diaphragm, which may be accompanied by localized involvement of an extralymphatic organ, or site, or both
–Stage IV - Diffuse or disseminated involvement of 1 or more extralymphatic organs or tissues with or without associated lymph node involvement

28
Q

coagulation disorders

A

–Acquired:

  • Vitamin K deficiency (leading to factor II, VII, IX and X deficiency),
  • Liver disease (impaired synthesis of clotting factors),
  • Anticoagulants, Disseminated intravascular coagulation

–Congenital:

  • Haemophilia A (factor VIII deficiency),
  • Haemophilia B (factor IX deficiency, Christmas disease),
  • Von Willebrand’s disease (causes a defect in platelet adhesion)
29
Q

Hemophilia A and B classification

A
  • Patients with severe disease usually have less than 1% factor activity. It is characterized by spontaneous hemarthrosis and soft tissue bleeding in the absence of precipitating trauma.
  • Patients with moderate disease have 1-5% factor activity and bleed with minimal trauma.
  • Patients with mild hemophilia have more than 5% FVIII activity and bleed only after significant trauma or surgery
30
Q

Thrombocytopenia:

A

Increased destruction :
immunological:

  • immune thrombocytopenic purpura,
  • systemic lupus erythematosus,
  • drugs

Non-immunological:

  • damage, e.g. prosthetic heart valve,
  • consumption, e.g.disseminated intravascular coagulation,
  • haemorrhage

Reduced production:

  • Marrow aplasia: drugs, chemicals, radiation
  • Marrow invasion, e.g. carcinoma, myeloma, leukaemia, fibrosis

Sequestration: Hypersplenism

31
Q

Platelet dysfunction:

A
  • Congenital or familial
  • Acquired: myeloproliferative disease ,dysproteinemia, chronic renal failure, chronic liver disease
32
Q

Bleeding due to small vessel disease:

A

–Infection: infective endocarditis, septicaemia

–viral exanthemata (measles)

–Drugs, e.g. steroids

–Scurvy (vitamin C deficiency)

–Vasculitis: polyarteritis nodosa, Henoch-Schönlein purpura

–Fat embolism

–Dysproteinemia

33
Q

Henoch-Schönlein Purpura

A
  • is a small-vessel vasculitis characterized by purpura, arthritis, abdominal pain, and hematuria. The etiology of HSP is unknown.
  • About 50% of patients have a preceding upper respiratory illness
  • Male-to-female ratio is about 2:1.
  • Cl:
    –Palpable purpura, particularly on the buttocks and legs
    –Edema of the hands, feet,
    –Arthritis, most commonly involving the knees and ankles
    –Abdominal tenderness
    –Gastrointestinal bleeding
34
Q

Massive splenomegaly

A
  • Common: chronic myeloid leukaemia, myelofibrosis
  • Rare: Malaria, primary lymphoma of spleen
35
Q

moderate splenomegaly

A
  • The above causes
  • Portal hypertension
  • Lymphoma, leukemia (acute or chronic)
  • Thalassaemia
  • Storage diseases (Gaucher’s disease)
36
Q

Small splenomegaly:

A
  • The above causes
  • Other myeloproliferative disorders:
    –polycythaemia rubra vera
    –essential thrombocythaemia
  • Haemolytic anaemia
  • Megaloblastic anaemia
  • Infection:
    –viral (e.g. infectious mononucleosis, hepatitis)
    –bacterial (e.g. infective endocarditis)
    –protozoal (e.g. malaria)
  • Connective tissue diseases:
    –rheumatoid arthritis
    –systemic lupus erythematosus
    –polyarteritis nodosa
  • Infiltrations: amyloid, sarcoid

Semiology (13 decks)

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