Anemia Flashcards
What is a normal hemoglobin value?
12-17 (~15)
What does a hematocrit value assess?
The percentage of blood that is red blood cells
What is a normal hematocrit level?
36-50%
What does an MCV measure?
Mean corpuscular volume (average size of red blood cell)
What MCV level is indicative of macrocytic anemia?
> 100 fL
What MCV level is indicative of microcytic anemia?
Less than 100
What does MCH measure?
Mean cell hemoglobin – average mass of hemoglobin per red blood cell
What does MCHC measure?
Mean cell hemoglobin concentration – average concentration of hemoglobin in given volume
Which MCHC value is indicative of hypochromic anemia?
Less than 31
Which MCHC value is indicative of normochromic anemia?
> 31 g/dL
What is a normal RBC count?
4.1-5.6
What does a hemoglobin value measure?
The oxygen-carrying capacity of the blood
What is a normal reticulocyte count?
Less than 1.5
What does a high reticulocyte count indicate?
High number of immature red blood cells indicates bone marrow response to anemia
Which types of anemia are macrocytic?
Hemorrhage, B12 deficiency, folate deficiency
Which types of anemia are normocytic?
Prior hemorrhage
Which types of anemia are microcytic?
Iron deficiency, prior hemorrhage, anemia of chronic disease, thalassemia
Where is erythropoietin produced and where is it released?
Produced in kidney, released into bloodstream
When does the body release erythropoietin?
In response to hypoxia to increase red blood cell production
How long does it take erythropoietin to increase reticulocyte count?
10 days
Which patients are advised to receive erythropoietin?
Those with anemia due to CKD, those being treated with chemo, those undergoing elective surgery
What do labs show in a hemorrhage patient?
Normocytic, normochromic, elevated reticulocytes
What is the treatment for a patient with hemorrhage?
Find source of bleeding, transfuse
What does the CBC show in a patient with anemia of chronic disease?
Microcytic, hypochromic anemia with normal ferritin and transferrin
What is the suggested treatment for anemia of chronic disease?
Treat underlying condition, can give iron, blood, erythropoietin (though not shown to improve quality of life)
What do labs show in aplastic anemia?
Decreased rbc, white blood cell, and platelets (pancytopenia)
What is the suggested treatment for aplastic anemia?
Short-term immunosuppression, intermittent transfusions, bone marrow transplant if severe
List major causes of folate deficiency
Alcoholism (especially in the US), poor dietary intake, intestinal malabsorption (Chrons), drug interaction
What is G6PD deficiency?
X-linked recessive hemolytic anemia causing destruction of red blood cells upon exposure to free radicals
List clinical findings of G6PD deficiency
Usually asymptomatic, can have jaundice, weakness, tachycardia, hematuria
How is G6PD deficiency treated?
Self limiting condition with spontaneous resolution – provide supportive care and avoid fava beans
What is thalassemia?
Hemolytic anemia involving improper production of alpha or beta chains
What are the clinical findings of thalassemia?
Anemia, cognitive dysfunction, bone deformities (usually diagnosed in infancy)
What do labs show in patients with thalassemia?
Low MCV, low MCHC, anisocytosis, poikilocytosis, low hemoglobin and low hematocrit
How is thalassemia treated?
Blood transfusion, splenectomy, bone marrow transplant, no real cure (patients often die in their 20s)
Describe the labs of a patient with sickle cell anemia
Shows sickle cells on peripheral smear
What symptoms might a patient with sickle cell anemia experience?
Painful crises, splenomegaly, shortness of breath, joint damage, retinopathy, increased infections
How is sickle cell anemia treated?
Pain medicines, fluids, oxygen, transfusions
What do labs show for patients with B12 deficiency anemia?
High MCV, normal MCHC, low B12
What symptoms do patients with B12 deficiency experience?
tingling in extremities, dementia, along with normal signs and symptoms of anemia
How is the B12 deficiency best treated?
A monthly B12 injection, proper nutrition
What do labs show in a patient with folate deficiency?
High MCV, normal MCHC, low folate level
What symptoms with a patient with folate deficiency experience?
Beefy red tongue, usual anemia symptoms
How is a folate deficiency best treated?
Folic acid pill, avoid alcohol
What symptoms with a patient with aplastic anemia experience?
Bleeding (thrombocytopenia), infections (leukocytopenia)
What do labs show in a patient with iron deficiency anemia?
Low MCV, low MCHC, low iron (serum ferritin)
What symptoms would you see in a patient with iron deficiency anemia?
Glossitis, angular cheilitis, koilonychia, pica, gastric atrophy
How is iron deficiency anemia best treated?
Give iron, stop bleeding, transfuse if necessary
What is Fanconi’s anemia?
Inherited aplastic anemia
