Anemia Flashcards
Anemia for men, women, and pregnant women
Less than 13, 12, and 11
What is anemia as a disease?
A symptom of something else, not a disease in and of itself
What is the most common type of anemia?
Iron deficiency anemia
How do you divide the causes of anemia?
Deficiencies, Central, and peripheral
Normal MCV?
80-100
Normal MCHC?
32-37
Normal MCH?
26-34
Normal reticulocyte count?
1-2%
Labs for anemia?
Ferritin, transferrin saturation, serum iron, TIBC, folate, B12, bone marrow aspiration, electrophoresis
Three types of anemia?
Microcytic hypochromic, Normocytic normochronic, Macrocytic, normochormic
Five types of microcytic hypo chromic anemia?
Iron deficiency anemia Thalassemia Lead poisoning G6PD Deficiency Sideroblastic Anemia
Besides menstruating women, what should you look for in IDA in post menopausal and men?
GI bleed (cancer), celiac disease, NSAIDs, vegetarian
Signs of IDA?
Pallor, tachycardia, kioonchia, pale conjunctiva, angular chelitis, atrophic glossitis
Labs for IDA?
Low serum ferritin
Treatment for IDA?
ferrous sulfate 300 mg TID, HCT should rise 1 point each weeks, give with vitamin C, can cause constipation, cramping, reflux, N/V
How do you test for Thalassemia?
Electrophoresis
What labs do alpha thalassemia show?
No increase in Hg A2 or F. No Hg F. Normal iron
What do labs for beta thalassemia show?
Elevated A2, sometimes elevated F
Treatment for thalassemia?
None. May transfuse. May need iron chelation therapy for hemolysis to prevent hemosiderosis, possibly spleenectomy
Risk factors for lead poisoning?
Old homes especially sills and putty, poor diet increases absorption of lead, origami paper, fumes from stained glass window, burning batteries, dirt that has leaded gas, folk medicines, moonshine bottles, lead fish weights
What is G6PD deficiency?
Deficiency of G6PD that produces glutathione, which prevents oxidative stress. Without this, lysis can occur.
S/S and history for G6PD deficiency?
S/S- palor, jaundice, lethargy, dark urine
Hx- new medications, recent infection
Labs for G6PD deficiency?
Normal labs, elevated direct and indirect bill, high reticulcyte count
Treatment for G6PD deficiency?
Remove affecting drug, transfuse as needed
When do most anemias become symptomatic?
When hemoglobin is less than 10
What is sideroblastic Anemia?
Anemia that is caused by retention of iron in the mitochondria of developing RBC.
What causes sideroblastic anemia?
ETOH, lead posoning, malignancy
Labs for sideroblastic anemia?
High serum ferritin, normal or high FE and TIBC, elevated bone marrow stores of iron.
How is sideroblastic anemia confirmed?
Bone marrow aspirate with prussian blue stain
Treatment for sideroblastic anemia?
Referral to hematology, trasnfuse, B6
Causes of normochoromic normocytic anemia?
Anemia of chronic disease
Causes of ACD?
chronic disease, malignancy, infection, inflammation.
S/S?
Usually absent. May look like IDA
Labs for ACD?
Decreased serum Fe and TIBC, ferritin normal or increased. Should also do a smear to look for sickle cell disease
Treatment of ACD?
Management of underlying disorder
Cause of Microcytic normochromic anemia? There are 4
B12- Pernicious Anemia
Folate
Antimetabolite drus
Other miscillaneous
Risk factors for pernicious anemia?
Family history, female, gastric surgery, other autoimmune diseases, H. Pylori, PPIs
What do schistocytes suggest?
Intravascular hemolysis, indicative of autoimmune disease in normochromic normocytic anemia
S/S of pernicious anemia?
Red beefy tongue, numbness and itingling in extremities, gingival bleeding, cognitive deficits, lack of coordination, abdominal mass, looks of vibratory sense, positive romberg, CHF, organomegaly
Labs for pernicous anemia?
High MCV >115, low B12
Risks for folic acid deficiency?
ETOH, pregnancy, malignancy, severe psoriasis, gastric diseases, anticonvulsants, oral contraceptives, or methotrexate
S/S of folic acid deficiency?
Like pernicious anemia, except no neuro deficits
Labs for folic acid deficiency
Low folate
Treatment of folic acid deficiency?
Correct cause, push foods high in folic acid, d/c ETOH, vitamin C enhances absorption
Compensatory mechanisms for anemia?
Increase in 2,3 diphosphoglycerate, CV, respiratory, Renal
IDA and megaloblastic anemia?
IDA occurs in 1/3rd of patients with megaloblastic anemia
What is TIBC?
Total iron binding capacity. Inversely related to iron stores
What does haptoglobin suggest and what are its limitations?
Haptoglobin binds to hemoglobin and is decreased with intravascular hemolytic anemia. Can also be decreased with liver disease
What is LDH?
enzyme abdundent in hemoglobin. Increased suggests hemolysis, but is not specific. Also occurs in many other disease like liver, heart disease, etcetera.
