Anemia Flashcards
Anemia is
dx
causes
reduced oxygen carrying capacity of blood
hgb
MCV
cell size
MCHC
cell color
RDW
variation in size
TIBC
iron binding capacity (baskets that carry iron)
serum fe is ___
not a great indicator (more about intake)
ferritin
specific for
storage protein for iron/bone marrow stores
specific for iron deficiency anemia
reticulocytes should be
1% because 1% of RBC turnover every day
Sx anemia
vary
sob, fatigue, headache, tachycardia, palpitations, pallor (late), hemic murmur (
Iron deficiency anemia common?
No, usually GI bleed, losing blood somewhere
Iron deficiency anemia blood findings
low mcv (small size) low MCHC (pale in color) increased TIBC (lots of empty baskets) decreased Fe increased rdw (variable in size) decreased transferrin percentage decreased reticulocyte (cant make baby cells without a lot of iron) -- will go up in 3-5 d
Iron deficiency anemia tx
how long to fix blood and stores?
what will you see first?
how long do you treat?
6 weeks to fix blood
reticulocyte count will be normal after 5 days
treat for about 3 months
SE iron and how to take
belching bloating n/v constipation
take on empty stomach, glass of OJ
Thalassemia
most common form
what is it?
most common in what population
beta thalassemia minor
ENOUGH IRON, malformed hgb
mediterranean, middle eastern, african, asian
Thalassemia blood findings
dec. MCV (small cell size)
dec. MCHC (pale in color)
normal ferritin and rdw (same sizes)
hgb electrophoresis: inc. hgb A2)
*genetic counselor
Sideroblastic
what is it?
think iron overload, enzyme d/o
adequate iron, but not inc. into hgb
iron is a ring, cant develop into mature rbc
Sideroblastic causes
hereditary
idopathic
acquired (ETOH, lead, INH, RA, lymphoma, leukemia)
HEMATOLOGY REFERRAL
Sideroblastic blood findings
low mcv (small cell size)
increased ferritin and Fe
increased transferrin saturation percentage
think iron overload
Microcytic anemia
iron deficiency
thalassemia
sideroblastic
Normocytic anemia
hemolytic
hemolytic anemias
sickle cell: pred. hgb s
G6PD: hemolysis with infection or exp to sulfonamides, antimalarials, fava beans, most common in african/mediterranean
drug induced: quinidine, aldomet, high dose pcn
autoimmune: lupus, lymphoma, ulcerative colitis, epstein barr, cmv, mycoplasma pneumonia, post viral
Findings hemolytic anemia
hemolytic anemias or normocytic nl MCV (size) nl MCHC (color) increased reticulocyte (lots of babies being made) positive coombs also: inc. LDH, bili dec. haptoglobin
Macrocytic anemias
B12
folate
B12 deficiency causes
Pernicious anemia (AUTOIMMUNE) gastric bypass long term vegetarians vegans
B12 sx
atrophic glossitis stocking glove neuropathy* memory loss/dementia depression, irritability balance problems loss position/vibration sense ataxia anorexia wgt loss
B12 blood findings
b12 tx
inc. mcv (cell size)
nl color
low reticulocyte (missing building block)
lifelong replacement IM daily x 1 week
weekly x 1 month
monthly (watch K+)
Folate deficiency causes
tx
dilantin, tegretol, phenobarb, azt, etoh, dialysis, malabsorption, celiac sprue
1mg daily
Pernicious anemia is a ____ deficiency
occurs in age?
higher risk of?
lab findings
b12 deficiency
50+
higher risk of gastric cancer
lab findings: hypersegmented neutrophils, oval macrocytes
