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PC 617 Anemia/Derm > Anemia > Flashcards

Anemia Flashcards

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Dermatology Board Prep flashcards
1
Q

3 types of Anemia

A

Microcytic
Macrocytic
Normocytic

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2
Q

Microcytic

A

MCV<80
Iron Deficiancy Anemia
Thalassemia

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3
Q

Normocytic

A

Anemia of Chronic Disease
Acute blood loss
Early IDA

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4
Q

Macrocytic

A

MCV>100
Vitamin B12 deficiency
Folate deficiency

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5
Q

Microcytic

A

Men and postmenopausal women
Menstrual loss
children-nutritional

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6
Q

Microcytic

A 
Low H&H
Low MCV and MCHC
****Low Serum ferritin
High TIBC
Low serum iron
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7
Q

Iron Deficiency Anemia Tx

A 
Identify cause
3x stool cards
elemental iron 50-100 mg 3x/day
pregnancy 60-120 mg then reduce to 30
elderly 15 mg
If after 3 weeks consider something wrong
normal hemoglobin in 2 months
Continue for 6 mos if it was severe
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8
Q

IDA

A

Keep away from children
take 2 hours apart from meals, antacides, calcium or medications
Take with Vitamin C (orange juice)

Retic count up in 2 weeks

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9
Q

Thalassemia-Alpha minor

A

reduction in synthesis of hemoglobin
Seen in more Asian, African and Mediterranean descent
Alpha minor-mild anemia MVC 60-75
Retic count and iron parameters are normal
Hemoglobin electrophoresis is normal

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10
Q

Thalassemia-Beta Minor

A

May see basophilic stippling(small dots)
retic count is normal or slightly elevated
Electrophosesis may show abnormal elevations

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11
Q

Important to differenciated Thalassemia from IDA

A

They do not respond to iron therapy

May need genetic counseling

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12
Q

Macrocytic Anemia

A

Vitamin B12 deficiency
In older population
Autoimmune disorder resulting in B12 absorption-lack of Intrinsic Factor (IF)
Malabsorption from:
alcohol, H. Pylori, long term use of antacids
Long term use of Metformin

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13
Q

Macrocytic Anemia

A

Smooth red beefy tongue

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14
Q

Macrocytic Symptoms

A 
irritable
memory impairment
neurological complaints
Chronic vegetarians
alcoholics
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15
Q

Macrocytic Dx

A 
MCV=elevated
serum B121 of
  elevated serum methylmalonic acid
   elevated serum homocysteine level
serum holotranscobalamin <35
absence of renal failutre, folate deficiency, or vitamin B6 def.
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16
Q

Macrocytic

A

Retic count is low
peripheral smear abnormal
folate level is normal
IF or anti parietal cell antibodies can confirm

17
Q

Macrocytic B12

A

B12 supplementation
orally at 1,000-2,000mcg/day
IM once daily or every other day for 1-2 weeks, then 100-1000 mcg every 1-3 months
intranalsal spray once weekly after normalized
Treat underlying contributing factors

18
Q

Macrocytic B12 severe

A

Refer
Significant reticulocytosis should be seen in 1-2 weeks
For mild-repeat serum B12, homocystein, and Methylmalonic acid levels in 2-3 months

19
Q

Folate Deficiency

A 
Reduced folate levels
Most common cause is inadequate dietary intake
Alcoholic, and anorectic clients
Drugs may interfere with absorption
  -Phenytoin
  -sulfa drugs
Supplements before and during pregnancy
0.4mg/day
20
Q

Folate symptoms

A

fatique
anorexia
gastritis
low-grade fever, dyspnea, palpitations

21
Q

Drugs that interfere with folate absorption

A

methotrexate, pyrmethamine, trimethorprin, triamterene, sulfa drugs (phenobarb, dilantin,)
oral contraceptives

22
Q

Folate deficiency

A

Ask about diet. May see pallor, glossitis, mild icterus

23
Q

Folate Diagnostics

A

serum folate<305
serum methymalonic acid (MMA) and total homocysteine can differenciate folate from B12
NORMAL MMA with elevated homocysteine indicates likely Folate Def,

24
Q

Folate Def Tx

A

folate rich foods
folic acid 1 mg per day (will replenish in weeks)
reduce alcohol
CBC in 10-14 days show increase hemoglobin and decreased MCV Good response in 8 weeks

25
Q

Normocytic Anemia

A

Anemia of chronic disease

26
Q

Normocytic Anemia

A

Comes with chronic infections, inflammation, autoimmune such as RA and Systemic lupus, and IBD, cancer, liver disease, renal failure

27
Q

Normocytic

A

fatique, dyspnea with exertion, may be pale,

28
Q

Normocytic Dx

A 
hemoglobin 8-9.5 g/dl
Low reticulyte count
MCV 81-99
low serum iron
low or normal transferrin
*****serum ferritin (normal or increased)
29
Q

Normocytic

A

optimal control of underlying condition

Purified recombinant erythropoietin many be effective for those with renal failure as well as cancer, and RA

PC 617 Anemia/Derm (3 decks)

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