Anemia Flashcards
What are the 3 general mechanisms the development of anemia
1) Acute blood loss
2) Under production
- chronic blood loss in this group as it leads to underproduction via depletion of iron stores
3) Increased hemolysis
What level would you expect reticulocytes to be at in an underproduction anemia? (High, Normal, Low)
- Normal or Low
- Should be high normally in response to anemia
What is the differential diagnosis for microcytic anemia?
TAILS
- Thalassemia
- Anemia of inflammation/chronic dx (commonly normocytic)
- Iron deficiency anemia
- Lead, Copper, or Zinc toxicity (rare)
- Sideroblastic anemia (congenital) - acquired is macro (also rare)
What is megaloblastic anemia? What feature can be seen in these cells?
- A macrocytic anemia caused when DNA synthesis is impaired
- Results in growth of the cell without division
- Hypersegmented (5+ lobed) neutrophils can be seen
What are the causes of megaloblastic anemia?
- B12 deficiency
- Folate deficiency
- Drugs impairing DNA synthesis (methotrexate, sulfa drugs, chemo)
- Orotic aciduria (defect in pyrimidine synthesis) affecting folate pathway
- Look at all of these - if they affect folic acid, they cause this
What are non-megaloblastic causes of macroscopic anemia?
- Liver disease
- Alcoholism
- Hypothyroidism
- Myelodysplasia
Someone has a normal MCV and high reticulocyte count. What can be causing their anemia?
- Bleeding
- Hemolysis
What are some common symptoms of anemia?
- Fatigue
- Headache
- Light headedness
- malaise
- Weakness
- Decreased exercise tolerance
- Dyspnea
- Palpitation
- Pre-syncope/syncope
What are some common physical findings associated with anemia?
- Pallor in mucous membranes, palms and conjunctiva
- Angular chelitis (inflammed corner(s) of mouth)
- Jaundice (if hemolytic)
- Tachycardia
- Orthostatic hypotention
- Systolic flow murmur
