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Practice topics Exam 1 > Anemia > Flashcards

Anemia Flashcards

1
Q

definition

A

Reduction in the total number of circulating erythrocytes

Decrease in quality or quantity of hemoglobin (Hb)

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2
Q

common causes

A

1 impaired RBC production
2 blood loss
3 inc RBC destruction
4 combination of the above

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3
Q

Measures

A 
CBC to include:
RBC count
Hematocrit - % RBC in whole blood 
Hemoglobin concentration
WBC count
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4
Q

Classification

A 
By the cause:
Nutritional
Physical injury
Chronic disease
Infections
Toxins

By the morphology

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5
Q

Morphological anemia includes what

A 
Microcytic
Macrocytic
Hyperchromic 
Hypochromic
Abnormal cell shape
Normocytic
Normochromic
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6
Q

Morphological anemia - Microcytic and Macrocytic

A 
Microcytic = abnormally small
Macrocytic = abnormally large
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7
Q

Morphological anemia - Hyperchromic and hypochromic

A 
Hyper = inc concentration of hemoglobin
Hypo = dec concentration of hemoglobin
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8
Q

Common clinical features - symptoms

A 
Fatigue
HA
Dizziness
SOB
Exertional angina
Intermittent claudication
Palpitations
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9
Q

Common clinical features - signs

A 
Pallor
Tachycardia
Systolic flow mumur
Dec mental status
Hypotension (orthostatic too)
Weight loss
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10
Q

Pernicious anemia is what

A

Chronic condition
Malabsorption of B12
Macrocytic, Normochromic anemia
AKA megaloblastic anemia

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11
Q

Pernicious anemia - how common and in who

A

One of the most common types
Late adulthood
F more than M

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12
Q

Pernicious anemia - common cause assoicated with

A

lack of intrinsic factor - GI system lacking it so can’t absorb B12 properly

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13
Q

Pernicious anemia - progression

A

develops slowly
early s/s vague and often ignored (mood swings, GI upset, cardiac and renal upset)
late s/s are more classic s/s of anemia (big one is Hb dec to 7)

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14
Q

Pernicious anemia - s/s are associated with

A

nervous system demyelination

If not treated will end up with peripheral neuropathy - glove pattern

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15
Q

Pernicious anemia - diagnosis with

A

blooc count
bone marrow aspiration
schilling test (inject B12 and see if absorb)

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16
Q

Pernicious anemia - prognosis and tx

A

If untreated is fatal within 1-3 years (cardiac arr)

Replacement therapy is tx - injections of B12 every 3-6 months

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17
Q

Folic acid anemia is what

A

Folate deficiency - Inadequate intake of folic acid

Macrocytic, Normochromic

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18
Q

Folic acid anemia - epidemiology

A

Alcoholics
Elderly
Pregnant females
Those in puberty

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19
Q

Folic acid anemia is often what type of issue

A

supply vs. demand - inadequate leafy greens (inadequate folic acid)

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20
Q

Folic acid anemia s/s

A

May or may not have neuro issues
Fissuring and ulceration of mouth and oral cavity
Dysphagia and other GI upset

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21
Q

Folic acid anemia - prognosis and tx

A

Takes 1 to 2 weeks for folate strores to be restored

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22
Q

Iron deficiency anemia

A

Microcytic, Hypochromic anemia

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23
Q

Iron deficiency anemia - epidemiology

A

Most common type of anemia worlwide
Females usually with menstruation or with pregnancy
Males is usually secondary to GI bleed
Children during growth spurts

24
Q

Iron deficiency anemia - causes

A

dietary lack of Fe
Fe stores are tightly controlled and daily ingestion is needed
F require mroe than M
Bleeding is a common cause - daily loss of 2-4ml/day

25
Q

Iron deficiency anemia - clinical presentation

A

Onset is gradual
Most common is fatigue, weak, SOB
Neuro changes - mental status change, paresthesia, weak
Alterations in epithelial tissues - changes in quality of hair, skin, tongue surfaces

26
Q

Iron deficiency anemia - prognosis and tx

A

Treat cause
Iron replacement
Rapid improvement

27
Q

Normocytic and Normochromic anemias includes:

A 
Aplastic
Posthemorrhagic
Hemolytic
Anemia of chronic disease
Sickle cell 
Polycythemia
Multiple myeloma
Hemochromatosis
28
Q

Aplastic anemia

A

related to bone marrow aplasia or hypoplasia

RBC stem cells damaged - leading to dec production

29
Q

Aplastic anemia - clinical manifestations include

A

classic anemia s/s as well as bleeding disorders! DIC is common

30
Q

Aplastic anemia - treatment

A

depends on cause

  • blood transfusions
  • bone marrow transplants may be required
31
Q

Posthemorrhagic anemia

A

Sudden massive blood loss

leads to cardiovascular complications

32
Q

Posthemorrhagic anemia - prognosis

A

it take 4 to 6 wks to restore normal blood counts

6 to 8 wks for normal hemoglobin to be restored

33
Q

Hemolytic anemia

A

Premature, accelerated destruction of RBCs

34
Q

Hemolytic anemia - what will you see with physical exam

A

increased spleen size
jaundice
bone deformities, bone pain, pathologic fractures

35
Q

Hemolytic anemia - treatment

A

depends on cause - splenectomy may be required

36
Q

Anemia of chronic disease

A

usually occurs within a coupld of months of active disease onset

37
Q

Anemia of chronic disease s/s

A

often mild and in many cases the pt is asymptomatic
usually discovered inadvertently
This is usually the least of the pt problems

38
Q

Sickle cell anemia

A

group of disorders characterized by abnormal form of hemoglobin
autosomal recessive disorder

39
Q

sickle cell anemia - epidemiology

A

Tends to occur in people with origins in equatorial countries
In US - most common in AA
1 in 400 live births!

40
Q

What happens with sickle cell anemia

A

RBCs change in shape as they deoxygenate, causing complications
There are triggers to the sickling (and usually pt will knoe their trigger)
Once re-oxygenated, the cell can return back to normal shape

41
Q

Sickle cell anemia - clinical manifestations

A

Most result from vascular occlusions which can lead to visceral infection
Includes typical anemia s/s
May present with anaplastic anemia too

42
Q

Sickle cell anemia - x and prognosis

A

Treatment includes prevention of infections and elimination of triggers
Genetic counseling and psychological support may be needed

43
Q

Polycythemia

A

Excessive RBC number

Can be relative or absolute

44
Q

Relative polycythemia

A

Hemoconcentration due to dec in plasma volume as seen with dehydration
Usually this relative type is not as big of a deal

45
Q

Absolute polycythemia

A

Primary - uncommon, seen in white male 40-60yr)
Secndary - physiologic response to the hypoxia, might been seen in those living at high altitudes, smokers, pt with CHF or COPD - non physiological response can be seen with renal disease

46
Q

Clinical presentation for polycythemia

A

Plethora - ruddy, red colored face, hands, feet, ears, mucous membranes
Liver and spleen enlargement
Severe pruritis
Thrombosis and inc blood viscosity s/s

47
Q

POlycythemia - treatemnt

A

dec blood volume

48
Q

Multiple myeloma

A

Neoplasia of plasma cells
Characterized by multiple malignment masses of plasma cells scattered throughotu the skeletal system
Progresssive destruction of corticol bone (flat ones)
Humeral suppression occurs

49
Q

Multiple myeloma - common bones affected

A

vertebrae, ribs, skull, pelvis, femur, clavicle, scapula

50
Q

Multiple myeloma - epidemiology

A

Incidence 3x greater than all other bone cancers
M more than F
AA more than C 2 to 1 ratio
Tyical age of diagnosis is over 40, mean age is 62

51
Q

Multiple myeloma clinical presentation

A 
Bone pain (t60%) severe!
Anemia and renal insufficiency (25%)
Osteomyelitits 
Chronic and recurrent infections
Pathologic fractures
Mental status changes, lethargy
Nerve root impingement is possible
52
Q

Multiple myelima - treatment and prgnosisn

A

Without treatment 6 to 12 month survival after bone lesions
With treatment is 2-5 yrs
10 year survival is 3%
Chemotherapy and prevention o complications
Exercise and ambulation are important to keep pt active and dec complications

53
Q

Hemochromatosis

A

Iron absorption disorder
autosomal recessive
gene has been identified

54
Q

Hemochromatotis - fundamental problem is

A

excessive loevels of iron in the blood, secondary to increased absorption
Excessive Fe is depositied in various cells
Liver, pancreas, heart, skin, joints (synovium - gets crystals)

55
Q

Hemochromatosis - ss

A

often asymptomatic until an overload occurs

56
Q

Hemochromatosis - diagnosis

A

primarily via measurement of trasnferrin or genetic testing

liver biopsy for definitive diagnosis migh tbe needed

57
Q

Hemochromatosis - traeatment and prognosis

A

Phlebotomy on weekly basis until iron is normal
Chelation migh tbe used if phleb has complications
Normal lifespan if Fe can be maintained at normal levels and no organ damage has occured
Arthropathies tend to worsen and will always be there even with controlled iron levels

Practice topics Exam 1 (15 decks)

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