anemia Flashcards

1
Q

megaloblastic anemia is caused from

A

defective DNA synthesis-B12/Folate deficiency

aka macrocytic anemia (large cells)

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2
Q

This binding protein ‘ ’ attaches to B-12 in gastric juice

A

R

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3
Q

Intrinsic factor is made via parietal cells. IF-B12 complex attaches to receptors in distal ileum and releases into blood stream. This complex attaches to ( ) in the portal blood

A
TC II (transcobolamine II) and brings it to the bone marrow
TC I and III grab the B12 but don't go anywhere
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4
Q

B12 is a coenzyme that methylates….

A

homocysteine to methionine

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5
Q

pernicious anemia

A

impaired uptake of Vit B12 from GI tract due to lack of intrinsic factor

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6
Q

pernicious anemia can present at age

A

2 when stores from utero are utilized

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7
Q

common clinical features of anemia

A
  • glossitis
  • angular stomatitis
  • jaundice
  • weight loss
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8
Q

when do neural tube defects occur?

A

within 10 days of conception

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9
Q

Serum Fe and ferritin levels are raised in

A

megaloblastic anemia bc Fe is used to make RBCs

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10
Q

Serum folate is elevated and RBC folate is decreased in…

A

B12 deficiency

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11
Q

use B12 with….

A
  • total gastrectomy

- ileal resection

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12
Q

use folate with…

A

-pregnancy ASAP

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13
Q

hereditary spherocytosis is caused by a defect in

A

spectrin (RBC membrane protein) defect

leads to decreased HH

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14
Q

hereditary spherocytosis inheritance is…

A

dominant, northern european

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15
Q

clinical features of spherocytosis….

A
  • aplastic crisis
  • splenomegaly (removed after age 5)
  • jaundice
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16
Q

What lab tests are used to dx spherocytosis?

A

osmotic fragility test “increased”

17
Q

elliptocytosis is ( ) than spherocytosis

A

milder disorder

18
Q

what is wrong with G6PD deficiency pts

A

impaired reduction of glutathione, inability to remove oxidants
x linked disease, follows malaria belt

19
Q

these cells are seen in G6PD deficiency crisis

A

bite cell
blister cell
heinz bodies removed by spleen

20
Q

pyruvate kinase deficiency shows this type of inheritance

A

autosomal recessive

21
Q

Evan’s syndrome vs

aplastic anemia

A

not making RBCs or platelets

not making any blood cells

22
Q

who requires increased Fe

A
  • pregnancy
  • infancy and adolescence
  • menstruation
23
Q

what are the types of Hg you have as an infant?

A

95% fetal Hg, rest is A1 and A2
Once you take your first breath you start making a1/a2 and stop making f
By 18 months of age a1 is 95%

24
Q

If hg electrophoresis is normal then you have the

A

alpha trait, if it is low then you have beta

25
sickle cell
Beta chain, 6th position glutamic acid (normal,negative) is replaced with valine (neutral) 2 different types of cells are produced, normal RBCs and sickled……the normal one cannot bend and they break and get trapped in the capillaries leading to a painful crisis
26
how to tx sickle cell
Tx-overload circulatory system with double maintenance fluid, give pks
27
Hg C disease
instead of glutamic acid it is leucine, target red cells that sickle
28
aplastic/hypoplastic anemia
loss of all blood cell type production
29
MCC aplastic anemia
Hep A
30
congenital aplastic anemia is AKA
fanconi, recessive inheritance skeletal defects, absent thumbs/radii occurs b/w ages 5-10
31
main presenting feature of ALL/AML
aplastic anemia
32
PE findings for a pt with aplastic anemia?
liver/spleen/nodes are not enlarged, the marrow however is no good
33
blood profile for an aplastic anemic pt
-MCV 95-110 -decreased retic count -no abnormal cells on smear -marrow replaced by fat essentially just making a few cells
34
MCC of marrow failure
graft verse host rejection
35
red cell aplasia
-no red cell production -low HH and almost no retic count congenital-blackfan-diamond recessive inheritance
36
transient erythroblastopenia of childhood
- transient form of red cell aplasia | - HH 5/15, leave kid alone, seen 2-3 years of age