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Clin Med 1 > Anemia > Flashcards

Anemia Flashcards

1
Q

hemoglobin range for anemia

A

men<14 women<12

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2
Q

Reticulocyte normal range, amount of time in bone marrow and peripheral blood, and RBC lifespan

A

normal 0.5-2%

3 days in marrow, 1 day in peripheral blood

120 days

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3
Q

causes of anemai

A

Decreased RBC production

  • nutritional deficiencies (iron, b12/folate)
  • chronic disease
  • ineffective erythropoisis

Increased RBC destruction
-hemolysis

Blood loss

  • menstrual
  • GI
  • Trauma
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4
Q

nomenclature for RBC size

and mean corpuscular volume MCV of each

A
  • normocytic: normal size 80-100
  • Microcytic= small <80
  • Macrocytic=large > 100
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5
Q

what does MCH measure

A

mean corpuscular hemoblobin (content in RBC)

-chromic

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6
Q

what does MCHC measure

A

mean corpuscular hemoglobin concentration (concentration per RBC)

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7
Q

what is normal red cell distribution width? RDW

A

normal RDW 11-15%

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8
Q

Three main categories of anemia and their cause

A
  • microcytic hypochromic: iron deficiency, thalassemia, sideroblastic anemia
  • normocytic normochromic: hypothryroidism, liver disease, chronic disease
  • macrocytic (megaloblastic): folate defieciency and vitamin B12 deficiency
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9
Q

Iron deficiency anemia IDA major causes

A
  • blood loss- MOST COMMON
  • decreased dietary intake-decreased iron absorption (upper GI) such as celiac celiac disease, bariatric surgery, H. pylori infection
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10
Q

Iron deficiency anemia diagnostic study key points

A
  • decreased RBC
  • microcytic, hypochromic
  • decreased ferritin
  • decreased serum Fe
  • increase total iron binding capacity TIBC
  • increase RDW
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11
Q

what is poikilocytosis

A

varying shapes of RBCs

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12
Q

what is anisocytosis

A

vary in RBC size

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13
Q

clinical manifestations of IDA

A 
atrophic glossitis
angular cheilitis
koilonychia
Pica (craving for ice)
dysphagia esophageal webs : plummer-vinson syndrom
restless legs sydrome
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14
Q

Treatment IDA

A
  • treat underlying cause
  • replace iron stores with oral ferrous sulfate 325mg TID on empty stomach
  • appropriate response is increase rate of 2-4 g/dl every three weeks until baseline
  • continue for 3-6 months
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15
Q

what is thalassemia

A

inherited hemoglobinopathy

can lead to ineffective erythropoiesis and hemolysis

  • variable degrees of anemia and extramedullary hematopoiesis
  • can lead to bone changes, impaired growth and IRON OVERLOAD
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16
Q

what is alpha thalassemia

A

deletion of one or more of the four a-globin chains
1-silent carrier
2- a-thalassemia minor; mild microcytic anemia
3- hemoglobin H disease; moderate microcytic anemia (chronic hemolytic anemia)
4- hydrops fetalis; usually fetal in utero

17
Q

What is beta-thalassemia

A

reduced or absent beta-globin chain synthesis
minor: dysfunction of ONE b globin chain, asymtomatic, mild microcytic anemia

intermedia: less severe than major, non-transfusion dependent, chronic HEMOLYTIC anemai

Major: dysfunction of BOTH b-globin chains, transfusion-dependent, severe hemolytic anemia, if untreated 85% of children will die by the age of 5 years

18
Q

Thalassemia lab eval key notes

A
  • normal to increased RBC
  • MCV is strikingly LOW
  • RDW is normal
  • retic count often elevated
  • normal to increased ferritin and serum iron
  • normal to decreased TIBC
  • microcytic, hypochromic, target cells

-HEMOGLOBIN ELECTROPHOESIS helps with diagnosis

19
Q

Thalassemia treatment

A
  • folic acid supplementation
  • AVOID IRON SUPPLEMENTATION
  • hematopoietic cell transplantation
20
Q

what is sideroblastic anemia

A

hereditary or acquired RBC disorder

abnormal RBC iron metabolism->diminished heme synthesis->iron accumulates in the cell

21
Q

sideroblastic anemia presentation

A

Bone marrow
-RING SIDEROBLASTS: blue stained iron

peripheral smear: siderocytes with pappenheimer bodies

22
Q

sideroblastic anemia causes

A 
-aquired
varient of myelodysplastic syndrome
-chronic etoh
-medications
-copper deficiency
23
Q

sideroblastic anemia diagnostic

A
  • ring sideroblasts
  • often elevated RDW
  • normal to low retic count
  • normal or elevated ferritin
  • SYSTEMIC iron overload
24
Q

sideroblastic anemia treatment

A 
pt education 
refer to rheum
treat underlying cause
removal of toxic agents
pyridoxine vit B6
transfulsion/mangment of iron overload
25
Q

Anemia of chronic disease pathogenesis

A

a reduction in RBC production by the bone marrow, with a component due to mild shortening of RBC survival

  • HEPCIDIN-INDUCED alterations in metabolism
  • inability to increase erythropoiesis in response to anemia
  • decreased erythropoietin EPO production
26
Q

anemai of chronic disease lab findings

A

often mild anemia Hb 10-11

  • MCV usually normocytic (normochromic)
  • normal or increased serum ferritin
  • retic: mildly decreased or normal
  • serum fe and TIBC both decreased with inflammation
  • treat underlying disease
  • EPO may be of benefit

Clin Med 1 (11 decks)

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