Anemia Flashcards
1
Q
Classification of anemia based on RBC size
A
Microcytic
- Iron deficiency
- Thalassemic disorders
- Sideroblastic anemia
Normocytic:
- Acute blood loss
- Hemolysis
- Anemia of chronic disease (infection, inflammation, malignancy)
- Chronic renal insufficiency/EPO deficiency
- Bone marrow suppression (bone marrow invasion, aplastic anemia)
- Hypothyroidism
- Testosterone deficiency
- Early microcytic or macrocytic
- Combine microcytic and macrocytic
Macrocytic
- Ethanol
- B12
- Folate
- Drug-induced
- Reticulocytosis
- Liver disease
- Myelodysplastic syndromes
- Hypothyroidism
2
Q
Important Hx for anemia
A
- Constitutional symptoms (fatigue, weight loss)
- GI bleeding or risk factors
- Abd pain
- Prior Hx of anemia or other blood diseases
- Meds
- Diet
- Alcohol
- Menstrual Hx
- Family Hx of anemia or other blood diseases
3
Q
Important PE in anemia
A
- Pallor (palms, conjunctiva, nail beds
- Mouth (glossitis, cheilosis)
- Hyperdynamic precordium, systolic flow murmur
- Lymph nodes
- Spleen
- Stool for occult blood testing
- Nervous system
4
Q
Important labs in anemia
A
- H/H
- Red cell indices (MCV, RDW)
- Reticulocyte count
- WBC and platelet count
- Iron studies (serum iron, TIBC, ferritin, transferrin)
- Serum B12 and folate
- Haptoglobin
- Lactate dehydrogenase
- Hgb electrophoresis
- Blood smear
- Bone marrow biopsy
5
Q
Iron replacement therapy for iron def anemia
A
- Ferrous sulfate, 750 mg/day, PO, divided BID for 3-6 months
- 5 mg ferrous sulfate = 1 mg elemental iron
6
Q
VitB12 for B12 deficiency
A
-1000 mcg SC/IM x qd for 1 wk, then qwk for 1 month, then qmonth
7
Q
Folate for folate deficiency
A
- Start 1 mg PO until hematologic correction (max 5 mg/day), then 0.4 mg PO qd
- If pregnant or breast feeding, maintenance dose is 0.8 mg, PO, qd
