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Diagnostics Exam 4 Shea > Anemia and Iron > Flashcards

Anemia and Iron Flashcards

1
Q

Most common hematologic disorder in the US affecting 3 million people

A

Anemia

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2
Q

Is anemia a diagnosis or condition?

A

Condition

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3
Q

What is anemia?

A

-A deficiency and/or dysfunction involving RBC

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4
Q

Decreased # of RBCs

Decreased Hgb

A

Anemia

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5
Q

What is considered to be anemia in females?

A

Hgb <12

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6
Q

What is considered to be anemia in males?

A

Hgb <14

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7
Q

4 sxs of severe anemia

A
  • Fainting
  • Chest Pain
  • Angina
  • Heart Attack
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8
Q 
Jaundice
Tachycardia
Splengomegaly
SOB
Muscle weakness
A

Sxs of anemia

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9
Q

Of skin:
Paleness
Coldness
Yellowing

A

Sxs of anemia

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10
Q

2 other sxs of anemia

A

Koilonychia (spoon shaped nails)

Pica (eating dirt)

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11
Q

3 main causes of anemia

A
  1. Reduced production of RBCs
  2. Increased destruction of RBCs
  3. Loss of RBCs
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12
Q

-Deficiencies in B12, Folate, Iron
-Bone marrow failure
-Renal failure (decreased erythropoietin)
All cause what?

A

Reduced production of RBCs

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13
Q

-Hemolysis
-drugs
-Hemoglobinpathies
All cause what?

A

Increased destruction of RBCs

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14
Q

-Bleeding

Causes what?

A

Loss of RBCs

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15
Q

RBC indicies are part of a CBC and do what?

A

Aid in determining etiology of anemia

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16
Q

Measure of average RBC size

A

MCV

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17
Q

Weight/amount of Hgb per RBC

A

MCH

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18
Q

Hgb concentration

A

MCHC

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19
Q

Can be hypochromic, normochromic, or hyperchromic

A

MCHC

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20
Q

Measure of variation in RBC size

A

RDW

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21
Q

Indicated degree of anisocytosis

A

RDW

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22
Q

Large MCV/Large RBC

A

Macrocytic anemia

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23
Q

Normal MCV/normal RBC

A

Normocytic anemia

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24
Q

Small MCV/small RBC

A

Microcytic anemia

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25
Q

Bright color

MCH > 31

A

Hyperchromic anemia

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26
Q

Normal color

MCH 27-31

A

Normochromic

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27
Q

Pale color

MCH <27

A

Hypochromic

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28
Q

Usually secondary to chronic blood loss such as a GI bleed/menstrual loss

A

Microcytic hypochromic

small MCV, MCH <27

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29
Q

Causes a mild microcytic hypochromic anemia w/basophilic stippling on peripheral smear

A

Lead poisoning

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30
Q

Hereditary disorder characterized by reduced synthesis of globin chains
What is low?

A 
Thalassemia
Small MCV (microcytic anemia)
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31
Q
  • Small MCV
  • Total RBC count normal/elevated
  • Peripheral smear showing target cells and basophilic stippling
A

Thalassemia minor

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32
Q
  • Detects abnormal forms of Hgb

- Can be used to diagnose sickle cell anemia

A

Hemoglobin electrophoresis

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33
Q

Hgb from lysed RBCs placed on paper, pattern of bands is created

A

Hemoglobin electrophoresis

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34
Q

Condition associated w/ particular patterns of bands

A

Thalassemia

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35
Q

Anemia of chronic diseases such as:

  • autoimmune/malignancy
  • renal failure
  • acute blood loss
A

Normocytic anemia

normal MCV/normal sized RBCs

36
Q

Anemia caused by

  • Vit B12 or Folate deficiency
  • Regular alcohol consumption
A

Macrocytic anemia

Large MCV/large RBCs

37
Q

Can cause macrocytosis with or without anemia

A

Regular alcohol consumption

38
Q

A type of macrocytic anemia that often results in B12/folate deficiency

A

Megablastic anemia

39
Q

Deficiency of B12/folate which causes inhibition of DNA synthesis during RBC production.
Leads to cell growth w/o division = big RBCs

A

Megaloblastic anemia

40
Q

Characterized by many large immature dysfunctional RBCs in the bone marrow and by hypersegmented neutrophils

A

Megaloblastic anemia

41
Q
  • Results from autoimmune destruction of gastric parietal cells.
  • Decrease in IF
  • Decreased absorption of B12
A

Pernicious anemia

42
Q

What are the risks associated w/ anemia (3)

A

Cardiac events:

  • MI
  • CHF
  • CVA (due to increased workload on heart)
43
Q

Hgb <8
Hct <24%
Transfuse?

A

Consider, but depends on clinical picture

44
Q

Who are we more likely to consider for a transfusion if Hgb is <10?
Why?

A

Elderly person, bc/ they are at higher risk of MI

45
Q

Hgb <5

Hct <15%

A

Critical!! Super low

46
Q

Iron studies ordered in groups or separate?

47
Q

Which iron studies are often ordered together?

A

Fe and TIBC

48
Q

Which iron study is often ordered separately?

49
Q

70% of the body’s iron is found where?

A

Hemoglobin of RBCs

50
Q

30% of iron is found where?

A

Stored as ferritin and hemosiderin

51
Q

What % of iron do we get in our diet?

52
Q

What % of iron is secreted?

53
Q

In plasma, iron is bound to what?

A

Transferrin (a protein)

54
Q

What steps do iron follow after ingested in diet?

A
  • Absorbed in small intestine
  • Transported to plasma
  • Bound to transferrin
  • Carried to bone marrow
  • Incorporated into hemoglobin
55
Q

What does a serum iron measure?

A

(iron level)

The quantity of iron bound to transferrin

56
Q

Measurement of all proteins available for binding mobile iron (as opposed to stored iron)

57
Q

During iron overload, what levels stay the same?

A

Transferrin (the main iron binding protein)

58
Q

Is increased in 70% of patients with iron deficiency

59
Q
  • Negative acute phase reactant protein

- Levels decrease in various acute inflammatory reactions

A

Transferrin

60
Q

May be decreased with chronic illness and liver disease

A

Transferrin

61
Q

Where is transferring produced?

A

Transferrin

62
Q

The BEST test for hemochromatosis

A

Transferrin saturation

63
Q

Saturation of what are increased with hemolytic, megaloblastic, sideroblastic anemia?

A

Transferrin sats

64
Q

Serum iron level X 100% divided by TIBC = ?

A

Transferrin Saturation

65
Q

Excess iron usually deposited in liver, heart, other organs. Causes severe organ dysfunction (cirrhosis) (cardiomyopathy) (diabetes due to pancreatic islet cell failure)

A

Hemochromatosis (iron overload)

66
Q

Which type of hemochromatosis is genetic (mostly autosomal recessive)

67
Q

Which type of hemochromatosis can be caused by repeated blood transfusions?

68
Q

Elevated LFTs

A

Finding with hemochromatosis

69
Q

Marker of iron storage

70
Q

Most sensitive test to detect iron deficiency

71
Q

Decreased Ferritin signifies what?

A

Decreased iron storage (iron deficiency)

72
Q

Increased Ferritin signifies what?

A

Iron excess (hemochromatosis)

73
Q

Elevated with inflammation and infection

A

Ferritin (opposite of transferrin)

74
Q

Results from decrease in serum iron

A

Iron Deficiency Anemia

75
Q

4 causes of Iron Deficiency Anemia

A
  • Blood loss
  • Increased requirement of Iron (late pregnancy, growing child)
  • Inadequate gut absorption of iron (Celiac disease)
  • Insufficient intake of iron (rare in US)
76
Q

A decreased amt of iron causes a decreased production of?

result?

A

Hemoglobin, results in small/pale RBCs

Microcytic/hypchromic

77
Q

With iron deficiency anemia, what values are low?

A

-Serum Fe
-Transferrin sats
-Ferritin
(all are low)

78
Q

With iron deficiency anemia, what values are high?

79
Q

With a “chronic illness” anemia, what values are low?

A

-Serum Fe
-TIBC
(are low)

80
Q

With a “chronic illness” anemia, what values are normal?

A

-Transferring sats

are normal

81
Q

With a “chronic illness” anemia, what values are high?

A

-Ferritin (acute phase reactant responding to illness)

82
Q

With hemochromatosis, what values are low?

83
Q

With hemochromatosis, what values are high?

A

-serum Fe
-Transferrin sats
-Ferritin
-LFTs
(are all high)

84
Q 
29 y/o Female presents with generalized fatigue. Has been healthy and denies specific complaints. VSS, exam is unremarkable. 
Labs show:
Low RBC
Low Hgb
Low Hct
Low MCV
Low MCH
Low MCHC
High RDW
A

Patient has microcytic, hypochromic anemia and her blood cells vary greatly in size.

85
Q 
54 y/o Male presents for routine PE, no recent complaints. 32 yr pack hx. VSS, lungs slightly diminished. 
Labs show:
High RBC
High Hgb
High Hct
A

Polycythemia / erythrocytosis

Diagnostics Exam 4 Shea (3 decks)

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