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Biol 430 > Anemia Case Studies > Flashcards

Anemia Case Studies Flashcards

0
Q

Your patient presents with tiredness, fatigue, shortness of breath:
RBC Count-3.8x10^6 ul
MCV-68fl
MCHC-29%
Decreased: storage iron, sideroblasts, serum iron, ferritin, %transferrin saturation, stainable bone marrow iron
Increased: TIBC, serum transferrin receptor levels

A

Iron-Deficiency Anemia

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1
Q

Your patient, who has an infection, presents with:
MCV-90fl
MCHC-31%
Increased: storage iron
Decreased: sideroblasts, serum iron, TIBC, % transferrin saturation, RBC count, Hgb

A

Anemia of Chronic Disease

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2
Q

Your patient, who has been diagnosed with lead poisoning, presents with:
RBC count: 3.8x10^6 ul
MCHC: 27%
Basophilic stippling present
Increase in Ringed Sideroblasts in bone marrow
Increased: Serum iron, serum ferritin, % transferrin saturation, stainable bone marrow iron
Decrease: Hgb, TIBC

A

Sideroblastic Anemia (Acquired Secondary)

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3
Q

Parents bring a baby into the ER who has been known to be collicy and sensitive to light. This child has a history of neurovisceral attacks as well as memory loss.

A

Porphyrias

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4
Q

Your patient presents with an enlarged liver as well as an enlarged spleen and fatigue. Lab results:
MCV-79fl
MCHC-29%
Anisocytosis and poiklocytosis is noted
Basophilic stippling noted
Increase: Serum Iron and Ferritin, % saturation of transferrin, Bone marrow Iron, sideroblasts, cellularity
Decreased: TIBC

A

Hemochromatosis or Iron Overload

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5
Q 
Your patient presents with:
MCV-110fL
Low M:E ratio 
Hypercellular Bone Marrow
Hypersegmented neutrophils
Increased: bilirubin, LD, serum iron and ferritin, erythropoietin
Decreased: Reticulocytes
Pancytopenia noted
Howell-Jolly, Basophilic stippling, and Cabot rings noted
A

Megaloblastic Anemia

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6
Q

Your patient presents with:
Neurological manifestations–degeneration of nerves
Autoantibody to parietal cells, IF, and thyroid tissue
Megaloblastic and macro-ovalocytes

A

Pernicious Anemia

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7
Q

Your patient is a 21 year old female and presents with:
Bone marrow cellularity-49%
Cytopenia of the WBCs and Platelets
Upon bone marrow aspiration–dry tap

A

Aplastic Anemia

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8
Q 
Your patient is a 4 month old baby and presents with:
Poor growth
Microcephaly
Pancytopenia
Increase of fetal Hgb
Mental retardation
A

Fanconi’s Anemia (Congenital Aplastic Anemia)

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9
Q 
Your patient presents with: 
Thrombosis
Cytopenias
Increase bilirubin
Bone Marrow hyperplasia
(+) Sugar-Water test
(+) Ham's Test
Brown Urine in the morning
A

Paroxysmal Nocturnal Hemoglobinuria (PNH)

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10
Q 
Your patient has experienced weightloss, jaundice, enlarged spleen, and gallstones. Lab results:
Decrease in haptoglobin levels
Anisocytosis noted
Spherocytes noted
Increased Osmotic Fragility
A

Hereditary Spherocytosis

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11
Q

Your patient presents with an enlarged spleen. Lab results:
Elliptocytes noted
Mutations in spectrin

A

Hereditary Elliptocytosis

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12
Q 
Your patient's lab results come back:
Increase in osmotic fragility 
Increase of water in the cells
Increase of sodium inside the cells
RBC swollen with central pallor slit
A

Hereditary Stomatocytosis

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13
Q 
Your patient's lab results return:
Decrease osmotic fragility 
Decrease potassium inside the cells
Decrease water inside the cells
Target cells, echinocytes, cells with Hgb concentrated on one side noted
A

Hereditary Xerocytosis

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14
Q 
Your patient's lab results return:
Hgb- 11 g/dL
RBC count- 3.8x10^6 /uL
Hct- 35%
Brown urine
Bite cells, Helmet cells, and Heinz bodies noted
A

Glucose-6-Phosphate Dehydrogenase Deficiency

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15
Q

Your patient presents with an enlarged spleen. Upon further inspection:
Cell shrinkage, distorted shape, and increased cell rigidity
Poiklocytosis noted
MCV- 60 fL

A

Pyruvate Kinase Deficiency

16
Q

Your patient is experiencing cyanosis. Upon further examination:
Increase ferric levels (oxidized Hgb)

A

Methemoglobin Reductase Deficiency

17
Q 
Your patient has experienced a stroke. You are attempting to find out the underlying issue. Upon further examination you note obstruction of blood flow and increase viscosity in blood. 
Decrease oxygenation
Decreased pH
Valine in 6th position
Production of Hemoglobin S
A

Sickle Cell Anemia

18
Q 
Your patient presents with:
Mild chronic anemia
Enlarged spleen
Target cells, folded cells, microspherocytes
Lysine in 6th position of beta chain
A

Hemoglobin C

19
Q

Your patient is complaining about cyanosis and chocolate brown urine. Lab results presents:
Oxidized Ferric
Methemoglobin levels- 1.3%

A

Methemoglobinemia

20
Q 
Your patient is presenting with severe jaundice, enlarged spleen, and you also notice a flattening of the face. Lab results indicate:
MCV-65 fL
MCHC- 30%
Anisopoiklocytosis noted
Hgb-11 g/dL
Increased Hb F
Increased Hb A2
A

Beta Thalassemia

21
Q

Your patient presents with severe renal damage. Lab results indicate:
(+) DAT
Increase: bilirubin, LD, etc.
Complement activated
IgM antibodies associated with ABO blood group

A

Acute Hemolytic Transfusion Reaction

22
Q

Your patient, who received a kidney transplant 8 days prior, presents with:
(+) DAT
IgG antibodies associated with blood groups
Increased bilirubin
Complement present

A

Delayed Hemolytic Transfusion Reaction

23
Q 
Your patient presents with:
Extravascular hemolysis in the spleen (enlarged spleen)
IgG antibodies
(+) DAT
Lysing of RBCs at 32 degrees C
A

Warm Autoimmune Hemolytic Anemia

24
Q

Your patient is complaining of pain when touching cold objects. Lab results indicate:
IgM autoantibody (anti-I) present
(+) DAT

A

Primary (Idiopathic) Cold Agglutinin Syndrome

25
Q

Your patient, who was diagnosed with infectious mononucleosis 4 weeks ago, is presenting with jaundice, shortness of breath. Lab results indicate:
IgM autoantibody (anti-I/anti-i)
Severe anemia
Donath-Lansteiner test negative
DAT (+)
Reactivity of antibody in temperature less than 30 C

A

CAS Secondary to Infection

26
Q 
A child, who experienced a Epsin-Barr virus infection 2 months ago, presents with:
Complement present
Donath-Lansteiner (+)
Antibody specificity IgG 
Brown/Black urine
A

Paroxysmal Cold Hemoglobinuria

27
Q

A patient who has been on Methyldopa presents with:
Autoantibody against IgG class
Strong (+) DAT
Hemolytic Anemia

A

Autoimmune Mechanism

28
Q

A patient who has been on Penicillin and Cephalosporin presents with:
Strong (+) DAT with anti-IgG
Hemolytic anemia
Extravascular hemolysis

A

Drug Absorption (Hapten) Mechanism

29
Q

A patient who has been taking Quinidine is presenting with:
DAT (+) with complement
Hemolytic Anemia

A

Immune Complex Mechanism

30
Q

A patient who has been taking Cephalosporins has received results of:
(+) DAT
No Hemolysis

A

Membrane Modification Mechanism

31
Q

A patient comes in who has been treated for alcoholism and is complaining of jaundice, fatigue, tiredness. Lab results:
MCV- 110 fL
Target cells noted

A

Anemia with Liver Disease

32
Q

A patient presents with:
Decreased RBC survival and life span
Impaired Iron metabolism and release from RE stores
Decrease: Erythropoietin levels, bone marrow response
Increase: Cytokines (IL-1 and IL-2 and IFN)

A

Anemia Associated with Chronic Disorders and Inflammation

Biol 430 (2 decks)

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