Anemia: Diagnosis and Management Flashcards
What are 6 signs and symptoms of an anemic patient?
1) Fatigue
2) Exercise intolerance
3) Tachycardia
4) Conjunctival Pallor
5) Systolic murmur
6) Edema
What is the earliest and most sensitive index that will change in iron deficiency anemia?
Anisocytosis
What is anisocytosis?
Increased red cell distribution width
What are indications that iron is low?
1) Low serum ferritin
2) Low transferrin saturation
What are indications that the body is just WAITING for iron (compensating)?
1) Increased Total Iron Binding Capacity (TIBC)
2) Increased transferrin receptor (TFR)
What symptoms of iron deficiency anemia can be seen in the nails?
1) Onychoschizia (split)
2) Koilonychia (spooned)
What compulsive behavior do patients with iron deficiency anemia display ?
Compulsion to eat substances like ice, soil, chalk, paper
In male patients or postmenopausal females, iron deficiency anemia should prompt an evaluation for sources of blood loss in what location?
Gastrointestinal
Normocytic anemia and normal reticulocyte count point towards?
Uncompensated blood loss
What can happen as a result of anemia from acute blood loss?
1) Hypovolemia
2) Myocardial ischemia
3) Renal failure
Coffee ground emesis and distended abdomen are clues that there is a bleed where?
Upper GI tract
During emergent blood replacement, what effect should a single unit of RBC have on Hgb?
Increase by about 1 g/dL
Blood group O can give blood to?
They can receive blood from?
1) All groups
2) Only O group
Blood group A can give blood to?
They can receive blood from?
1) A and AB
2) A and O
Blood group B can give blood to?
They can receive blood from?
1) B and AB
2) B and O
Blood group AB can give blood to?
They can receive blood from?
1) AB
2) All groups
When a blood type is referred to as O(+), A(-), etc, the positive or negative refers to?
Rh (D) antigen
Which patients will not develop anti-D Ab?
Which may develop anti-D Ab?
1) Rh+
2) Rh-
Sickle cell anemia is characterized by what Hg?
What mutation causes it?
Its Hg type confers survival advantage against what disease?
1) HgS
2) Glutamic acid -> valine mutation
3) Endemic malaria
When deoxygenated, what will happen to HbS?
What does this cause?
The sickled red cells will interact with inflammatory cells, platelets, and endothelial cells to promote?
1) Polmerize
2) Hemolysis
3) Vaso-occlusion
What is a devastating consequence of vaso occlusion in sickle cell anemia?
Because it may affect up to 15% of children, what can help prevent this above event from occurring?
1) Stroke
2) Transfusions in childhood
Acute chest syndrome is a potentially fatal phenomenon of SCA which is initiated by vaso-occlusion caused from?
Vaso-occlusion in the lungs leads to?
1) Marrow emboli from necrosing bone
2) Lower oxygenation, which worsens systemic vaso-occlusion
In SCA patients, urine cannot be concentrated due to?
What is also an often manifestation of the same phenomenon above?
This area is so sensitive that it can even affect?
1) Medullary damage
2) Hematuria
3) Heterozygous individuals
What is the major cause of pain in SCA patients?
Avascular necrosis
