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SBL > Anemia Diagnosis/Management > Flashcards

Anemia Diagnosis/Management Flashcards

1
Q

Anemia =

A

Decreased RBC mass

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2
Q

Anemia for males is Hgb < ___

A

14

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3
Q

Anemia for females is Hgb < ____

A

12

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4
Q

What are common symptoms of Anemia?

A 
Fatigue
Weakness
Dizziness
PALE skin and PALE conjunctiva
Dyspnea
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5
Q

If the Reticulocyte Index is greater than 2, that means?

A

There is an adequate bone marrow response

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6
Q

Normocytic MCV range?

A

78-98

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7
Q

3 clues to hemolysis?

A
  1. Lactate Dehydrogenase
  2. Indirect Bilirubin
  3. Haptoglobin
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8
Q

Ferritin =

A

Iron storage protein

- It is proportional to iron levels

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9
Q

Transferrin =

A

Iron transport protein

- synonymous to TIBC (total iron binding capacity)

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10
Q

___ RDW indicates Anemia

A

Increased

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11
Q

What is the earliest and most sensitive index that will change in Iron Deficiency Anemia?

A

RDW

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12
Q

With Iron Deficient Anemia, what will the levels be for:

Iron, Ferritin, TIBC and MCV

A 
Iron = LOW
Ferritin = LOW
TIBC = HIGH
MCV = LOW
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13
Q

In older patients with Iron Deficient Anemia, what should you check for?

A

GI BLEED

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14
Q

Anemia of Chronic Disease is caused by?

A

Inflammation (inflammatory cytokines)

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15
Q

With Anemia of Chronic Disease, what will the levels be for:

Iron, Ferritin, TIBC and MCV

A 
Iron = LOW
Ferritin = HIGH**
TIBC = LOW
MCV = Normal to low
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16
Q

What do Inflammatory cytokines activate with Anemia of Chronic Disease?

A

Hepcidin

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17
Q

If Hepcidin is activated, what are its effects on Ferritin and Transferrin and Ferroportin?

A 
Ferritin = HIGH
Transferrin = LOW
Ferroportin = LOW
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18
Q

In patients with Anemia of Chronic Disease, how should you treat them?

A

TREAT THE UNDERLYING DISEASE

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19
Q

Inflammatory cytokines also decrease _____ production (seen with Anemia of Chronic Disease)

A

Decreased Erythropoietin production

20
Q

What are signs of hypovolemic shock (acute blood loss)?

A

Pulse - INCREASED
BP - DECREASED
PALLOR
Cool extremities

21
Q

What are signs of hypovolemic shock (acute blood loss)?

A

Pulse - INCREASED
BP - DECREASED
PALLOR
Cool extremities

22
Q

Levels of MCV and reticulocytes with UNcompensated acute blood loss

A

MCV - normal

Reticulocytes - normal

23
Q

What are 2 things that can result from hemorrhagic shock?

A

Myocardial ischemia

Renal failure

24
Q

Treatment for Hypovolemic shock due to acute blood loss?

A

RECOGNIZE

** BLOOD TRANSFUSION!!!!!

25
Q

Treatment for Hypovolemic shock due to acute blood loss?

A

Recognize it

= BLOOD TRANSFUSION!!!!

26
Q

A single unit of RBCs can increase Hgb by ___

A

1

27
Q

How is Sickle Cell Anemia inherited?

A

Autosomal Recessive

28
Q

Sickle cell Anemia is more common in what populations?

A

African Americans

29
Q

Describe the cycle that is Sickle cell anemia

A
  • HbS will polymerize when de-oxygenated
  • Creates Sickled cells
  • Sickled cells occlude vasculature = de-oxygenation
  • More HbS polymerizes
30
Q

Chronic hemolysis, tissue damage and vascular occlusion point towards?

A

Sickle cell anemia

31
Q

Who is at risk for stroke with sickle cell anemia?

A

Children

32
Q

Low O2 saturation, anemia, avascular necrosis of bone can point towards?

A

Sickle cell anemia

33
Q

What is Acute Chest Syndrome and what is it seen with?

A
  • Seen with Sickle cell anemia
    = Vaso-occlusion in the lungs that leads to hypoxia
    – This worsens the vaso-occlusion and causes chest pain, dyspnea and pneumonia
    – Pulmonary infiltrates in the lungs can be fatal
34
Q

What organ is usually enlarged with sickle cell anemia and what can occur?
- Also what are they at risk for?

A

Splenomegaly

  • Autosplenectomy can occur due to infarcts in the blood supply
    • increased risk for infections
35
Q

How is sickle cell anemia diagnosed?

A

Hemoglobin electrophoresis

= Increased HbS and HbF

36
Q

Initial treatment for Sickle cell anemia?

A

Give oxygen to decrease cell sickling and control pain

37
Q

What drug can be given for sickle cell anemia?

A

Hydroxyurea (increased HbF)

38
Q

What is Aplastic Anemia?

A

PANCYTOPENIA

39
Q

With Aplastic Anemia, what are the levels for:

MCV, RDW, and reticulocytes

A 
MCV = HIGH
RDW = normal
Reticulocytes = LOW
40
Q

High MCV, normal RDW and low reticulocytes could indicate?

A

Aplastic Anemia

- Pancytopenia

41
Q

What is the first sign of Aplastic Anemia?

A

Bleeding

42
Q

What does the bone marrow biopsy show with Aplastic Anemia?

A

Adipose tissue and hypocellularity

43
Q

What will be increased if there is a B12 deficiency causing megaloblastic anemia?

A

INCREASED MMA and Homocysteine

44
Q

What will be increased if there is a folate deficiency causing megaloblastic anemia?

A

INCREASED Homocysteine only

45
Q

Where is folate normally absorbed and what diseases can impair this?

A

Normally absorbed in the jejunum and ileum

- Impaired by celiac and crohn’s diseases

46
Q

What medication can cause a folate deficiency?

A

Methotrexate

47
Q

Methotrexate commonly causes a deficiency in?

A

Folate

SBL (48 decks)

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