Anemia Diagnosis/Management Flashcards
Anemia =
Decreased RBC mass
Anemia for males is Hgb < ___
14
Anemia for females is Hgb < ____
12
What are common symptoms of Anemia?
Fatigue Weakness Dizziness PALE skin and PALE conjunctiva Dyspnea
If the Reticulocyte Index is greater than 2, that means?
There is an adequate bone marrow response
Normocytic MCV range?
78-98
3 clues to hemolysis?
- Lactate Dehydrogenase
- Indirect Bilirubin
- Haptoglobin
Ferritin =
Iron storage protein
- It is proportional to iron levels
Transferrin =
Iron transport protein
- synonymous to TIBC (total iron binding capacity)
___ RDW indicates Anemia
Increased
What is the earliest and most sensitive index that will change in Iron Deficiency Anemia?
RDW
With Iron Deficient Anemia, what will the levels be for:
Iron, Ferritin, TIBC and MCV
Iron = LOW Ferritin = LOW TIBC = HIGH MCV = LOW
In older patients with Iron Deficient Anemia, what should you check for?
GI BLEED
Anemia of Chronic Disease is caused by?
Inflammation (inflammatory cytokines)
With Anemia of Chronic Disease, what will the levels be for:
Iron, Ferritin, TIBC and MCV
Iron = LOW Ferritin = HIGH** TIBC = LOW MCV = Normal to low
What do Inflammatory cytokines activate with Anemia of Chronic Disease?
Hepcidin
If Hepcidin is activated, what are its effects on Ferritin and Transferrin and Ferroportin?
Ferritin = HIGH Transferrin = LOW Ferroportin = LOW
In patients with Anemia of Chronic Disease, how should you treat them?
TREAT THE UNDERLYING DISEASE
Inflammatory cytokines also decrease _____ production (seen with Anemia of Chronic Disease)
Decreased Erythropoietin production
What are signs of hypovolemic shock (acute blood loss)?
Pulse - INCREASED
BP - DECREASED
PALLOR
Cool extremities
What are signs of hypovolemic shock (acute blood loss)?
Pulse - INCREASED
BP - DECREASED
PALLOR
Cool extremities
Levels of MCV and reticulocytes with UNcompensated acute blood loss
MCV - normal
Reticulocytes - normal
What are 2 things that can result from hemorrhagic shock?
Myocardial ischemia
Renal failure
Treatment for Hypovolemic shock due to acute blood loss?
RECOGNIZE
** BLOOD TRANSFUSION!!!!!
Treatment for Hypovolemic shock due to acute blood loss?
Recognize it
= BLOOD TRANSFUSION!!!!
A single unit of RBCs can increase Hgb by ___
1
How is Sickle Cell Anemia inherited?
Autosomal Recessive
Sickle cell Anemia is more common in what populations?
African Americans
Describe the cycle that is Sickle cell anemia
- HbS will polymerize when de-oxygenated
- Creates Sickled cells
- Sickled cells occlude vasculature = de-oxygenation
- More HbS polymerizes
Chronic hemolysis, tissue damage and vascular occlusion point towards?
Sickle cell anemia
Who is at risk for stroke with sickle cell anemia?
Children
Low O2 saturation, anemia, avascular necrosis of bone can point towards?
Sickle cell anemia
What is Acute Chest Syndrome and what is it seen with?
- 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
What organ is usually enlarged with sickle cell anemia and what can occur?
- Also what are they at risk for?
Splenomegaly
- Autosplenectomy can occur due to infarcts in the blood supply
- increased risk for infections
How is sickle cell anemia diagnosed?
Hemoglobin electrophoresis
= Increased HbS and HbF
Initial treatment for Sickle cell anemia?
Give oxygen to decrease cell sickling and control pain
What drug can be given for sickle cell anemia?
Hydroxyurea (increased HbF)
What is Aplastic Anemia?
PANCYTOPENIA
With Aplastic Anemia, what are the levels for:
MCV, RDW, and reticulocytes
MCV = HIGH RDW = normal Reticulocytes = LOW
High MCV, normal RDW and low reticulocytes could indicate?
Aplastic Anemia
- Pancytopenia
What is the first sign of Aplastic Anemia?
Bleeding
What does the bone marrow biopsy show with Aplastic Anemia?
Adipose tissue and hypocellularity
What will be increased if there is a B12 deficiency causing megaloblastic anemia?
INCREASED MMA and Homocysteine
What will be increased if there is a folate deficiency causing megaloblastic anemia?
INCREASED Homocysteine only
Where is folate normally absorbed and what diseases can impair this?
Normally absorbed in the jejunum and ileum
- Impaired by celiac and crohn’s diseases
What medication can cause a folate deficiency?
Methotrexate
Methotrexate commonly causes a deficiency in?
Folate
