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B&L Unit 1 > Anemia first couple lectures > Flashcards

Anemia first couple lectures Flashcards

1
Q

What is the relationshiop between Hepcidin, inflammation and iron?

A

Inflamation inc. Synthesis of Hepcidin.

Inc Hepcidin = Dec iron absorption.

Involved in Anemia of Chronic Disease.

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2
Q

Characteristics of Iron deficiency

A

Dec Hemoglobin
Dec Cell proliferation
Mild hemolysis

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3
Q

What are the questions I ask to diagnose anemia.

A

Questions:
1. Is Anemia associated with other hematologic abnormalities?

  1. Is there an appropriate reticulocyte response?

3-Yes Hemolysis?

3-No What are the RBC indicies?

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4
Q

Describe the two pathways of pathophysiology of Anemia of Chronic Disease (sepsis and Chronic infection)

A

Sepsis-> TNF and INFB-> dec EPO and Erythroid proliferation respectively
* with sepsis, think necrosis (TNF)

Chronic Infection-> IL-1 and INFy-> Same effects as above

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5
Q

How does Lead cause Anemia?

A

Lead inhibits iron from being placed in heme.

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6
Q

Where is EPO produced?

A

Kidney

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7
Q

What are the clinical features and lab tests associated with Chronic inflammation or infection anemias? Treatment?

A

Clincal Features:
Fever, Arhralgias, arthritis, swelling

Lab Tests:
Look for normal to dec Iron Binding Capacity and normal or inc ferritin.

Treat underlying disease.

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8
Q

What are the clinical features and lab tests associated with lead intoxication anemias? Treatment?

A

Clincal Features:
Change in personality, headache, wt loss

Lab Tests:
Microcytosis and hypochromia.
Inc protoporphyrin (heme rings without iron).

Treat with chelation of lead.

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9
Q

What are the clinical features and lab tests associated with renal insufficeiency anemias? Treat?

A

Clincal Features:
irregular renal fxn

Lab Tests:
Normochromic, normocytic RBCs
Dec EPO

Treat with EPO doses

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10
Q

What are the clinical features and lab tests associated with endocrine anemias? Treat?

A

Clincal Features:
Hypo/hyper activity.

Lab Tests:
Hypo/Hyper thyroidism
Adrenal

Generally all mild anemias.

Treat with hormone replacement

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11
Q

What do Folic Acid and Vitamin B12 do?

A

Support proliferation of all cells. Particularly hematopoietic cells.

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12
Q

Where is B12 absorbed?

A

Ileum

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13
Q

Where is folate absorbed?

A

Jejunum. Not as much storage as B12 in the body.

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14
Q

What are the main causes of folate and B12 deficiency?

A

B12- Autoimune

Folate-Diet

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15
Q

How do you describe RBCs in B12/Folate deficient patients?

A

Macrocytic

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16
Q

Sensory Losses are important in which type of deficiency?

A

B12 Deficiency

17
Q

What is RI and how is it calculated?

A

Reticulocyte index

Reticulocyte count x Pat Hgb/normal hgb x 1/stress factor

1-2 is normal

18
Q

A patient comes into your clinic with anemia that is not associated with other hematologic abnormalities. She does not exhibit an appropriate reticulocyte response to her anemia. Her RBCs have an MCV of 85. What do you do?

A

Evaluate for normocytic anemia

+100 macrocytic anemia
80-100 normocytic
>80 microcytic

19
Q

A patient comes into your clinic with anemia that is not associated with other hematologic abnormalities. She does exhibit an appropriate reticulocyte response to her anemia. What do you do next?

A

Check to see if there is hemolysis and then evaluate for:

  1. Hemolytic anemia if yes
  2. Hemorrhagic anemia if no.
20
Q

Which form of iron is Fe2+?

A

Ferro-us

Just the two of US.

21
Q

True or false:

Iron is actively excreted from the body.

A

FALSE

Losses of iron include loss from exfoliation of skin and mucosal surfaces (GI tract, etc.), in the urine or with
menstruation.

22
Q

What are the stages of iron deficiency?

A
  1. Iron depletion
  2. Iron deficient erythropoiesis
  3. Overt iron deficiency anemia
23
Q

In which stage of iron deficiency do only iron stores run out?

A

Iron Depletion

24
Q

In which stage of iron deficiency do both iron stores and erythron iron run out?

A

Iron Deficient anemia.

25
Q

What is pernicious anemia?

A

Autoimmune destruction of IF-producting gastric parietal cells. Intrinsic Factor binds B-12 and allows for absorption.

26
Q

Describe the Schilling Test:

A

Oral dose of labeled B12.
B12 binds in body.
Flushing dose of B12.
Measure radioactive labels in urine.

B&L Unit 1 (13 decks)

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