Anemia (Full power point) Flashcards
What are classic signs/symptoms of anemia?
Pallor, fatigue, dyspnea on exertion (these were in bold on her slides)
dizziness
These symptoms can vary in severity based on the individual.
What compensatory mechanisms are observed in anemia?
Tachycardia, palpitations, vasoconstriction, tachypnea, increased depth of breathing
These mechanisms help to maintain oxygen delivery to tissues.
What is the most common type of anemia?
Iron Deficiency Anemia
More common in females.
What is the classification of Iron Deficiency Anemia?
Microcytic-hypochromic
Characterized by small, pale red blood cells.
What are common causes of Iron Deficiency Anemia?
- Poor dietary intake
- Menses
- Pregnancy
- Ulcerative colitis
- Certain medications
- Parasitic infections
- Neoplasms
- Lead poisoning
Each of these factors can lead to decreased iron levels.
What are the most common causes of Anemia of Chronic Blood Loss?
GI tract
- Peptic ulcer
- Inflammatory bowel disease
- Colon cancer
- Menorrhagia
Blood loss from GI tract
These conditions can lead to significant blood loss over time.
What is hematemesis?
Vomiting blood
Often seen in patients with esophageal varices.
What is melena?
Dark, tarry stool due to blood mixed in stool
Indicates upper gastrointestinal bleeding.
What is the importance of iron in the body?
Main nutritional element needed for hemoglobin synthesis
Iron is essential for oxygen transport in the blood.
What are the components of iron in the body?
- 60% in hemoglobin (RBC)
- 35% stored as ferritin in macrophages, liver, spleen, bone marrow
- Rest in myoglobin and bound to transferrin
Very little free iron exists as it is toxic to cells.
What does a low ferritin level indicate?
Iron Deficient Anemia
Ferritin reflects the body’s iron stores.
What are treatment options for Iron Deficiency Anemia?
- Oral iron preparations (ferrous sulfate, ferrous gluconate)
- Orange juice to improve absorption
- Intravenous iron (iron-dextran)
Treatment aims to replenish iron stores and improve hemoglobin levels.
What is the normal reticulocyte count?
Approximately 1% of total RBCs
Increased counts suggest accelerated destruction or loss of RBCs.
What is Polycythemia Vera?
An overabundance of RBCs with elevated hematocrit and hemoglobin levels
It can increase the risk of thromboembolisms.
What are the classifications of anemia based on morphology?
- Normocytic
- Microcytic
- Macrocytic
- Hypochromic
- Hyperchromic
- Anisocytic
- Poikilocytosis
These classifications help in diagnosing and determining the cause of anemia.
What is the most common oral form of iron used for treatment?
Ferrous sulfate
Contains 65 mg of elemental iron.
What are side effects of oral iron preparations?
- GI disturbances (nausea, heartburn, constipation)
- Black/dark green stools
- Teeth staining
Patients are advised to take iron with food to minimize GI upset.
What are common causes of Aplastic Anemia?
- Radiation exposure
- Chemotherapy
- Chemicals (e.g., benzene)
- Viral illnesses (e.g., hepatitis)
- Unknown causes in about 2/3 of cases
Aplastic anemia results from a failure of the bone marrow to produce adequate blood cells.
What characterizes Sickle Cell Anemia?
Inherited defect of Hemoglobin S leading to hemolytic anemia and chronic organ damage
It is more prevalent in African Americans and certain Mediterranean populations.
What is the role of Hydroxyurea in Sickle Cell Anemia?
Produces more HbF to displace HbS and decreases the inflammatory response
It helps prevent complications and crises associated with sickle cell disease.
What is the difference between acute blood loss and chronic blood loss?
Acute blood loss is rapid and can lead to severe consequences; chronic blood loss occurs gradually, often leading to iron deficiency
Both types can result in anemia but differ in onset and management.
What serious adverse effects can occur with a blood loss of 1,000 mL or more?
Hypovolemic shock and cerebral hypoperfusion
These conditions arise due to insufficient blood volume and oxygen delivery to the brain.
What are the causes of acute blood loss?
Hemorrhage caused by trauma, childbirth, rupture of a major blood vessel, or organ
Acute blood loss can lead to significant health complications.
What can cause severe gastrointestinal bleeding?
Disorders such as esophageal varices or penetrating peptic ulcer
What is Aplastic Anemia?
Results from breakdown in production in bone marrow stem cells that inhibit growth of RBC, WBC and Platelets
What happens to red cells in Aplastic Anemia?
The marrow fails to replace the senescent red cells as they are destroyed and leave circulation
What is a key characteristic of the cells in Aplastic Anemia?
Cells are normal size and normal color
What symptoms are often presented in Aplastic Anemia?
Infection or bleeding, as opposed to anemia
What are some clinical manifestations of Aplastic Anemia?
Classic signs of anemia, no neurological symptoms, manifestations related to malnourishment such as:
* Cheilosis
* Stomatitis
* Burning mouth syndrome
* Dysphagia
* Flatulence
* GI disturbances
I’m pretty sure these are the signs of folic acid deficiency, which presents as related to malnourishment and B12 presents as more neurological when severe. Aplastic anemia presents as more like bleeding and infection due to lower numbers of WBCs and platelets since it’s aplastic
What can reduce or eliminate B12 absorption?
Anything that affects the parietal cells, such as:
* Type A chronic gastritis
* H pylori infection
* Excessive ETOH
* Smoking
* Hot tea ingestion
* Gastrectomy, gastric bypass
* Proton pump inhibitors
What is Pernicious Anemia?
A deficiency in Vitamin B12 that can be fatal if left untreated
What causes Pernicious Anemia?
Conditions that cause malabsorption of B12, decreased intake of B12 products, defective gastric secretions of intrinsic factor
What are Megaloblastic Anemias usually related to?
Deficiencies in Vitamin B12 and folic acid
What happens to defective cells in Megaloblastic Anemia?
They die too early which decreases numbers in circulation (eryptosis)
What is the storage capacity and requirement for Vitamin B12?
Stores about 1000-5000 mcg and only need 1 mg per year
What laboratory findings are seen in Folic Acid Deficiency?
CBC showing changes in indices before hemoglobin, MCV > 100, MCHC and MHC normal, low folic acid levels
What are the two forms of folic acid?
Active and inactive (more common)
How can folic acid be administered?
Oral, IV, SQ, IM
What are some clinical manifestations of Folic Acid Deficiency?
Classic signs of anemia, vague symptoms such as:
* Fatigue
* Mood swings
* Anorexia
* Weight loss
* Hyperbilirubinemia
* Neurologic symptoms with severe anemia
This is vitamin B 12 signs
Folic acid presents more like malnourishment
Who is at risk for Folic Acid Deficiency?
Pregnant women, alcoholics, individuals on fad diets, those with celiac disease or inflammatory bowel disease, chronic inflammatory disorders
What diagnostic tests are used for Folic Acid Deficiency?
CBC with differential, Vitamin B-12 levels, intrinsic factor, antibodies to parietal cells and IF, bone marrow aspiration
What is the treatment for Pernicious Anemia?
Vitamin B-12 (Cobalamin or Cyanocobalamin) given orally or via injection if deficiency is the problem
How is the effectiveness of Pernicious Anemia treatment measured?
By rising reticulocyte count and normalization in 6 weeks
