Anemia - Hubbard

Question 1

What is the word for wanting to eat ice all the time?

Answer 1

Pagophagia

Question 2

What is the cause of paroxysmal cold hemoglobinuria (PCH)?

Answer 2

Tertiary syphilis (Donath-Landsteiner hemolytic anemia)

Question 3

When do symptoms of AIP occur?

What is the most common sx?

How often are attacks?

Answer 3

After puberty

Abdominal pain

Intermittent

Question 5

PCT pts are at increased risk for what?

May occur in what?

Answer 5

Hepatoma

ESRD

Question 7

Prognosis for AIP minimally affected pt?

Severely?

Answer 7

Normal

Chronically debilitated

Question 8

What are the following lab values in G6PD?

Reticulocyte count?
Haptoglobin?
LDH?
Bilirubin?

Answer 8

Inc
Dec
Inc
Inc

Question 10

Major CF in PCT?

What is not seen?

Occurs in what setting?

Answer 10

Cutaneous photosensitivity

No neurologic effects

Alcohol drinking

Question 12

Warm agglutinin reaction to what?

Cold?

Answer 12

IgG

IgM

Question 14

Tx of PV?

Answer 14

Phlebotomy (every 1-2 weeks)

hydroxyurea

Question 16

Tx for ACD if mild?

Severe?

What is NOT helpful?

Answer 16

Supportive (10-12 Hb)

Transfusion

Fe supplementation

Question 19

What is the reticulocyte count in immune mediated hemolytic anemia?

Answer 19

Elevated

Question 20

MOA in Bartonellosis (Carrion)?

What special CF?

Vector?

Tx?

Answer 20

Adheres to rbc membrane

Oriya fever

Sand flea

Antibiotics and support

Question 22

Acute intermittent porphyria (AIP) is most common in whom?

Due to what?

More common in whom?

Answer 22

Scandinavia, British, eastern Europe

Def. of porhobilinogen deaminase (PBG)

Psychiatric pts

Question 23

Does folate or B12 have minimal body stores?

What condition can deplete it faster?

Answer 23

Folic acid

Pregnancy

Question 24

What are the bolded clinical features in PV?

Acc CF?

Answer 24

Facial rubor, pruritis w/hot shower

Hyperviscosity, splenomegaly in 70%

Question 25

CFs of N/V/C, tachycardia, HTN, and neurologic changes are common in what?

Answer 25

AIP

Question 27

What disease is from a parasite in rodents and has a slow gradual course, myalgia with darker urine?

Answer 27

Babesia microti

Or he could just give it away w/Maltese cross

Question 28

What is reticulin?

Answer 28

RNA that is generating hemoglobin

Question 29

W/out tx, prognosis of PV?

Been linked to what?

Usual cause of death in treated pts?

Answer 29

50% mortality w/in 18 months

Budd-Chiari syndrome

Progressive marrow fibrosis w/pancytopenia aka spent phase

Question 30

What is the most common of the porphyria?

Due to what defect?

Answer 30

Porphyria cutanea Garda (PCT)

No uroporphyrinogen decarboxylase in liver

Question 33

Tx for PCT?

Answer 33

Chloroquine
Phlebotomy
Stop drugs/alcohol

Question 34

What causes cardiac anemia?

Severity of anemia?

Answer 34

Severe AS (valve gradient > 50 mmHG)
Prosthetic valves

Mild

Question 35

What random chemicals can induce hemolytic anemia?

Answer 35

Copper
Pure oxygen –> astronauts
Bee/spider venom

Question 36

What are common causes of GI bleeding leading to Fe def anemia?

Answer 36

PUD
Angiodysplasia
Inflammatory states
Tumors

Question 39

How does Lead fuck up rbcs?

Answer 39

Interferes w/cation pump leading to shortened rbc survival time

Question 42

Pseudoscleroderma occurs in what? What else present?

Answer 42

PCT After minor trauma, sun exposed skin gets gross

Question 43

What 3 medicines should pts w/sickle cell take?

Answer 43

Hydroxyurea PCN folic acid

Question 44

Lab features of PCT?

Answer 44

Increased liver enzymes, iron in liver, porphyrins in urine and stool (ALA)

Question 46

Treatment of cold antibody hemolytic anemia?

Answer 46

Supportive Avoid cold Tx infections

Question 47

What is the mainstay of tx for warm antibody hemolytic anemia? What else may be used? What if disease is chronic over a long time?

Answer 47

Steroids in high doses Immunosuppressives -> cyclophosphamide and azathioprine Splenectomy

Question 49

Tx of acute attacks in AIP?

Answer 49

Hydration w/D5 or D10 Hemin infusion Beta blocker Analgesic

Question 51

What chemicals can cause aplastic anemia?

Answer 51

Toluene | Glue

Question 53

What are the precipitating factors of AIP?

Answer 53

``` Hormones Drugs - anticonvulsants, barbiturates, sulfonamides, alcohol Low calorie intake Surgery Infection ``` Mark Fagala has AIP at SABA in the Caribbean

Question 56

What drugs can cause aplastic anemia? What infections?

Answer 56

Chloramphenicol, quinacrine Hepatitis, EBV, Erythrovirus (parvovirus), HIV

Question 57

Refractory megaloblastic anemia may occur in what?

Answer 57

Myelodysplasia

Question 58

Tx for malaria?

Answer 58

Antimalarials and supportive care

Question 61

What is characterized by loss of hematopoietic stem cells, fatty replacement of marrow, and pancytopenia?

Answer 61

Aplastic anemia

Question 62

What drug can cause megaloblastic anemia? What toxin?

Answer 62

Methotrexate Arsenic

Question 64

What is the genetic acquired malabsorption that leads to Fe def anemia?

Answer 64

nRAMP2 which codes for DCT1/DMT1 in the brush border

Question 65

Describe labs in ACD? Fe? TIBC Ferritin?

Answer 65

Dec Dec Inc

Question 68

Tx for cardiac anemia?

Answer 68

New prosthesis | Fe replacement

Question 70

What chronic condition produces acantholytic on peripheral smear and can cause erythroid progenitor proliferation defects?

Answer 70

Chronic kidney disease

Question 75

What dose given for supplemental folate tx?

Answer 75

1 mg po qd