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clin med final > Anemia I > Flashcards

Anemia I Flashcards

1
Q

anemia

A

decrease in circulating RBC mass

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2
Q

volume of packed RBC

A

Hematocrit

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3
Q

usual ratio of Hgb to Hct

A

Hgb:Hct = 1:3

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4
Q

RBC life span

A

120

  • old RBCs are removed by the spleen
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5
Q

reticulocyte count

A

indication of bone marrows production of RBC

  • normal 1-2%
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6
Q

polychromasia

A

reticulocytosis

  • except to see lots of blue on peripheral smear
    • “lots of blue means lots of new”
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7
Q

nomenclature for RBC size

A
  • normocytic: normal size RBC
  • microcytic: small than normal
  • macrocytic: larger than normal
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8
Q

Mean corpuscular volume. List MCV values for Micro, Normo, and Macro

A
  • calculated value to determine average volume of RBC
  • Microcytic: < 80 fL
  • Normocytic: 80-100 fL
  • Macrocytic: > 100 fL
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9
Q

mean corpuscular hemoglobin concentration

A

a measure of the concentration of hemoglobin in a given volume of packed red blood cells

  • normochromic vs hypochromic
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10
Q

anisocytosis

A

variation in size of RBC

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11
Q

red cell distribution width

A

measurement of variation in the size of RBC

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12
Q

symptoms often occur when Hgb drops below

A

7 g/dL

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13
Q

What conditions falls under microcytic, hypochromic

A
  • iron deficiency
  • thalassemia
  • sideroblastic
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14
Q

What conditions falls under normocytic, normochromic

A
  • Hypothyroidism
  • liver disease
  • chronic disease
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15
Q

What conditions falls under macrocytic (megaloblastic)

A
  • folate defiency
  • vitamin B12 deficiency
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16
Q

Presentation

  • MCV low <80
  • Low Fe
  • High TIBC
  • low ferritin
A
  • iron deficiency: determine cause
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17
Q

Presentation

  • MCV low <80
  • Low Fe
  • Normal or low TIBC
  • normal or high ferritin
A
  • anemia of chronic disease
    • infection
    • inflammation
    • malignancy
18
Q

Presentation

  • MCV low <80
  • normal to high Fe
  • any TIBC
  • normal to high ferritin
A
  • sideroblastic anemia

OR

  • alpha or beta thalassemia
19
Q

Which test is most sensitive for iron defiency

A

decrased ferritin: depletion of iron stores occurs first

20
Q

TIBC. High or low in iron deficiency anemia

A

total iron binding capacity

  • measures transferrin (what serum iron binds to in the body)
  • transferrin will increrase to maximize the low iron available
21
Q

IS RDW increased or decreased in iron deficiency anemia

A

increased: variation in RBC size

22
Q

Clinical presentation

  • glossitis, cheilitis, koilonychia
  • pica
  • dysphagia
  • restless leg syndrome
A

iron deficiency anemia

23
Q

treatment of iron deficiency anemia

A
  • **treat underlying cause
  • replace iron stores
    • oral ferrous sulfate 325 mg BID-TID until anemia corrected + 3-6 months
    • blood transfusions (select patients)
24
Q

what is considered a low ferritin level

A

< 12 ng/mL

25
Q

Alpha thalassemia is a deletion of

A

one or more of the four alpha globin chains

26
Q

normal Hb genetic makeup

A

aa/aa + B/B

27
Q

list number of deletions of a-globin chains and manifestation in alpha thalassemia

A
  • 1 deletion: silent carrier (-a/aa + B/B)
  • 2 deletions: alpha-thalassemia trait
    • mild microcytic anemia
  • 3 deletions: hemolytic anemia
  • 4 deletions: hydrops fetalis
    • not compatible with life
28
Q

beta thalassemia

A

reduced or absent beta-globulin chains

29
Q

list number of deletions of b-globin chains and manifestation in beta thalassemia

A
  • dysfunction of one B-globin chain -> thalassemia minor
    • asymptomatic
    • microcytic, hypochromic anemia
  • severe dysfunction of both B globin chains -> thalassemia major (cooley anemia)
    • patients die before age 30
30
Q

poikilocytosis

A

abnormal shaped RBC

31
Q

RDW is normal or elevated in thalassemia

A

normal

32
Q

diagnosis of thalassemia

A

Hgb electrophoresis

33
Q

peripheral smear of thalassemia

A
  • target cells
  • teardrop red cells
    • poikilocytosis
34
Q

treatment of thalassemia

A
  • folic acid supplementation
  • regular transfusion schedule (severe cases)
  • hematopoietic cell transplantation (severe Beta-T)
  • Avoid iron supplementation**
35
Q

presentation

  • MCV normal to decreased
  • Serum FE normal to decreased
  • TIBC: normal to decreased
  • Ferritin: normal to increased
A

anemia of chronic disease/inflammation

36
Q

What is Myelodysplastic syndromes

A
  • acquired disorder to hematopoietic stem cells
  • ineffective blood cell production
37
Q

Myelodysplastic syndromes can progress to what conditions

A
  • marrow failure
  • leukemia
38
Q

What is Sideroblastic anemia

A
  • hereditary or acquired RBC disorder
  • abnormal RBC iron metabolism -> diminished heme synthesis
  • bone marrow produces ringed sideroblasts
39
Q

what are sideroblasts

A
  • normally found in bone marrow of healthy people
  • nucleated RBC precursors (erythroblasts)
  • contains iron-containing granules in cytoplasm
  • **abnormal form: ringed
40
Q

sideroblastic anemia is most often a subtype of what condition

A

myelodysplastic syndrome

41
Q

Presentation

  • MCV varied
  • moderate anemia (Hct 20-30%)
  • normal or elevated ferritin
  • marked anisocytosis and poikilocytosis
  • systemic iron overload
A

sideroblastic anemia

42
Q

what are some other causes of sideroblastic anemia

A
  • chronic alcoholism
  • lead poisoning
  • medications
  • chronic infection or inflammation

clin med final (9 decks)

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