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Obgyn Clinicals > Anemia In Pregnancy > Flashcards

Anemia In Pregnancy Flashcards

1
Q

Past history

A

Melena,hemetemesis,piles,epistaxia,gi disorders
Bleeding tendency
Worm infestation,walking barefoot
Malnutrition,diarrhea,vomiting
Malaria,tb,rheumatoid arthritis
Epilepsy
Recurrent uti
Hemolytic anemia

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2
Q

Family history

A

Sickle cell anemia
Thalassemia

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3
Q

Normal values of MCV,mch,mchc

A

Mcv- 75-95 meu m cubed
Mch-26-31 pg
Mchc-34%

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4
Q

Peripheral smear of IDA

A

Hypochromic,microcytic,anisocytosis,poikilocytosis

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5
Q

Peripheral smear in megaloblastic anemia

A

Hyperchromic,macrocytic,hypersegmentation of neutrophils,presence of megaloblasts,Howell jolly bodies

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6
Q

Target cells seen in

A

Thalasemia
Ida

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7
Q

Presence of eosinophils

A

Hookworm infestation

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8
Q

Presence of shistocutes in smear indicates

A

Hemolysis

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9
Q

Normal platelet count

A

1.5-4 lakhs/ mm cube

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10
Q

Platelets deficient in

A

Idiopathic thrombocytopenic purpura

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11
Q

Normal total serum iron

A

65-120 meu g/ dl

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12
Q

TIBC

A

300-400 meu g/ dl

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13
Q

Normal serum ferritin

A

15-200 meu g/l

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14
Q

Inv for anemia

A

HB,RBC,pcv
Peripheral smear
Platelet count
Reticulocyte count
Blood grp,rh type
Bleeding clotting time
Stool examination
Urine
Serum protein
Bone marrow study

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15
Q

Causes of anemia

A

Nutritional- deficiency of iron,folic acid,vit b12
Due to inc destruction- hemolytic anemia,hemoglobinopathies,malaria
Due to blood loss- heavy menstrual bleeding,hook worm,gi bleeding,obstetric hemorrhage
Due to impaired production - aplastic anemia,chronic renal disease

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16
Q

What is anemia

A

Decrease in oxygen carrying capacity of blood due to quantitative or qualitative decrease in RBC and hb concentration in blood

17
Q

ICMR classification of anemia

A

Mild-10-10.9 g/dl
Moderate-7-10
Severe-4-7
Very severe -<4

18
Q

FOGSI classification of anemia

A

Mild-8-10 g/dl
Moderate-6.5-8
Severe-<6.5

19
Q

Causes of increased iron requirement during pregnancy

A

Fetus,placenta-300 mg
Maternal hb mass expansion-500 mg,loss by excretion-200 mg
Parturition and lactation-300 mg
Conservation of iron due to amenorrhea -300 mg
Total requirment -1000 mg

20
Q

Physiological anemia in pregnancy

A

Hemodilution,results in decrease in hb concentration

21
Q

Criteria for physiological anemia

A

Lower limit of hb-10 g/dl
Lower limit of rbc-3.2 mill/ml
Lower limit of pcv-30%
Normal peripheral smear

22
Q

Anemia prophylaxis

A

Prophylactic dose of 100 mg elemental iron and 0.5 mg folic acid at least 10/ days after first trimester,from 14-26 weeks,to be repeated 100 days after post partum

23
Q

Calculation of iron requirement

A

2.4× wt in kg× hb def in gm+ 1000 mg(to replenish stores)

24
Q

Stages of iron deficiency

A

First stage- depletion of iron stores,decrease in ferritin
Second- decrease in serum iron and increase in TIBC
third - IDA

25
Q

Effect of anemia in fetus

A

Low birth wt
Iugr
Pre term
Iud
Asphyxia
Feeding difficulty

26
Q

Antenatal anemia treatment

A

Oral iron- pregnancy<30 weeks,mild and moderate anemia
Parenteral iron- 30-36 weeks,moderate anemia
Packed RBC transfusion->36 weeks,severe anemia, hemoglobinopathies,acute blood loss

27
Q

Parenteral iron- preparations

A

Iron dextran
Iron sorbitol citric acid
Iron sucrose(dose, 100 mg in 100 ml of normal saline iv in 15 min/ day)

28
Q

Daily requirment of iron

A

Non pregnant women -2-3 mg a day
Pregnant-6-7 mg a day

29
Q

Factors that decrease iron absorption

A

Phytates
Tannins
Phosphates
Calcium
Milk
Tea
Antacids
Ppi

30
Q

Factors that increase iron absorption

A

Vit c
Amino acids
Citric acid

31
Q

Daily requirment of folic acid

A

500 microgram a day

32
Q

Complications in pregnancy

A

Cardiac failure
Subinvolution of uterus
Cortical vein thrombosis
DVT
Morbidity and mortality

33
Q

Types of hemolytic anemia

A

Hereditary
. Hereditary spherocytosis
. Hemoglobinopathies
. Glucose 6 phosphate def
Acquired
. Paroxysmal nocturnal hemoglobinuria

34
Q

Hemoglobinopathies

A

Sickle cell
Thalasemia
Spherocytosis

35
Q

Complaints in anemia

A

Lethargy
Fatigue
Swelling of face,arms,abdomen,feet
Palpitation
Breathlessness
Chest pain

Obgyn Clinicals (3 decks)

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