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Pathology > Anemia intro > Flashcards

Anemia intro Flashcards

1
Q

Definition of Anemia

A

Reduction in total RBC, amount of Hg, or circulating RBC mass

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2
Q

Clincal signs of anemia

A

Pallor, fatigure, syncope, dyspnea, tachycardia, palpitations, heart murmurs, CHF, postural hypotension

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3
Q

Scleral icterus

A

Hemolysis

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4
Q

Smooth tongue with glossitis

A

Pernicious anemia, severe iron deficiency

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5
Q

Petechiae

A

Thrombocytopenia, marrow replacement/failure

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6
Q

Koilonychia

A

Iron deficiency

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7
Q

Lymphadenopathy

A

Hematolymphoid malignancy, infection

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8
Q

Splenomegaly

A

hematolymphoid malignancy, infectious Mono

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9
Q

Skin ulcers

A

sickel cell disease

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10
Q

Massive splenomegaly

A

Chronic myeloid leukemia, myelofibrosis

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11
Q

Hepatosplenomegalywith ascites

A

liver disease

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12
Q

Subacute combined degeneration of spinal cord

A

pernicious anemia

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13
Q

Delayed achilles tendon reflex

A

hypothyrodism

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14
Q

General causes of anemia

A

Blood loss, hemolysis, insufficient production of erythrocytes

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15
Q

Anemia Classification by morphology

A

RBC size, RBC shapes, proliferation index

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16
Q

Increased reticulocytes

A

Marrow is responding to anemia by producing more RBCs

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17
Q

No increased reticulocytes

A

Marrow is not responding appropriately to anemia

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18
Q

Iron deficiency anemia

A

Typical S/S. Pale nail bed color. Pica. Koilonychia. Glossitis

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19
Q

Morphology of iron deficiency anemia

A

Microcytic hypochromic anemia, anisocytosis, poikilocytosis (elliptocytes with pencil cells), decreassed reticulocyte count**, mild thrombocytosis

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20
Q

Anemia of chronic disease

A

about 1-2 months after chronic disease onset.

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21
Q

Path of anemia of chronic disease

A

Immune-driven cytokine respone. Cytokine mediated disturbences in iron homeostasis( decreased absorp. Increased iron shunting into macrophages). CytoK mediated inhibition of erythroid precursor proliferation/differentiation in marrow

22
Q

Morphology of anemia of chronic disease

A

Microcytic hypochromic anemia or normocytic normochromic anemia with normal RDW. Low reticulocyte count

23
Q

Disorders of globin synthesis

A

Thalassemias, abnormal globin chains

24
Q

Thalassemias

A

Heterogeneous group of inheritied disorders charac. Reduced globin chain synthesis

25
Q

Morphology of beta thalassemia major

A

Marked anisocytosis/poikilocytosis. Many nucleated RBCs. Polychromasia. Severe microcytic hypochromic anemia

26
Q

Normochromic normocytic anemias

A

Anemia of chronic disease. Sickle cell. Early iron deficiency. Vit B12/folate def. Medication/toxin effect. Hereditary anemias

27
Q

Macrocytic Megablastic Marrow Causes

A

Folate/vitamin B12/Copper def. Drug effect

28
Q

Non-megaloblastic marrow macrocytic causes

A

Drug effect, alcohol abuse, hypothyrodism, myelodysplastic neoplasms, aplastic anemia

29
Q

Megaloblastic anemia

A

Usually from vit B12/folate def. Impaired DNA synthesis so cells divide more slowly. Ineffective hematopoiesis

30
Q

Causes of B12 def

A

Pernicious anemia, gastrectomy, pancreatic damage, ileal disease/resection, fish tapeworm, bacterial overgrowth

31
Q

Pts with increased B12 requirement

A

Pregnancy, hyperthyrodism, advanced cancer, chronic infection

32
Q

Folate def causes

A

Diet, alcoholism, malabsorption, intestinal disease, anticonvulsants, oral contraceptives

33
Q

Pts with increased folate req

A

pregnancy, infancy, advanced cancer, marked increased hematopoiesis

34
Q

S/S of megaloblastic anemia

A

Anemia with mild jaundice. Glossitis. Angular stomatitis. Mild symptoms of malabsoprtion. Purpura due to thrombocytopenia

35
Q

Long standing, untreated B12 deficiency

A

spinal cord degeneration

36
Q

Megaloblastic anemia morphology

A

Oval macrocytes. Hypersegmentaed neutrophils. Rare teardrop cells, schistocytes, or spherocytes may be seen

37
Q

Intravascular hemolysis

A

Direct lysis of RBCs within circ system. Extracorpuscular defects

38
Q

Extravascular hemolysis

A

Premature removal of RBCs by reticuloendothelial system

39
Q

RBC destruction releases what?

A

Heme, Globin, Iron, Lactate dehydrogenase

40
Q

Methemalbumin

A

Binding of free hemoglobin to transferrin and albumin. Most commonly seen in intravascular hemolysis

41
Q

Intravascular hemolysis clincal/lab findings

A

Anemia, hemoglobinemia, hemoglobinuria, hemosiderinuria, decreased plasma haptoglobin, jaundice

42
Q

Sickle cell disease

A

Hemoglobin S results from single point mutation on beta-globin gene that promotes polymerization of hemoglobin in conditions of low O2 tension or dehydration

43
Q

Sickle Cell clincal findings

A

Chronic hemolysis, chronic tissue hypoxia, infarcts, skin ulcers, severe pain, tissue damage, functional autosplenectomy, osteomylitis with Salmonella species

44
Q

Morphology of sickle cell

A

Normochromic normocytic anemia. Sickle cells. Anisopoikilocytosis. Polychromasia/reticulocytosis. Howell-Jolly boides after splenic infarcts/autosplenectomy

45
Q

Hereditary spherocytosis

A

Northern Euro decent. Basic defect in spectrin (anchors membrane to cytoskeleton). Cells gradually become spherical

46
Q

S/S of herditary spherocytosis

A

Anemia, intermittent jaundice, splenomegaly

47
Q

Morphology of hereditary spherocytosis

A

Variable normochromic normocytic anemia. Many spherocytes. Polychromasia/reticulocytosis

48
Q

Warm Autoimmune Hemolytic Anemia

A

Pt Ab to own RBC antigens. IgG Ab binds to RBC at 37º and are phagocytosed.

49
Q

Morphology of warm AIHA

A

Anisopoikilocytosis, spherocytes (and micro), marked polychromasia, nucleated RBCs

50
Q

Microangiopathic hemolytic anemia causes

A

TTP. HUS. DIC. Mechanical heart valves. Vasulitis, disseminated cancer. Malignang hypertension. (aka RBC fragment syndrome)

Pathology (4 decks)

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