Anemia - Krafts

Question 1

Define Anemia

Answer 1

A reduction in hemoglobin or RBCs

Question 2

Symptoms of Anemia

Answer 2

Pale Skin
Jaundice (with hemolytic anemia)
Tachycardia
SOB
Dizziness
Fatigue

Question 3

Atrophic Glossitis

Answer 3

Papillae of the tongue become atrophied

Question 4

Angular Cheilitis

Answer 4

Cracks at the corners of the mouth

Question 5

Koilonychia

Answer 5

Spoon-shaped nails in IDA

Question 6

What are the three ways to get anemia?

Answer 6

1. Blood loss
2. Destroy too much blood
3. Make too little blood

Question 7

2 ways to destroy too much blood

Answer 7

Intracorpuscular reasons and extracorpuscular reasons

Question 8

3 ways to make too little blood

Answer 8

Too few building blocks
Too few erythroblasts
Not enough room

Question 9

What are the 3 morphologic groups of anemia?

Answer 9

1. Weird Size
2. Weird Shape
3. Normal size and shape

Question 10

Iron-Deficiency Anemia

Answer 10

n

Question 11

Classify Iron-Deficiency Anemia

Answer 11

Microcytic, hypochromic with increased anisocytosis and poikilocytosis

Question 12

Anisocytosis

Answer 12

Varying sized red blood cells

Question 13

Poikilocytosis

Answer 13

Funny shaped red blood cells

Question 14

Primary cause of Iron-Deficiency Anemia

Answer 14

GI bleeding

Question 15

Key indicator of Iron-Deficiency Anemia

Answer 15

Abnormal Iron Studies

Question 16

How is iron absorbed?

Answer 16

In duodenum it binds to transferrin

Question 17

How is iron circulated?

Answer 17

Transferrin carries iron to the red cell precursors and organs

Question 18

Iron only binds oxygen in what state?

Answer 18

Ferrous (Fe2+) State

Question 19

What makes up Hemoglobin?

Answer 19

4 globin chains (2 alpha and 2 beta)

4 heme molecules (carry Fe2+ and O2)

Question 20

How is iron metabolized?

Answer 20

Most in RBCs, rest in Macrophages

Question 21

How is iron stored?

Answer 21

Ferritin = easily accessible iron storage
Hemosiderin = more stable storage

Question 22

Symptoms of Anemia

Answer 22

Pale Skin
Jaundice (with hemolytic anemia)
Tachycardia
SOB
Dizziness
Fatigue
PICA

Question 23

Atrophic Glossitis

Answer 23

Papillae of the tongue become atrophied (smooth tongue)

Question 24

Classify Iron-Deficiency Anemia

Answer 24

Microcytic, hypochromic with increased anisocytosis, poikilocytosis, platelets and decreased reticulocytes

Question 25

Cause of Iron-Deficiency Anemia in Premenopausal women?

Answer 25

Menorrhagia

Question 26

Morphology of Bone Marrow in Iron-Deficiency Anemia

Answer 26

Erythroid Hypoplasia (not enough RBCs) Dyserythropoiesis Decreased Iron Stores

Question 27

Labs in Iron-Deficiency Anemia

Answer 27

Low Serum Iron Low Ferritin (Definitive Diagnosis) High TIBC

Question 28

Megaloblastic Anemia Facts:

Answer 28

Defective DNA Synthesis Macrocytic Anemia with oval macrocytes and hypersegmented neutrophils Nuclear/Cytoplasm Asynchrony Decreased B12 and Folic Acid

Question 29

B12 Absorption and Transport

Answer 29

Intrinsic Factor from the parietal cells facilitates absorption through the distal ileum and is then B12 is transported in the blood by transcobalamin II

Question 30

Causes of B12 Deficiency

Answer 30

``` Diet (rare) Lack of Intrinsic Factor Pancreatic Damage Ileal Damage Tapeworm ```

Question 31

Megaloblastic Anemia Symptoms

Answer 31

Atrophic Glossitis

Question 32

Folate Absorption and Transport

Answer 32

Absorbed in jejunum, converted to methyl-FH4, transported to liver and red cells

Question 33

Causes of Folate Deficiency

Answer 33

Diet Alcohol Jejunal Damage Drugs

Question 34

2 Type of Hemolytic Anemia

Answer 34

Chronic = usually congenital and Acute = usually acquired

Question 35

Define Hemolytic Anemia

Answer 35

Increased red blood cell destruction leads to increased red blood cedd production

Question 36

Labs for Hemolytic Anemia

Answer 36

``` Destruction: Increased Serum Bilirubin Increase Lactate Dehydrogenase Decreased Free Haptoglobin Hemoglobinemia/-uria Production: Reticulocytes Nucleated RBCs ```

Question 37

Direct Antiglobulin Test

Answer 37

Detects antibody on RBC surface, indicates immune process

Question 38

Osmotic Fragility Test

Answer 38

Measures RBC fragility, indicates spherocytes present

Question 39

Classify Hemolytic Anemia

Answer 39

Normochromic, normocytic, Spherocytes + other poikilocytes (fragments, targets, sickles

Question 40

What my "cure" hemolytic anemia?

Answer 40

Splenectomy

Question 41

Hereditary Spherocytosis Facts:

Answer 41

Lots of Spherocytes RBC Cytoskeleton Defect (Spectrin) Cure: Splenectomy

Question 42

Triad of Hereditary Spherocytosis

Answer 42

Anemia, Jaundice, Splenomegaly with variable age of onset and severity; often caused by a crisis (parvovirus)

Question 43

Pathogenesis of Hereditary Spherocytosis

Answer 43

Abnormal RBC Cytoskeleton with loss of surface area = spleen removes spheres

Question 44

Characteristics of Warm Autoimmune Hemolytic Anemia (WAHA)

Answer 44

IgG coat on RBC Splenic Macrophages (causes Splenomegaly) eat entire RBC nibble RBCs into Spherocytes

Question 45

Diagnosis and Treatment for WAHA

Answer 45

Direct Antiglobulin Test | Treat with Steroids and Splenectomy

Question 46

Characteristics of Cold Autoimmune Hemolytic Anemia (CAHA)

Answer 46

IgM and Complement Some Intravascular Hemolysis Mostly in Spleen RBC Agglutination

Question 47

Pathogenesis of CAHA

Answer 47

IgM and Complement coat RBCs IgM falls off in warm body parts IgM bridges RBCs (agglutination) Complement can lyse RBCs Intravascularly or opsonize RBCs for Splenic Macrophages

Question 48

Signs of CAHA

Answer 48

Chronic hemolysis aggravated by cold with pallor and cyanosis in cold body parts

Question 49

Diagnosis and Treatment for CAHA

Answer 49

Direct Antiglobulin Test for complement | Keep patient warm and treat underlying cause