Anemia - Krafts Flashcards
What is anemia?
A reduction below normal in hemoglobin OR RBC number
What are symptoms of anemia?
- Pale skin (not a great judgment)
- Mucous membranes
- Jaundice (if hemolytic)
What does heme break into if hemolytic?
Bilirubin –> causes Jaundice
What are symptoms of anemia?
- Pale skin (not a great judgment)
- Mucous membranes
- Jaundice (if hemolytic)
- Tachycardia
- Breathlessness
- Dizziness
- Fatigue
- Atrophic glossitis (papillae in tongue shrink/atriphy, and become shiny, angular cheilitis- cracks at edge of mouth)
- Koilonychia (spoon nails) in iron-deficiency anemia
What are three ways to “get anemic”?
- Lose blood
- Destroy too much blood
- Intracorpuscular reasons
- Extracorpuscular reasons - Make too little blood
- Too few building blocks
- Too few erythroblasts
- Not enough room
What is important about Iron-deficiency anemia?
MOST IMP. TO LEARN/CATCH: Microcytic
- Most imp cause = GI bleeding
- Microcytic, hypochromic anemia
- Increased anisocytosis (patients RBCs of unequal size) and poikilocytosis (funny shaped red blood cell)
- Abnormal iron studies
Basics of Iron:
- Most Iron is in hemoglobin
- Iron absorption: In duodenum/proximal jejunum, binds to transferrin
- Iron circulation: transferrin carries iron, iron goes to red cell precursors, organs
Hemoglobin review:
- 4 globin chains, 4 heme molecules
- Globin: polypeptide chains (2 alpha, 2 beta)
- Heme: Iron molecule in protoporphyrin ring
- Iron only binds O2 in ferrous (Fe2+) state
- In ferric (Fe3+) state, “methemoglobin”
How is iron metabolized?
- Most goes to RBCs
- Rest goes to macrophages
Where is iron stored?
- Ferritin: quick in, quick out
- Hemosiderin: more stable
Where is iron stored?
- Ferritin: quick in, quick out
- Hemosiderin: more stable (looks blue-ish in bone marrow)
What causes iron deficiency?
- Decreased iron intake
- –bad diet
- –bad absorption
- Increased iron loss
- –GI bleed
- –menses
- –hemorrhage
- Increased iron requirement
- –pregnancy
Bottom line in iron-deficiency anemia:
Premenopausal women:
-think MENORRHAGIA
Everyone else:
-think GI BLOOD LOSS
Why shouldn’t elderly people take iron supplements?
-Supplements will hide iron deficiency in labs/hide colon cancer
Clinical Picture of Iron-Deficiency Anemia:
- Symptoms: asymptomatic, or fatigue, dizziness
- Signs: pale, spoon nails, smooth tongue
- Pica: craving for dirt, windex, household cleaners
- Cause of symptom?
