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Block 6 > anemia of diminished erythropoiesis > Flashcards

anemia of diminished erythropoiesis Flashcards

1
Q

causes of anemia

A

diminished production
accelerated destruction
blood loss

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2
Q

causes of diminished production

A 
renal failure
vitamin deficiency
iron deficiency
anemia of chronic disease
aplastic anemia
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3
Q

causes of accelerated destruction

A

hemolysis

RBC structural abnormality

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4
Q

causes of acute blood loss

A

loss of intravascular volume

dilution with fluids

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5
Q

treatment of acute blood loss

A

stop bleeding

transfusion with blood products

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6
Q

normocytic/normochromic causes of anemia

A

acute hemorrhage

anemia of chronic disease

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7
Q

microcytic/hypochromic causes of anemia

A

iron deficiency
thalassemia
anemia of chronic disease
hemoglobin disorders

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8
Q

macrocytic/normochromic causes of anemia

A

B12/folate deficiency
myelodysplastic syndromes
liver/alcohol disease

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9
Q

signs of anemia

A 
weakness
fatigue
headache
dizziness
palpitations
dyspnea
pallor
tachycardia
systolic murmur
low PB
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10
Q

megaloblastic anemia

A

impaired DNA synthesis leading to large erythroid precursor cells
cytoplasm replicates but nucleus can’t

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11
Q

causes of megaloblastic anemia

A

b12/folate deficiency
impaired absorption
chemo, antiretrovirals
rare inherited

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12
Q

signs/symptoms of megaloblastic anemia

A 
low Hb
high MCV, MCH
low reticulocyte count
hyper chromic, microcytic
ovalocytes
hyperhsegmented neutrophils
large erythroid cells in bone marrow
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13
Q

pancytopenia

A

neutropenic
thrombopenic
anemic

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14
Q

normal B12 metabolism

A 
B12 separated from proteins by pepsin
free b12 binds r binders
pancreatic enzymes separates the complex
B12 binds IF in ileum
released, absorbed, and binds transcobalamin II in plasma
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15
Q

B12 use

A

needed to switch folic acid from active into usable form and transfers a methyl group to homocysteine to make methionine

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16
Q

B12 functions

A

DNA synthesis

fatty acid synthesis for nerve sheaths

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17
Q

pernicious anemia

A

IF deficiency impairing B12 absorption

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18
Q

morphology of pernicious anemia

A

atrophic glossitis and gastritis of funds
increased risk gastric cancer
increased acid secretion
myelin degeneration in dorsal and lateral tracts
neuropsychiatric changes

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19
Q

Schilling test

A

radio labeled B12 given with IF to determine if IF is the cause of b12 deficiency

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20
Q

treatment of megaloblastic anemia

A

b12 deficiency responds to folate, but neuro symptoms worsen

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21
Q

causes of microcytic anemia

A 
iron deficiency
thalassemia
anemia of chronic disease
sideroblastic anemia
red cell fragments
hereditary spherocytosis
defective porphyrin synthesis
22
Q

hemosiderin

A

iron binding protein for iron storage

water insoluble- outside cell

23
Q

ferritin

A

iron binding protein for storage

water soluble- inside cell

24
Q

transferrin

A

glycoprotein that delivers iron to cells

25
Q

causes of iron loss

A

gut cells
sweat
blood loss

26
Q

ferroportin

A

iron transporter that moves iron from inside the cell to the plasma

27
Q

hepaestin

A

oxidizes iron in plasma

28
Q

hepcidin

A

acute phase reactant

downregulates ferroportin to decrease iron absorption

29
Q

hepcidin synthesis control

A

IL6 increases synthesis
increased RBC demand decreases synthesis
increased plasma/stores of iron decreases synthesis

30
Q

hemochromatosis

A

excess iron

31
Q

consequences of no hepcidin

A 
hemochromatosis
increased iron absorption
increased TIBC
transferrin saturated
increased ferritin
32
Q

anemic older male

A

colon adenocarcinoma

33
Q

clinical features of iron deficiency

A 
numbness/tingling
angular stomatitis
atrophy and soreness of tongue
pica
brittle nails
difficulty swallowing
34
Q

TIBC relationship with iron levels

A

low iron = high TIBC

35
Q

TIBC

A

total iron biding capacity

measure of affinity of iron for transferrin

36
Q

ferritin is proportional to

A

cellular iron stores

EXCEPT with inflammation

37
Q

anemia of chronic disease

A

low plasma iron but normal stores because hepcidin is produced which decreases iferroportin which reduces iron movement

38
Q

markers of anemia of chronic disease

A

low TIBC- lots of iron present but not used

high ferritin- iron is held inside cells

39
Q

markers of iron deficiency anemia

A

high TIBC- low iron means transferrin (takes iron to cellS)

low ferritin- iron NOT in cells because it is needed

40
Q

aplastic anemia

A

chronic primary hematopoietic failure with pancytopenia

41
Q

main cause of aplastic anemia

A

idiopathic

42
Q

causes of aplastic anemia

A

idiopathic
acquired- drugs, radiation, chemicals, viruses
inherited- fanconi’s anemia

43
Q

pathophysiology of aplastic anemia

A

immune mediated marrow suppression

damaged stem cells stimulate T cell response which stops stem cell proliferation

44
Q

treatment for aplastic anemia

A

young- bone marrow transplant

old- immunosuppressants

45
Q

pure red cell apalsia

A

erythroid hypoplasia with normal other eclls

46
Q

cause of pure red cell aplasia

A

tyoma
large granular lymphocytic leukemia
drugs
viruses

47
Q

causes of marrow failure syndromes

A

diffuse liver disease
chronic renal failure
myelophthic anemia

48
Q

diffuse liver disease

A

linked to alcoholism- toxic effect on erythroid precursors
chronic disease
vitamin deficiency

49
Q

chronic renal failure

A

decreased EPO –> reduced production dn survival

50
Q

myelophthic anemia

A

normal marrow replaced by other cells
metastatic cancer
granulomatous disease
spent phase myeloproliferative disorder

Block 6 (24 decks)

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