Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

IHO Week 1 > Anemia Overview - Johns > Flashcards

Anemia Overview - Johns Flashcards

(43 cards)

Start Studying
1
Q

What is the definition of anemia?

A
  • Operationally defined as reduction in one or more of the major RBC measurements:
  • –Hemoglobin concentration, hematocrit, or RBC count
  • –All of these are concentration measures
  • Anemia is a CONCENTRATION ISSU - ration of plasma to RBCs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

With ___ _____ you won’t be anemic.

A

acute bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

There are two questions with anemia:

A
  1. Is it caused by production problems?

2. Is it caused by survival/destruction problems?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the key test for anemia?

A

Reticulocyte count!!
-Reticulocytes are early precursors of RBCs. The majority of RBCs are in the bone marrow but some are in the blood/periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two main approaches (not mutually exclusive) for looking at anemia?

A
  1. Biologic or kinetic approach

2. Morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you make a reticulocyte count useful?

A

The reticulocyte count must be adjusted for the patient’s hematocrit (erythrocyte volume function). When hematocrit is lower, reticulocytes are released earlier from the marrow - so one can adjust for this phenomenon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does reticulocyte count tell us (kinetic approach)?

A
  • Increased reticulocytes (greater than 2-3% or 100,000 mm^3 total) are seen in blood loss and hemolytic processes, although up to 25% of hemolytic anemia will present with a normal reticulocyte count due to immune destruction of red cell precursors.
  • Reticulocyte counts are most helpful if extremely low (
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does reticulocyte count tell us (kinetic approach)?

A
  • Increased reticulocytes (greater than 2-3% or 100,000 mm^3 total) are seen in blood loss and hemolytic processes, although up to 25% of hemolytic anemia will present with a normal reticulocyte count due to immune destruction of red cell precursors.
  • Reticulocyte counts are most helpful if extremely low (
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is normal hemoglobin in men and women?

A

Men - 13-16

Women - 11.5-14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is normocytic normochromic anemia?

A

-Reticulocyte count - Index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is micro or macrocytic anemia?

A

-Reticulocyte count - Index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is hemolysis/hemorrage anemia?

A
  • Reticulocyte count - Index >/= 2.5
  • Hemolysis/hemorrhage: blood loss, intravascular hemolysis, metabolic defect, membrane abnormality, hemoglobinopathy, immune destruction, fragmentation hemolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does a normal reticulocyte count indicate?

What does a high reticulocyte count indicate?

A

Normal - production problem

High - problem with destruction (cross out blood loss - especially acute)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Whites the morphological approach of investigating anemia?

A

Big vs. little (measurement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you determine RBC size?

A

MCV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is normal MCV?

A

80-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What causes MCV of 80-100 (normocytic)?

A
  • Anemia of chronic disease
  • Mixed deficiencies
  • Renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes MCV > 100 (macrocytic - over production)?

Study These Flashcards
A
  • B12, Folic acid deficiency (B12 and folic acid go together like ham & eggs!)
  • Drugs that impair DNA synthesis (AZT, chemotherapy, alcohol, azathioprine)
19
Q

What causes MCV

Study These Flashcards
A
  • Iron deficiency
  • Thalassemia trait
  • Anemai of chronic disease (30-40%)
  • Sideroblastic anemias
20
Q

What does CBC tell you?

Study These Flashcards
A

Complete blood count

  • Tells you your white blood cell count - differential (WBC)
  • Hemoglobin
  • Platelets
  • Indices - various measures of red cell size: MCV - mean corpuscular volume, MCHC
21
Q

What is the etiology of Macrocytic Anemia?

Study These Flashcards
A

B12/Folate Deficiency

  • Anemia: Vitamin B12 and folate are needed for DNA synthesis deoxyuridate to thymidylate, including RBC precursors
  • Deficiency: B12 - dietary intake (rare), decreased gastric secretion of intrinsic factor, Folate - poor dietary intake +/- EtOH, malabsorption, increased demand (pregnancy, hemolytic anemias)
22
Q

How to diagnose macrocytic anemia?

Study These Flashcards
A
  • Smear: Macrocytic (High MCV) RBCs, +/- hypersegmented neutrophils, +/- modest neutropenia (low count neutrophils), but . . .
  • –B12
  • Low serum B12, elevated serum methylmalonic acid levels
  • Anti-IF Abs, Schilling test (?), PA accounts for 75%
  • –Folate
  • Serum folate level– can normalize with a single good meal
23
Q

What causes MCV

Study These Flashcards
A
  • Iron deficiency
  • Thalassemia trait
  • Anemia of chronic disease (30-40%)
  • Sideroblastic anemias
24
Q

What causes MCV

Study These Flashcards
A
  • Iron deficiency
  • Thalassemia trait
  • Anemia of chronic disease (30-40%)
  • Sideroblastic anemias
25
How to treat B12/Folate Deficiency?
B12 deficiency: B12 1 mg/month IM
26
What can cobalamin/Vitamin B12 deficiency cause?
Neurological problems | -Subacute combined degeneration of the dorsal and lateral spinal columns
27
When do you have increased iron requirements?
- Blood loss - GI disorder (esophageal varices, hemorrhoids) - Extensive and prolonged menstruation - Chronic blood donations - Rapid growth in body size between 2 and 36 months of age - Pregnancy and lactation
28
When do you have an inadequate iron supply?
- Poor nutritional intake in children - Malabsorption - Gastric bypass surgery for ulcers or obesity - Achlorhydria from gastritis or drug therapy - Severe malabsorption (for example, celiac disease [nontropical sprue])
29
How to test for iron deficiency?
- Decreased hemoglobin - Microcytic MCV - Decreased serum iron - Increased or normal TIBC (total iron binding capacity) - Decreased iron saturation - --Serum Fe/TIBC
30
What are Thalassemias?
- Genetic defects in hemoglobin synthesis! - --Dec. synthesis of one of the 2 globin chains (alph or beta) - --Imbalance of globin chain synthesis leads to depression of hemoglobin production and precipitation of excess globin (toxic) - --
31
What are Thalassemias?
- Genetic defects in hemoglobin synthesis! - --Dec. synthesis of one of the 2 globin chains (alph or beta) - --Imbalance of globin chain synthesis leads to depression of hemoglobin production and precipitation of excess globin (toxic) - --"ineffective erythropoiesis" - --Ranges in severity from asymptomatic to incompatible with life (hydrous fetalis) - --Found in people of African, Asian, and Mediterranean heritage
32
How do you diagnose Thalassemias?
- Smear: microcytic/hypochromic, misshapen RBCs - Beta-thal will have an abnormal Hgb electrophoresis (Inc. HbA2, Inc. HbF) - The more severe alpha-thal syndromes can have HbH inclusions in RBCs - Fe stores are usually elevated
33
How do you treat Thalassemias?
Mild: None Severe: RBC transfusions + Fe chelation, Stem cell transplants
34
What is anemia of chronic disease?
- Normocytic (normal red cell size) | - You NEED a chronic disease (usually inflammatory or infectious)
35
What is the pathogenesis of anemia of chronic disease?
- Cytokines are produced (IFN-gamma, IL-1beta, TNF-alpha,etc.) and cause: - --Decreased EPO production - --Suppression of erythroid progenitors - --Blockade of reticuloendothelial iron release
36
What does anemia of chronic disease look like (lab panel)?
- Microcytic or normocytic anemia - Decreased serum iron - Decreased serum TIBC (total iron binding capacity) - Normal Fe/TIBC percentage - Normal or increased ferritin (stores and releases iron in a controlled fashion)
37
What is ferratin?
Measures your total body iron stores! - If you're iron deficient, this number will be decreased - If you have anemia of chronic disease - your fourteen number will be normal
38
What are sideroblastic anemias?
- Sideroblasts are produced instead of healthy red blood cells - Heterogenous grouping of anemias defined by presence of ringed sideroblasts in the BM
39
What are the etiologies of sideroblastic anemias?
- Hereditary (rare), type of porphyria - Myelodysplasia - EtOH - Drugs (INH, Chloramphenicol)
40
Auto-immune conditions can cause. . .
hemoglobin and platelets to decrease
41
What should you do after an MCV test if its normal?
Bone marrow biopsy to diagnose | -If MCV normal, you need to determine, is there a chronic disease?
42
What should you do if you find anemia?
-If MCV is high, could be B12, folate or hemolytic anemia (if you have tons of reticulocytes -> but we always do retriculocyte count first)
43
What are the general principles of anemia?
- It's a sign, not a sieges - Anemias are a dynamic process - It's never normal to be anemic - The diagnosis of iron deficiency anemia mandates further work-up

IHO Week 1 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions