Anemia: Overview of Approach to Patient Flashcards

1
Q

Define anemia.

A

Insufficient red cell mass to deliver oxygen to peripheral tissues

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2
Q

What is the first question you ask in response to patient anemia?

A

Are there other hematologic abnormalities? If yes, test bone marrow.

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3
Q

What should you ask if there are no other hematologic abnormalities in an anemic patient?

A

Is there a normal reticulocyte response? If yes, is there evidence of hemolysis. If no, test MCV.

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4
Q

If there is no evidence of hemolysis in an anemic patient without other hematologic abnormalities and with a normal reticulocyte response, what should you be thinking?

A

Hemorrhage!

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5
Q

Iron is absorbed through the ______.

A

duodenum (because it is solubilized by the low pH and protein gastroferrin in the stomach)

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6
Q

_____ is on the apical surface of duodenal cells and converts iron from ___ to ___.

A

DCYTB; Fe3+; Fe2+

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7
Q

______ imports iron from the duodenal lumen through the apical membrane.

A

DMT1

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8
Q

______ exports Fe2+ through the basolateral membrane, where it then is converted back to Fe3+ by _____.

A

Ferroportin; hephaestin

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9
Q

_____ is an intracellular iron-storage protein.

A

Ferritin

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10
Q

Transferrin is a plasma protein (produced by the liver) that can bind up to ____ of iron.

A

two moles

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11
Q

During infection or inflammation, _____ can lead to anemia.

A

inhibition of ferroportin (which releases iron through the basolateral membrane)

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12
Q

Iron overload is also called _____ and can be caused by ____ deficiency.

A

hemochromotosis; hepcidin (which is a negative regulator of iron absorption)

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13
Q

List the characteristics of iron deficiency.

A
Decreased Hgb synthesis
Decreased cell proliferation
Hemolysis
Anemia
Immune deficiency 
Pica
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14
Q

Normal hemoglobin levels (g/dL) range from _____ in menstruating women to ______ in infants.

A

12; 17

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15
Q

Normal hematocrit levels (%) range from ____ in children ages 3 months to five years to ____ in infants.

A

36; 52

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16
Q

______ stains are used to study red cell morphology.

A

Wright’s

17
Q

The normal reticulocyte count is ____.

A

0.4 - 1.7%

18
Q

Hepcidin is a polypeptide, produced by the _____, that ________.

A

liver; negatively regulates iron absorption (even degrading ferroportin)

19
Q

Transferrin gets __________.

A

ingested in clathrin-coated pits that acidify (endosomes), thus releasing iron into the cell

20
Q

Hereditary hemochromatosis results from ________.

A

autosomal recessive defects in the HFE gene