Anemia: Overview of Approach to Patient Flashcards
Define anemia.
Insufficient red cell mass to deliver oxygen to peripheral tissues
What is the first question you ask in response to patient anemia?
Are there other hematologic abnormalities? If yes, test bone marrow.
What should you ask if there are no other hematologic abnormalities in an anemic patient?
Is there a normal reticulocyte response? If yes, is there evidence of hemolysis. If no, test MCV.
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?
Hemorrhage!
Iron is absorbed through the ______.
duodenum (because it is solubilized by the low pH and protein gastroferrin in the stomach)
_____ is on the apical surface of duodenal cells and converts iron from ___ to ___.
DCYTB; Fe3+; Fe2+
______ imports iron from the duodenal lumen through the apical membrane.
DMT1
______ exports Fe2+ through the basolateral membrane, where it then is converted back to Fe3+ by _____.
Ferroportin; hephaestin
_____ is an intracellular iron-storage protein.
Ferritin
Transferrin is a plasma protein (produced by the liver) that can bind up to ____ of iron.
two moles
During infection or inflammation, _____ can lead to anemia.
inhibition of ferroportin (which releases iron through the basolateral membrane)
Iron overload is also called _____ and can be caused by ____ deficiency.
hemochromotosis; hepcidin (which is a negative regulator of iron absorption)
List the characteristics of iron deficiency.
Decreased Hgb synthesis Decreased cell proliferation Hemolysis Anemia Immune deficiency Pica
Normal hemoglobin levels (g/dL) range from _____ in menstruating women to ______ in infants.
12; 17
Normal hematocrit levels (%) range from ____ in children ages 3 months to five years to ____ in infants.
36; 52