Anemia Part 1 Flashcards
is a condition in which number
of RBC or Hgb concentration is lower than the normal.
Anemia
Anemia is a condition in which number
of RBC or Hgb concentration is _______ (lower or higher) than the normal.
Lower
Etiology of anemia:
Thalassemia major
Iron deficiency anemia
Megaloblastic anemia
Leukemia
is a manifestation of a certain disease associated with a decrease in the red blood cell, decrease in hematocrit and a decrease in hemoglobin.
Anemia
Anemia is a manifestation of a certain disease associated with a decrease in the __________, decrease in __________ and
a decrease in ___________.
red blood cell, hematocrit and hemoglobin
There is a different definition for Anemia we have
Funtional
Operational
Conventional
Anaimia is a greek word of
Lack of blood
An means
Lack
Haima means
Blood
Functional of anemia:
Decrease oxygen carrying in blood
Operational anemia:
Reduction of total number of red blood cell
Conventional of anemia
Decrease in red blood cell, hematocrit and hemoglobin below normal
Clinical Findings of Anemia:
History
Physical examination
Signs and symptoms
Laboratory procedures
Sign and symptoms of anemia most common:
Shortness of breath
Fatigue
Weakness
History of Patient:
Diet
Bleeding history
Drug ingestion
Travel
Previous drugs
Physical examination
Skin: pallor
Eyes: hemorrhage
Mouth: mucosal bleeding
Cardiac murmurs
Vital signs: temp, blood pressure and heart rate
General causes of Anemia
Decreased of red blood cells
Increased red blood cell reduction
Blood loss
Anemia due to decreased production of RBC:
Iron Deficiency Anemia
Megaloblastic anemia
Thalassemia anemia
Sideroblastoc anemia
Aplastic anemia
Anemia due to increased destruction of RBC
Intracorpuscular abnormalities
Extracorpuscular abnormalities
Intracorpuscular abnormalities:
Enzyme deficiency
Membrane defect
Globin abnormality
Paroxysmal nocturnal hemoglobinuria
Extracorpuscular abnormalities:
Mechanical
Infection
Chemical and physical agent
Antibody mediated anemia
Anemia due to blood loss:
Acute post hemorrhagic anemia
Chronic post hemorrhagic anemia
Laboratory test for Anemia assessment
Complete blood count
Reticulocyte count
Iron studies
Urinalysis
Fecalysis
Morphological Classification of Anemia:
Microcytic normochromic anemia ( decrease rbc)
Macrocytic normochromic anemia
Normocytic normochromic anemia (aplastic anemia)
Morphological under SIGA
Microcytic
Morphological under MNM
Macrocytic
3 stages of Iron Deficiency:
Stage 1: iron depletion
Stage 2: exhaustion of storage pool of iron
Stage 3: frank anemia
Stage 1: iron depletion result
Normal: Hb, serum iron, total iron binding capacity
Low: ferritin
Stage 2: exhaustion of storage pool of iron result
Normal: hb and rbc dev
Decrease: serum iron & ferritin
Increase: tibc
Stage 3: frank anemia result
Decrease: hb, serum iron, ferritin
Increase: tibc
will measure the
circulating iron that is bound to
transferring
Serum iron
measure the capacity of
iron to bind transferrin
Total iron binding capacity
protein that are used for
storge of iron
Ferritin
Size of RBC
Anisocytosis
Shape of Rbc
Poikilocytosis
Treatment of iron deficiency anemia:
Ferry sulfate supplements
Avoid late sleep
Eat nutritious food
CATEGORIES OF LAB DIAGNOSIS FOR ANEMIA: screening
Complete blood count
Red blood cells indices
CATEGORIES OF LAB DIAGNOSIS FOR ANEMIA: diagnostic
Backbone of anemia
Iron studie
CATEGORIES OF LAB DIAGNOSIS FOR ANEMIA: specialize:
Hemoglobin electrophoresis
Underlying causes
SEVERE TYPE OF IRON DEFICIENCY:
Smooth tongue and koilonychia in iron deficiency
a condition also referred to as
“spoon-shaped nails,” is associated with iron
deficiency in which the fingernails are thin, brittle,
and concave with raised edges.
Koilonychia
Koilonychia a condition also referred to as
“_____________,” is associated with iron
deficiency in which the fingernails are thin, brittle,
and concave with raised edges.
spoon-shaped nails
Condition where there’s a craving for uncertain food. Ex: dirt, clay, chalk
PICA
Love eating ice clinical term
Pagophagia
develop when the incorporation of iron into heme is blocked.
Sideroblastic anemia
Sideroblastic primary cause
Genetic
Sideroblastic secondary cause:
Alchohol
Food fad
Iron in water
2 type of sideroblastic anemia
Hereditary sideroblastic anemia
Primary acquired sideroblastic anemia
due to a congenital enzyme defect delta amino-levulinic acid
synthetase or heme synthetase
Hereditary Sideroblastic anemia
due to somatic mutation of the erythroid progenitor cells that
cause either defects in heme synthesis or defects in DNA
synthesis
Primary acquired sideroblastic anemia
Rare disease caused by accumulation of
porphyrins in developing RBC’s
Porphyria
Clinical features: poisoning
Skin problem
Impaired production of heme
Neurologic complication
anemia associated with systemic diseases:
Arthritis
Tuberculosis
Human immunodeficiency virus
Malignancies
second most common type of anemia
Anemia due to chronic disease
inherited disorders caused by genetic alterations that reduce
or preclude the synthesis of the globin chains of hemoglobin
tetramer.
Thalassemia
Thalassemia predominant in
Mediterranean
African and asian ancestry
Thalassemia first describe by
Cooley and lee (1925)
Type of thalassemia
Alpha and beta thalassemia
Hemoglobin lepore
Type of thalassemia
Alpha and beta thalassemia
Hemoglobin lepore
most severe form
and transfusion
dependent anemia
Thalassemia major/cooley’s anemia
more severe
anemia than minor
B-thalassemia but
do not require
regular transfusion
Intermediate beta thalassemia/ thalassemia intermedia
results when one of
the 2 genes that
produce beta globin
is defective
Thalassemia minor/ cooley’s trait
thalassemia with increased levels of fetal hemoglobin
Hemoglobin persistence Of hemoglobin F
a rare class of thalassemia caused by crossing over of beta
and delta genes
Hemoglobin lepore
is a double heterozygous abnormality and the abnormal genes for Hb S and thalassemia are co-
inherited
Hemoglobin S- thalassemia
β thalassemia with inherited Hb C
Hemoglobin C- thalassemia
co-inherited of Hemoglobin E and β thalassemia that results
to a marked reduction of β chain production.
Hemoglobin E- thalassemia
LABORATORY FINDINGS OF THALASSEMIA
Complete blood count
Mass spectrometry
Electrophoresis
Supravital stain
disorder in the DNA synthesis of RBC
Megaloblastic anemia
Type of megaloblastic:
Pernicious anemia
Folic acid deficiency
This test will determine or distinguish whether the problem is
impaired absorption or malabsorption of B12 from other causes.
Schilling test
Pernicious vitamin that effects
Vitamin B 12
Treatment of megaloblstic anemia
Vitamin therapy and supplement therapy
Laboratory Findings of Megaloblastic Anemia:
Complete blood count
Peripheral smear
Decrease reticulocyte count
anemia caused by conditions such as alcoholism and chronic liver disease
Non-Megaloblastic anemia
characterized by premature RBC destruction caused by
autoantibodies that bind the RBC surface.
Autoimmune hemolytic anemia
characterized by premature RBC destruction caused by
autoantibodies that bind the RBC surface.
Autoimmune hemolytic anemia
Types of Autoimmune Hemolytic Anemia
Warm reactive autoimmune hemolytic anemia
Cold reactive autoimmune hemolytic anemia
Paroxysmal cold hemoglobinuria
Drug-Induced Immune Hemolytic Anemia: drugs involved in
Penicillin
Stibophen
Alpha methyldopa
usually occurs in newborns following the transplacental passage
of maternal anti-fetal red cells antibody.
Alloimmune hemolytic anemia
Alloimunne hemolytic anemia causes
Erythroblastosis fetalis
Isoimmune hemolytic disease of newborn
Alloimunne hemolytic anemia causes
Erythroblastosis fetalis
Isoimmune hemolytic disease of newborn
self-limiting, but severe even fatal following the administration of
drug that can cause immune hemolytic anemia
Drug induced immune hemolytic anemia
