Anemia Part 1 Flashcards
1
Q
define anemia
A
reduction in amount of circulating Hb, in total number of RBCs , or circulating RBC mass
2
Q
how does the bone marrow compensate for acute anemia
A
3x increase in RBC production
3
Q
how does the bone marrow compensate for chronic hemolytic anemia
A
up to o 6x - 8x RBC production
4
Q
what happens when bone marrow cannot compensate for blood loss
A
anemia
5
Q
what is a result of anemia
A
tissue hypoxia
6
Q
what are some clinical symptoms of hypoxia from anemia
A
pallor dyspnea angina kiolonychia ( spoon nails) esophageal webs pica ( craving for dirt)
7
Q
what organ compensates due to blood loss? consequences
A
heart
- heart murmurs
- congestive heart failure
8
Q
what does CBC measure
A
hemablgobin
hematorcrit
RBC indices
WBC
9
Q
what volumes compose the average adult volume
A
3 liters of plasma
2 liters of blood cells
10
Q
MCV
A
mean corpuscular volume
size of RBC
11
Q
What is normal MCV
A
8-100
12
Q
MCH
A
mean corpuscular hemoglobin
average amount/MASS of Hb in RBC
13
Q
hematorcirt
A
ratio of volume RBC/ total volume of blood
14
Q
RDW
A
red cell distribution width
15
Q
anisocytosis
A
highe RDW
16
Q
reticulocyte
A
young RBC with residual rRNA
17
Q
how do reticulocytes stain
A
polychromasia, bluish cytoplasm
18
Q
how is reticulocytes increased
A
EPO
increase bone funciton
19
Q
Anemia is a sign for what
A
underlying disease, not a diagnosis itself
20
Q
hemorrhage
A
depletion of RBC
21
Q
hemolysis
A
excess destruction of RBC
22
Q
what is the most common classification of anemia
A
microcytic hypochromic
iron deficiency
23
Q
Iron Deficiency anemia have what lab results
A
decreased MCV, MCH, MCHC
increase RDW
24
Q
normocytic , normochromic anemia lab results
A
normal MCV, MCH, MCHC
25
what deficiencies cause macrocytic anemia
vitamin B12 and folate
26
lab results for marcocytic anemia
Increased MCV
| variable MCH and MCHC
27
what are blood smear characteristics for iron deficiency anemia
hypochromic, microcytic anisoppoikilocytic ( size and shape variable)
28
what is the major cause of microcytic anemia
iron deficiency anemia
29
thrombocytosis
high platelet levels
30
what is the mechanism of excretion for iron
no natural mechanism
31
what delivers iron to cells in blood vessels, duodenum
transferrin
32
what binds iron, absorbs iron-laden transferrin at cell surface
transferrin receptor
33
what binds iron for storage
ferritin
34
how many grams of total body iron
2-4 grams
35
how much of our iron diet is absorbed
10%
36
what are 3 main causes of iron deficiency in anemia
nutritional deficient
malabsorption
blood loss
states that cause increase iron uptake
37
older men and post-menopausal women, if they have Fe deficiency anemia, what is their likely cause
occult gastrointestinal bleeding,
| colon cancers
38
absorption of iron occurs where
duodenum
39
what lines the villi of the duodenum
enterocytes
40
enterocytes transport iron across cell membrane into blood via
ferroprotin
41
how are infants iron deficient
mother's milk low in iron
42
what form of iron is more readily absorbed
Fe2+
43
what parasite can cause iron defiency
hookworm
necator americanus
ancylostoma duodenale
44
when does the body demand an increase of iron uptake
infancy
adolescence
pregnancy
lactation
45
serum iron
measure of iron in blood
46
total iron-binding capacity (TIBC)
measure of transferrin in blood
47
serum ferritin
reflects iron stores in macrophages and liver
48
serum levels in iron deficiency anemia
low
49
TIBC levels in iron deficiency anemia
high
50
how is transferrin saturation calculated
[Fe]/ [TIBC}
51
what is the treatment for iron deficiency anemia
iron supplements
52
what is the most common anemia in hospitalized patients
anemia of chronic disease
53
what is the peripheral blood for chronic desease
normocytic
| monochromic
54
what happens to the half life of RBC for anemia of chronic disease
shortened
55
what happens to iron in anemia of chronic disease
hepcidin sequesters iron in body/phagocytes
56
what happens to the bon marrow in anemia of chronic disease
suppression of bone marrow
57
serum iron in anemia of chronic disease
low
58
serum ferritin in anemia of chronic disease
high
59
transferrin and transferrin saturtion levels in chronic disease
low
60
name chronic diseases associated with anemia
renal failure
diabetes mellitus
liver disease
alcoholism
61
what are the 2 most common causes of megaloblastic anemias
vitamin B12 and folate deficiency
62
what is the CBC report for megaloblastic anemia
pancytpenia ( decrease WBC, RBC, platelet)
63
what does the peripheral smear for megaloblastic anemia
hypersegmented neutrophils
mactocytic
anisopoikilocytosis
macro-ovalocytes
64
what are some clinical signs and symptoms for B12 deficiency
atrophic glossitis: smooth beefy red toungue
neurological defects: demyelination
gastric gland atrophy
65
pernicious anemia is the common cause of what
malabsorption
66
what can cause deficient anemia
GI surgery, disease
67
what type of diet puts you at risk for pernicious anemia
vegans
68
when does the body demand B12
pregnancy
disseminated cancer
hyperthroidism
69
what causes pernicious anemia
absent intrinsic factor
70
explain the autoimmunity aspect of pernicious anemia
autoantibodies in serum either block binding of B12 to IF (type I) or block binding B12-IF complex ( Type II)
71
what autoimmune diseases are associated with pernicious anemia
hashimoto's thyroiditis
adrenalitis
grave's diseae
72
what causes a folate deficiency
dietary insufficiency
73
what is an important negative finding in folate deficiency
negative methylmalonic acid ( no neurological defects)
74
what is the drawback of folate treatment
partially corrects vitamin B12 deficiency, but does not affect neurologic deficits
75
what is the vitamin B12 treatment
intramuscular injections
76
what happens when only stage I of schilling test is abnomral
pernicious anemia, no IF available
77
what happens when stage I and stage II of schilling test are abnormal
malabsorption of vitamin B12 and IF in the small intestine
78
what are other causes of macrocytic anemia besides vitamin B12 and folate deficiency
alcoholism
hypothyroidism
liver disease
79
aplastic anemia
damage to hematopoietic stem cell, underproducing
80
in aplastic anemia what happens to the bone marrow
turns into fat
81
what does the peripheral blood smear look like in aplastic anemia
pancytopenia
normocytic, normochromic anemia
no reticulocytosis
82
what is the biopsy of the bone marrow for aplastic anemia
dry tap
83
what is the clinical presentation for aplastic anemia
prone to infections, bleeding
| no splenomegaly and lymphadenopathy
84
what are acquired causes of aplastic anemia
```
chemicals, toxins, drugs
Chloramphenicol
radiation
viral infection
SLE
half are idiopathic
```
85
what is the hereditary aplastic anemia
Fanconi's anemia
86
what happens in Fanconi's anemia
defect in DNA mechanism = chromosomal instability
87
Clinical presenation for Fanconi's anemia
bilateral thumb hypoplasia
| chromosome breakage
88
what is the treatment for Fanconi's anemia
immunosuppression
| bone marrow transplantation
89
what is the peripheral blood smear for pure red cell aplasia
normocytic
| no reticulocytosis
90
pure red cell aplasia is an autoimmune disease mediated by
T-lymphs or IgG antibody vs. red cell precruors
91
pure red cell aplasia is associated with other diseases
thymomas
CLL
SLE
92
what is the primary form of pure red cell aplasia
Diamond-Blackfan syndrome
93
what is Diamond Blackfan syndrome
severe anemia during first year of life
94
what is the secondary form of pure red cell aplasia
parvovirus B19
rheumatic disease
medications
95
what is the treatment for pure red cell aplasia
stop drugs
thymoma resection
high dose IV IG
immunosuppression
96
lead poisoning can cause
sideroblasts
97
what happens in siderblastic anemias
failure to incorporate heme into protoporphyrin to form hemoglobin
- defective utilization of iron within mitochondria of RBC
98
serum iron, ferritin, transferrin saturation levels in sideroblastic anemia
high in all
99
how is the herediatory for of siderblastic anemia gotten
X-linked recessive
| - amino-levulonic acid synthase (ALA synthase) defect
100
how is acquired siderblastic anemia gotten
drugs
LEAD
copper deficient
101
what is the treatment for sideroblastic anemia
pyridoxine ( vitamin B6)
