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PCM III final exam > anemia patient > Flashcards

anemia patient Flashcards

1
Q

Anemia Definition

A

a decrease in blood red cell mass or hemoglobin which results in a decreased oxygen-carrying capacity; it is not a disease

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2
Q

Anemia is a laboratory measurement indicating the red cell mass measurement (Hgb or Hct) in a patient is:

A
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3
Q

Three reasons to be anemic:

A
  1. Blood loss
  2. Increased destruction (hemolysis)
  3. Decreased RBC production
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4
Q

Three categories of MCV?

A
  1. Microcytic
  2. Normocytic
  3. Macrocytic
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5
Q

What is MCHC relevant for?

A

chromaticity

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6
Q

Most Common Forms of Macrocytic Anemia (3)

A
  • Ethanol abuse
  • Folate Deficiency
  • Vit B12 Deficiency
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7
Q

Reticulocytes are _____than mature red blood cells and circulate for _____ before all remnants of the ribosomal-endoplasmic structures are _____. Reticulocytes represent _____ of the red cell population

A

20-30% larger …. 2-3 days…..extruded……~2%

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8
Q

What is MCHC?

A

Mean Cell HgB - average HgB concentration in a volume of red cells; Surrogate measure of HgB concentration within an average sized red cell

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9
Q

Reticulocyte Ref range for adults and ped’s.

A

A: 0.5 -1.5%
P: 3.0-7.0%

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10
Q

Chromic” designations are coupled with ____ as a second important quantitative measure of individual red cells in anemia.

A

size (ex. hypochromic)

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11
Q

Reticulocyte: The remnant _____ stains blue with _____.

A

Ribosomal RNA reticulum…..Methylene Blue

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12
Q

The _____ allows detection and measurement of reticulocytes as a distinct population.

A

residual RNA

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13
Q

Reticulocyte levels provide a measure of _______.

A

the rate of production and release of red cells by the marrow into the peripheral blood.

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14
Q

______ occurs ____after an episode of acute hemorrhage and the Retic count will peak in ____.

A

reticulocytosis…3-4 days….6-10 days

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15
Q

At peak reticulocytosis, the relative concentration of reticulocytes may increase ___fold with reticulocyte count increased to ___.

A

4 to 6 ….6 - 8%

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16
Q

Common Causes of Reticulocytosis

A
  • Acute blood loss or hemorrhage
  • Acute hemolysis
  • Hemolytic anemia
  • Response to therapy (Fe or other nutritional correction of deficiency)
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17
Q

Common Causes

Microcytic Anemia

A
  1. Iron Deficiency
  2. Impairment Globin Synthesis
  3. Decreased/Abnormal Synthesis Protopoporphyrin-Heme
  4. Abnormal Hemoglobin
18
Q

Common Causes
Microcytic Anemia;
Types of Iron Deficiency Anemia

A
  1. Iron Deficiency Anemia

2. Anemia of Chronic Disease

19
Q

Common Causes
Microcytic Anemia:
Types of Impairment Globin Synthesis

A

Alpha Thalassemia and Beta Thalassemia

20
Q

Common Causes
Microcytic Anemia:
Types of
Decreased/Abnormal Synthesis Protopoporphyrin-Heme

A
  1. Lead Intoxication anemia

2. Sideroblastic anemia

21
Q

Common Causes
Microcytic Anemia:
Types of Abnormal Hemoglobin

A

Hemoglobin C Disease

22
Q

MVC value for Microcytic anemia

A
23
Q

Serum Values in Iron Deficiency Anemia: Ferritin, TIBC, Serum Iron, Soluble Transferrin Receptor (sTfR)

A

Ferritin: low
TIBC: high
Serum Iron: low
sTfR: high

24
Q

Serum Values in Anemia of Chronic Disease: Ferritin, TIBC, Serum Iron, Soluble Transferrin Receptor (sTfR)

A

Ferritin: high
TIBC: low
Serum Iron: low
sTfR: normal

25
Q

Serum Values in Sideroblastic Anemia: Ferritin, TIBC, Serum Iron, Soluble Transferrin Receptor (sTfR)

A

Ferritin: high
TIBC: low
Serum Iron: high
sTfR: low

26
Q

Laboratory Approach to Diagnosis of Hypochromic, Microcytic

A
  1. Hemoglobin electrophoresis –> Hemoglobinopathies: thalassemias, hgb S, C
  2. Lead level
  3. Prussian blue Fe stain for ring sideroblasts in marrow
27
Q

MCV value for Normocytic Anemia

A

80-100

28
Q 
Common Causes
Normocytic Anemia (7)
A
  1. Acute Blood Loss
  2. Autoimmune Hemolytic
  3. Anemia of Chronic Disease
  4. Anemia of Chronic Renal Failure
  5. Bone Marrow Failure
  6. Sickle Cell Anemia
29
Q

Common Causes

Normocytic Anemia: Anemia of Chronic Disease types

A
  1. Infection
  2. Inflammation
  3. Malignancy
30
Q

Common Causes

Normocytic Anemia: Bone Marrow Failure Types

A
  1. Aplastic Anemia

2. Marrow Replacement - fibrosis/malignancy

31
Q

Hemolytic Anemias lab Values: Reticulocytes and RDW

A

both high

32
Q

Hemolytic Anemias lab Values: Haptoglobin

A

low

33
Q

Hemolytic Anemias lab Values: Coombs test

A

Positive

34
Q

Hemolytic Anemias lab Values: Hemoglobin electrophoresis

A 
Hgb A2 and F (Thalassemia)
Hgb S (Sickle Cell)
35
Q

Hemolytic Anemias lab Values: Bilirubin

A

elevated total and unconjugated

36
Q

Hemolytic Anemias lab Values: Peripheral smear

A

Fragmented RBCs, spherocytes, elliptocytes, nRBCs, dacrocytes

37
Q

Macrocytic MVC value

A

> 100

38
Q

Common Causes*

Macrocytic Anemia

A
  1. vitamin b12 deficiency

2. folic acid deficiency

39
Q

vitamin b12 deficiency causes

A
  1. Decreased Intake - Inadequate diet, vegetarian
  2. Impaired Absorption - Intrinsic factor deficiency (Pernicious anemia, Gastrectomy, Malabsorption, Ileal resection)
40
Q

folic acid deficiency causes

A
  1. Decreased Intake - dietary deficiency, ethanol abuse
  2. Impaired Absorption: - malabsorption
  3. Increased Loss - hemodialysis
  4. Increased Requirement - pregnancy, greatly increased hematopoiesis
  5. Impaired Utilization - folic acid antagonists, metabolic inhibitors DNA synthesis & folate metabolism- methotrexate
41
Q

Laboratory Approach to Diagnosis Macrocytic (Megaloblastic) anemia

A
  • Reticulocytes
  • Peripheral smear
  • B12/Folate level

PCM III final exam (7 decks)

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