Anemias Flashcards
Function of the B lymphocytes?
Humoral immunity
Function of the T lymphocytes?
Cellular mediated immunity
What are the levels of EPO in P.vera?
Low
What happends to the production of reticulocytes in case of anemia?
Increases (good bone marrow response)
What is the normal level of reticulocytes?
< 3%
What is the name of the phenomenon of RBC that have different in size?
Anisocytosis
What type of anemia we have with Iron deficiency anemia?
Microcytic anemia
What type of anemia we have with vitamin B12 deficiency?
MACROcytic anemia
Is the RDW affected in Thalassemia?
No
1st definition for anemia?
Decreased O2 carrying capacity of the blood
2nd definition of anemia?
Decreased total RBC mass
3rd definition of anemia?
Decreased Hgb, HCT, or RBC concentration
Are S02 and PaO2 affected in anemia?
No, the lungs still work, it has no effect
Will the oxygen content be affected in anemia?
Yes, because of the decreased Hb concentration
Clinical signs of Anemia?
Tired and pale, pale and tired.
Dyspnea
Dizziness
Flow murmer (Because of low viscosity in the blood)
the other murmer is ORGANIC (not related)
Heme is made of?
Iron + Protoporphyrin
What is the difference between anemia of chronic disease and Iron deficiency anemia?
in anemia of chronic disease you have iron but can not use
In the second one you don’t have Iron
Fe 2+ carry ________
O2
what is the MCC of anemia worlwide?
Iron deficiency
Nail manifestation of Iron deficiency anemia?
Koilonychia
Iron deficiency effect on the urine?
Beeturia
Can i rely on Ferritin for labs in anemia if i have an ongoing inflammation?
No (Ferritin is an acute phase reactant)
Treatment for iron deficiency anemia?
- Oral ferrous sulfate
- IM or IV Iron
What is the other name of “Anemia of chronic disease”?
Anemia of chronic inflammation
What is the defect in Sideroblastic anemia?
Protoporphyrin synthesis
Causes for sideroblastic anemia?
B6 deficiency
Alcoholism
What do we see in the labs of sideroblastic anemia?
High Iron
Ringed sideroblasts in the bone marrow
What treatment can help sideroblastic anemia?
Supplement of B6
Macrocytic anemia is divided into two types ;
- Megaloblastic
- Non-megaloblastic
How does Megaloblastic anemia differs from Non-megaloblastic ?
Megaloblastic has hypersegmented Neutrophils
causes for the megaloblastic anemia ?
Folate def
B12 def
What are the causes for Non-megaloblastic anemia ?
Liver disease
Drugs
Alcohol
By definition, what is the MCV of macrocytic anemia?
>100
Does RNA synthesis and protein synthesis affected in Macrocytic anemia?
No (But DNA synthesis does!!!)
What is the most common neurological sequlae in B12 deficiency?
Peripheral neuritis
which one, B12 def, or Folate def has neurological symptoms?
B12 def
What is the mcc for Non-megaloblastic anemia?
Alcoholism
3 main reasons for normocytic anemia?
Acute blood loss
Underproduction
Hemolysis
In what stage of CKD anemia will begin?
Stage 3 of CKD
Causes of anemia in CKD?
Relative EPO deficiency
Chronic inflammation
What type of anemia is Hereditary Shperocytosis?
Hemolytic anemia
3 important signs for Hereditary spherocytosis?
- Jaundice
- Splenomegaly
- Dark stones in gallbladder
what proteins have defect in Hereditary spherocytosis?
Spectrin
Ankyrin
Band 3
What is the defect in sickle cell anemia?
Defect in the beta globin chains
what is the type of mutation present in sickle cell disease?
Non-consverative Missence point mutation (Glutamine substituted by Valine)
What happends to HbS in sickle cell anemia when it is deoxygenated?
HbS polymerizes, causing deformation of erythrocytes (“sickling”)
Heinz bodies are typical of ?
G6PD deficiency
Which antibody is involved in warm AIHA?
IgG
Warm weather is Great
Which antibody is involved in cold AIHA?
IgM
Cold ice cream is yuMMy
What type of hemolysis we have in AIHA warm autoantibodies ?
Extravascular
Autoimmune hemolysis TRIAD ?
- Rapid drop of Hb
- Jaundice
- Splenomegaly
what is the gold standard test for AIHA with warm aotoantibodies?
Direct coomb’s test
What type of hemolysis do we have in cold AIHA?
Intravascular
What agents can cause cold agglutinin syndrome?
Mycoplasma pneumoniae or EBV infection
What triggers the Cold agglutinin hemolytic anemia?
low body temperature and/or cold ambient temperatures
Most important sign of Cold agglutinin hemolytic anemia?
Painful cyanosis of the extremities (acrocyanosis)
What is a positive test for direct coombs test for Cold agglutinin hemolytic anemia?
DAT positive for C3d
In which AIHA (hot/cold) do we see spherocytes?
Spherocytes may be seen in both cold AIHA and warm AIHA.
However, abundant spherocytosis is characteristic of warm AIHA.
Long term therapy for Cold agglutinin hemolytic anemia?
rituximab (anti-CD20 antibody)
Do we recommend splenectomy for cold agglutinin hemolytic anemia?
Splenectomy is not recommended for cold AIHA.
It is not effective as most extravascular hemolysis occurs in the liver
