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Step 1 Clues > Anemias > Flashcards

Anemias Flashcards

1
Q

02 content=

A

Sa02(bound) + p02(dissolved_

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2
Q

Chronic Hypoxia

A

high erythropoietin production (kidney parenchyma)
increase mito density
angiogenesis (digital clubbing)

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3
Q

2 approches to anemia

A

inadequate production (reticulocytes high in serum)
excessive destruction

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4
Q

cyanosis

A

02 not getting to tissue(deoxyhemoglobin 5g of Hg)

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5
Q

Hypo-proliferative bone marrow problem

A

low reticulocyte count

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6
Q

how does Renal failure affect anemia

A

dec erythropoietin
treat with: Procrit, Epogen, Darbepoetin

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7
Q

Hypothyroidism: erythropoietin
can’t work, treat with

A

levothyroxine

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8
Q

mcc is infection: parvo b19, mcc: drugs, chemicals, chemo: chloramphenicol, Benzene, AZT, Vinblastine

A

aplastic anemia

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9
Q

Fanconi anemia

A

pure RBC aplasia, hereditary or 2nd to thymoma

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10
Q

Diamond blackfen syndrome

A

RBC aplasia + finger abnormalities like triphalangeal thumb

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11
Q

high retic count

A

destruction leading to bone marrow creating more

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12
Q

Mcc of high retic count

A

extravascular hemolytic anemia

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13
Q

intravascular hemolytic anemia

A

vasculitis: schistocytes, Burr cells, Helmet cells, dec haptoglobin (protein that binds free Hb)

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14
Q

extravascular hemolytic anemia sign

A

splenomegaly & jaundice

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15
Q

diseases causing extravascular hemolytic anemia

A

Hereditary spherocytosis
G6PD
sickle cell anemia
hemoglobin c disease (lysine for glutamate)
pyruvate kinase def

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16
Q

osmotic fragility test, defective spectrin/ankyrin, AD

A

hereditary spherocytosis

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17
Q

Coombs test

A

test antibodies that attack RBC: directly on the RBC surface or in the plasma

18
Q

pos direct Coombs test:

A

autoimmune Hemolytic anemia: IgG warm, IgM cold

19
Q

drugs causing H.Anemia

A

penicillins
cephalosporins
sulfa drugs
alpha-methyldopa
PTU
antimalarials
Dapsone

20
Q

Lupus causing drugs

A

Ethusuximide
Isoniazid.
Hydralazine.
Procainamide.
Tumor-necrosis factor (TNF) alpha inhibitors (such as etanercept, infliximab and adalimumab)
Minocycline.
Quinidine
Pennicillamide
Phenytoin

21
Q

Howell jolly bodies.. think

A

hemolytic anemia and splenectomy

22
Q

schistocytes …think

A

vasculitis

23
Q

Target cell …think

A

iron def anemia or thalassemia

24
Q

Hienz body….think

A

G6PD

25
Q

Basophilic stippling…think

A

lead poisoning

26
Q

example of non-immune hemolytic anemia

A

G6PD
malaria
MAHA: MicroAngiopathic Hemolytic Anemia
PNH: paroxysmal Nocturnal Hemoglobin

27
Q

CBC with differential

A

MCV
MCH
MCHC=MCH/MCV=concentration of MCH

28
Q

Microcytic Hypochromic

A

Impaired Hg production
low retic count
low MCV or low MCH

29
Q

mcc micro. hypochromic

A

Fe def: Rx: Ferrous iron with Vit C
fe &ferritin low, Transferrin(TIBC) high

30
Q

late chronic disease : any dz lasting over 3 weeks affect Bone marrow

A

low Fe, low TIBC
RBC dies 60-90 day instead of 140 days

31
Q

lead poisoning

A

Blocks Delta ALA dehydrate and Ferrochetolase
basophil stippling
high free erythrocyte protoporphyrin

32
Q

Hemoglobinopathies

A

Thalassemia:
Alpha
Beta

Hemoglobin S
SCD glu to Val on position 6 beta chain
SCD trait

33
Q

Sideroblastic anemia: cells, inheritance,test

A

hereditary
macrophages holding on to iron
Prussian blue stain

34
Q

hereditary spherocytoisis

A

low mcv, high MCHC, high Retic count, hight bill, hyperkalemia

35
Q

high MCV with defective nuclear division

A

Macrocytic anemia

36
Q

B12 def mcc, enzymes

A

mcc type A Gastritis(pernicious Anemia)
enzymes: Malonyl-CoA mutase
Homocysteine Methyl transferase

37
Q

how does anti-convulsive drug cause macrocytic anemia

A

they block Ca(needed for microtubules)
block folate (B9)
block sodium

38
Q

Anti-convulsive drugs
phenytoin
Ethosuximide
Valproic acid
carbamazepine

A

Blocks
Ca and folate
Ca
Na, Ca, folate
Na and Ca

39
Q

Glycosyl-phosphatidylinositol (GPI) missing on RBC, complement tag for destruction

A

Paroxysmal nocturnal Hg
pt may present with usual clot due to thrombosis
may die of MI and stroke

40
Q

Dx. PNH

A

flow cytometry to detect CD55 and CD59

Block C5 with
Eculizumab
mepolizumab
Reslizumab
Benralizumab

Step 1 Clues (27 decks)

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