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Final Exam > Anemias > Flashcards

Anemias Flashcards

1
Q

MCV < 82

N or Increased ferritin

N or Increased SI

N or Decreased TIBC

Decreased production of globin chains, but normal structure, that leads to an imbalance

What type of anemia?

A

Hereditary Thalassemia

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2
Q

Microcytic/Hypochromic

Decreased Hgb production

Increased ferritin and SI

Decreased TIBC, Retics, Hgb, RBCs.

Due to a block in the protoporphyrin ring pathway leading to Iron overload.

Mild-Severe anemia

Basophilic Stippling & PHBs

What anemia am I?

A

Sideroblastic Anemia

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3
Q

N or Increased Iron stores

Decreased SI and TIBC

Blood shows mild microcytic or normocytic anemia.

Due to having storage iron, but can’t release it for Hgb or RBC production.

Seen in malignant disease and RA.

What anemia am I?

A

Anemia of Chronic disease (ACD)

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4
Q

Homozygous

Slightly decreased Hgb

N to increased RBCs

No NRBCs

Micro/hypo RBCs

Target cells

Possible ovalocytes

Basophilic Stippling

No PHBs

NORMAL IRON TESTS

Increased A2 on electrophoresis

A

Beta Thala minor

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5
Q

Heterozygous

Slightly decreased Hgb

Mild in most cases

Basophilic stippling

Targets

Normal Hgb electrophoresis

Bart’s blood in cord.

Due to a deletion of 1-2 alpha genes.

What am I?

A

Alpha Thala minor/trait

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6
Q

Homozygous

DECREASED Hgb and RBC

Severe diagnosis

Increased # of NRBCs

Aniso/Poik

Basophilic Stippling, HJBs, Schistos, PHBs.

Increased: ferritin, SI, bilirubin, and Hgb F

Decreased TIBC, OF test, and Hgb A.

BM hypercellular

Hepatosplenomegaly and splenectomy after 4 and transfusion dependence.

What am I?

A

Beta Thala major (Cooley’s)

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7
Q

Which type of SA has increased basophilic stippling?

A

Lead poisoning

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8
Q

How can you differentiate IDA based on cell morph?

A

No basophilic stippling or PHBs.

Normal electrophoresis, maybe a decrease in Hb A2.

Decreased Iron stores, usually the first thing effected.

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9
Q

Tests used in order to differentiate micro/hypo anemias?

A

Iron Studies

Hgb Electrophoresis

Basophilic Stippling

PHBs

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10
Q

Macrocytic RBCs (>98 MCV)

Normochromic

Mild-Severe anemia

Increased SI, bilirubin, and super increased LDH.

Decreased to N: RBCs, Hgb, Hct

Increased MCH

Normal MCHC

Megakaryocytes abnormal resulting in thrombocytopenia.

Oval macrocytes, HJBs, Cabot rings possible, Hyper-seg Neuts, Giant PLTs, Teardrops,

RBCs are fragile, causing increased LDH.

M:E Ratio decreased

A

Megaloblastic anemia

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11
Q

Types of megaloblastic anemia?

A

Vitamin B-12 deficiency

Folate Deficiency

Pernicious Anemia

B-12 & folate deficiency (together).

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12
Q

Tests to differentiate megaloblastic anemias in order?

A

Vitamin B-12 and Folate

Antibody Tests

Retic Count

Liver tests

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13
Q

What is the schilling test and what is it used to determine?

A

A test for vitamin b-12 deficiency.

Establishes the exact cause of the deficiency.

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14
Q

Steps in Schilling test?

A

B-12

MMA test

IF blocking antibody

Parietal Cell Antibody test

Gastrin Test

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15
Q

When to proceed to the next step in diagnosis of pernicious anemia?

A

B-12 ( <300pg/mL)
leads to

Methylmalonic Acid test
(> 0.4 umol/L) leads to

Intrinsic factor blocking antibody
(Positive- PA) Negative leads to

Parietal cell antibody test (Positive=PA) Negative leads to

Gastrin test (< 100 pg/mL not PA) ( > 100 pg/mL PA, indirect confirmation)

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16
Q

Malabsorption causes of B-12 deficiency?

A

Gastrectomy

Blind loop syndrome (bacteria use up)

H. pylori infections

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17
Q

Drugs that cause B-12 deficiency?

A

Alcohol

Nitrous Oxide

Antitubercular drugs

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18
Q

Increase need B-12 deficiency causes?

A

Pregnancy/Lactation

Growth

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19
Q

Malabsorption of folic acid causes?

A

Ileitis/Crohn’s

Blind loop syndrome

Gluten-sensitivity

Childhood celiac disease

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20
Q

Folic acid deficiency due to increased requirement?

A

Pregnancy

Infancy

Hematologic diseases (Sickle cell anemia).

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21
Q

Drugs that cause folate deficiency?

A

Methotrexate (Chemo)

Alcohol

Oral contraceptives

Long-term Anticoagulant drugs (block vitamin K), Antiseizure meds.

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22
Q

Megaloblastic anemia treatment?

A

Vitamin therapy for B-12 and folate deficiency.

Intramuscular injections for pernicious anemia.

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23
Q

No DNA synth impairment

Round macrocytes

No hyper-seg neuts

Leukos and PLTs normal

No jaundice, glossitis, or neuropathy

Due to: Chronic liver disease, Alcoholism, Stim erythropoiesis (newborns).

INCREASED Retics, including stress retics

What am I?

A

Non-megaloblastic Anemia

24
Q

Normocytic RBCs

Intrinsic

Increased retics

Abnormal RBC membrane or Hgb structure.

Deficient enzyme

Abnormal RBC destruction tests

A

Hereditary Hemolytic Anemia

25
Q

Membrane defects?

A

H Spherocytosis

HS post-splenectomy

H Ovalocytosis

H Stomatocytosis

H Acanthocytosis

26
Q

Increased permeability to Na W/ loss of membrane.

True macrocytic RBCs

MCHC > 36%

DAT ( - )

OF Increased

A

H Spherocytosis

27
Q

Spherocytes

MCHC > 36%

HJBs, PHBs, Hgb rises

Increased PLTs

A

HS Post-Splenectomy

28
Q

> 25% of ovalocytes have polarized cholesterol on the ends.

Normal OF test

A

H Ovalocytosis

29
Q

Altered membrane lipids

Abetalipoproteinemia

Normal OF test

Many spur cells

A

H Acanthocytosis

30
Q

Hemoglobin Defects?

A

Hgb SS Disease

Hgb SA trait

Hgb SC disease

Hgb CC disease

Hgb CA trait

31
Q

What is the membrane defect in Hgb?

A

Amino acid substitution of valine

32
Q

Hemoglobin Defect W/:

Mild anemia

Targets, C-crystals

Decreased OF

A

Hgb CC disease

33
Q

Hemoglobin Double heterozygous defect

Mod Anemia

Targets, SC crystals, occasional sickles and C crystals.

Decreased OF

A

Hgb SC disease

34
Q

Heterozygous Hgb defect

Not anemic

Targets, No C crystals

A

Hgb CA trait

35
Q

Involved in Vaso-occlusive disease

SCP ( + )

Severe Anemia

NRBCs, targets, sickle cells, HJBs, PHBs, basophilic stippling

Decreased OF

Hypercellular BM

Decreased M:E

A

Hgb SS disease

36
Q

Heterozygous

No anemia

Targets, no sickles

SCP (+)

Hgb defect

A

Hgb SA trait

37
Q

HMP Pathway defect

Decreased NADPH

HBs, Schistos, Spheros

X-linked

A

G6PD deficiency

38
Q

EMB pathway defect

Decreased ATP

Anemia W/ echinocytes

A

Pk deficiency

39
Q

Extrinsic defects

Increased retics

Abnormal RBC destruction tests

Reduced RBC Lifespan

A

Acquired Hemolytic Anemia

40
Q

Causes of acquired hemolytic anemia?

A

Antibodies

Trauma (Mechanical, Microangiopathic)

Infectious or physical agents

41
Q

Antibody defect

Unknown 1st cause

CLL or drugs 2nd cause

Spheros

MCHC > 36%

DAT (+)

Increased OF test

Warm Autoantibodies

A

Warm Auto-Immune Hemolytic Anemia (WAIHA)

42
Q

Unknown 1st cause

2nd cause due to mycoplasma RBC agglutination

Raynaud’s

Cold Autoantibodies

A

Cold Auto-Immune Hemolytic Anemia (CAIHA)

43
Q

Severe Anemia

INCREASED NRBCs and Bilirubin

A

HDN-Rh

44
Q

Not anemic

Spheros

Increased Bilirubin

A

HDN-ABO

45
Q

Mechanical-Valves Schistocytes

MAHAs-DIC/HUS-Schistocytes

Marked Hemoglobinuria- Schistocytes

A

Trauma caused Hemolytic Anemia

46
Q

Schistocytes and Spherocytes

Infectious toxin in Hemolytic Anemia

A

Clostridia toxins

47
Q

Infectious Agent in Hemolytic Anemia

Schistocytes

Spherocytes

Parasitic

A

Malarial parasites

48
Q

A physical agent, causing schistocytes and spherocytes in hemolytic anemia?

A

Thermal burns

49
Q

Pancytopenia or imparied cell production anemia

Decreased retics

Normal RBC destruction test

A

BM failure Hemolytic Anemia

50
Q

BM failure HA

Immature neuts

NRBCs

Leukoerythroblastic picture

A

BM transplant

51
Q

Marrow injury

1st cause is idiopathic

2nd cause Benezene, RADs, viral, chloramphenicol, pesticides.

Congenital- Fanconi’s

Blood: Pancytopenia, No polychromasia or NRBCs

Normal bilirubin

Hypocellular BM

Increased Fat and decreased cells

A

Aplastic Anemia

52
Q

Aplastic anemia has what ratio in the BM?

A

3:1

53
Q

What is not used in aplastic anemia?

A

Iron

54
Q

Tests to differentiate Hemolytic Anemias in order?

A

Retic Count

RBC destruction tests (Bilirubin, LD, etc).

OF test, Hgb electrophoresis and/or DAT

BM Exam

55
Q
A

Final Exam (27 decks)

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