Anemias Flashcards

1
Q

Iron difficiency

A
Microcytic, hypochromic
Pregnancy, growth spurts, vegetarian
If over 50 with low iron, think colon CA
Bone marrow Fe stain is gold standard Dx
Chrons and ciliac can cause this
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

alpha thalassemia

A

Microcytic, hemolytic

Can get hemochromatosis (iron overload)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Beta thalassemia

A

Microcytic, hemolytic
Minor-Dx with a2delta2 band
Major- xray crewcut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sideroblastic anemia

A

Microcytic
X linked defect in ALAS
Treat with B6

Also ETOH and Pb (basophilic stipling) can cause it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pb poisoning

A

Can see lead lines, encephelopathy, abd pain, foot/wrist drop, and microcytic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Macrocytic with megaloblast

A

Hypersegmented neutrophil
Folate: low folate, high homocysteine, normal methylmalonic acid
Low RBC, WBC, and platelets

B12: low B12, high homocysteine, high methylmalonic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Low b12 causes

A

Poor nutrition/chrons/ileal resection
Pernicious anemia against parietal or intrinsic factor. Higher risk for gastric carcinoma
D. latum fish worm
Has neuro symptoms
Elevated homocysteine and methylmalonic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes Low folate

A

Alcoholism and malnutrition can cause this and methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nonmegaloblastic macrocytic anemia

A

Bleeding disorders, liver disease, alcoholism, reticulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Non-hemolytic normocytic anemia

A

Anemia of chronic disease
Aplastic anemia
Can also present as microcytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anemia of chronic disease

A

Inflamation–increased hepcidin—decreased macrophage and transferrin to release iron

Labs: low iron, low TIBC, High ferritin

If kidney: treat with EPO if low hematopoiesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Aplastic anemia

A

Pancytopenia—petechiae, bleeding, infection, neutropenia

Causes: radiation, viruses, fanconi, ideopathic following hepatitis

Tx: Eliminate cause, BMT, GM-CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Intravascular hemolysis

A

Low haptoglogin, high LDH, hemoglobinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Extravascular hemolysis

A

High LDH, high unconjugated bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Spherocytosis

A
RBC become spherical and weak
Splenomegaly (Howell jolly bodies if no spleen)
\+ Osmotic fragility test
Aplastic crisis (Parvo B19)
Increase RDW and MCHC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

G6PD

A

More common in African Americans
Low glutathione and NADPH so more oxidative stress
Get heinz bodies with precipitating factors:
Fava beans, sulfonamides, primaquine, anti TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sickle cell anemia

A

Can also show up as crew cut
Valine for glutamic acid
Aplastic crisis (Parvo B19), autosplenectomy, pain, renal papillary necrosis, avascular necrosis of hip, Salmonella osteomelitis

Tx: hydroxyurea (increases HbF)

18
Q

HbC defect

A

Lysine for glutamic acid. Like Sickle cell but not as bad

19
Q

Haptiglobin

A

Binds hemoglobin in the serum. If RBCs lysed, more binds to RBC and total in serum is decreased.

20
Q

B symptoms-

A

Worry about cancers

Fever, night sweats, or weight loss

21
Q

Jak2 mutation

A

Too much RBC, WBC, Platelets

Polycythemia vera

22
Q

Warm antibody

A
IgG
SLE, Lymphoma, CLL
Drug induced (PCN and Quinidine)
Use prednisone or anti CD20 Ab (rutiximab) 
Can do spleenectomy 

Confirm with direct coombs test

23
Q

CLL

A

Relisten to lecture around 40 minutes in

24
Q

Cold antibody

A

IgM
Mycoplasma infection, viral, CLL, Lymphoma
Tx: stay warm, treat problem, rituximab

25
Coombs test/Direct indirect
``` Testing Ab against RBCs Direct: Ab to RBC Test newborn Indirect: Ab in serum to R Test for mother ```
26
TTP
Negative direct coombs High LDH Plasma exchange Thrombocytopenia, microangiopathic hemolytic anemia, neuro, kidney failure, fever
27
Heinz body
Heinz bodies are formed by damage to the hemoglobin component molecules, usually through oxidant damage, or from an inherited mutation Liver disease, G6PDH, NADPH, a-thalla
28
Hypersegmented neutophils
B12, Folate, myodisplastic syndrome
29
Other causes of megoloblastic anemias
Drugs that impair DNA metabolism Metabolic disorders (orotic aciduria, lesch nyhan) Refractory megaloblastic anemia Di guglielmos syndrome
30
Causes of folic acid deficiency
Inhibitors of dihydrofolate reductase: methotrexate, pyrimethamine, triamterene, pentamidine, trimethoprim Alcohol Rare enzyme deficiencies: dihydrofolate reductase, others
31
Indirect/Unconjugated bilirubin
Hemolytic anemia
32
Direct/conjugated bilirubin
Biliary obstruction
33
Alpha thalassemia trait
Wont show up on hemoglobin electrophoresis
34
Sickle cell vaccines
Salmonela, S.aureus, H. flu, S. pneumo,, M. pneumo | Give 2 weeks before spleen removal
35
Target cell
``` HALT HbC Asplenia Liver disease Thalassemia ```
36
Schistocytes
DIC/TTP/HUS, trauma
37
Bite cell
G6PDH deficiency
38
Basophilic stippling
``` TAIL Thalassemia Anemia of chronic disease Iron difficiency Lead poisoing ```
39
Acanthocyte spur cell
Liver disease, abetalipoproteinemia
40
Heinz bodies
Denatured hb seen in a-thalassemia and G6PDH deficiency | leads to bite cells
41
Howell jolly bodies
Nuclear remnants found in asplenic patients