Anemias

Question 1

storage form of iron

Answer 1

ferritin

Question 2

iron transport

Answer 2

transferrin

measured by total iron binding capacity

Question 3

what are the examples of Microcytic anemia

Answer 3

iron deficiency
thalassemia
anemia of chronic disease 
sideroblastic anemia 
lead poisoning

Question 4

what are some causes of iron deficiency

Answer 4

dietary
decreased absorption
-gastrectomy- due to decreased acid which is needed for ferrous absorption

-chronic blood loss (menses or carcinoma, parasite)

Question 5

why might ferritin still be elevated in a microcytic anemia

Answer 5

b/c it is an acute phase reactant so it could be elevated if the anemia is microcytic due to anemia of inflammation
whereas it would be lower in a pure iron deficiency

Question 6

what lab findings are present with iron deficiency anemia

Answer 6

microcytic

decreased ferritin
decreased serum iron
increased TIBC
decreased MCV (microcytic)
decreased MCHC (hypochromic) 
high RDW - b/c with each round of new blood cells, they are smaller and smaller so there will be variation

Question 7

hepcidin

Answer 7

produced by the liver–> prevents the release of iron stores, trapping it in bone marrow macrophages

Question 8

anemia of chronic disease lab findings

Answer 8

microcytic anemia
decreased serum iron
decreased TIBC

iron is trapped in bone marrow macrophages

increased serum ferritin

hepcidin is most likely elevated in chronic inflammatory process–> prevents release of iron

Question 9

alpha thalassemia

Answer 9

decreased alpha globin chains

excess in beta chains

Question 10

beta thalassemia

Answer 10

excess in alpha chains

decreased beta chains

Question 11

alpha thalassemia –> silent carrier state

Answer 11

one deletion in alpha

asymptomatic

Question 12

alpha thalassemia trait

Answer 12

2 deletions of alpha

Question 13

hemoglobin H disease

Answer 13

3 deletions of alpha (alpha thalassemia)

increased HbH which forms heinz bodies

Question 14

hydrops fetalis

Answer 14

has 4 alpha deletions (alpha thalassemia)

lethal in utero

Question 15

HbA

Answer 15

2 alpha

2 gamma

Question 16

Hb A2

Answer 16

2 alpha

2 delta

Question 17

HbF

Answer 17

2 alpha

2 gamma

Question 18

b thalassemia minor

Answer 18

one beta chain is damaged

asymptomatic

increased hemoglobin A2 and increased hemoglobin F

Question 19

B thalassemia major

Answer 19

normal at birth

symptoms develop at about 6 months as HbF starts to decling

severe hemolytic anemia results from decreased erythrocyte life span

intramedullary destruction –> ineffective erythropoiesis

hemolysis–> jaundice

“Chipmunk face”
Hair on end skull

microcytic/hypochromic anemia

Target cells

increased retic count

Question 20

sideroblastic anemia

Answer 20

adequate iron stores but cant incoporate the iron into hemoglobin

ring sideroblasts (accumulated iron in mitochondria of erythroblasts) in bone marrow

increased serum iron
increased serum ferritin

decreased TIBC

Question 21

what are some normocytic anemias

Answer 21

acute blood loss
hemolytic anemias
sickle cell
bone marrow aplasia/hypoplasia
renal insufficiency
myelofibrosis
myelodysplasia
anemia of inflammation

Question 22

what are some macrocytic anemias

Answer 22

Vit B12 deficiency
Folate deficiency
Treatment with drugs that interfere with DNA synthesis and cell division

Cancer chemo
Mylodysplasia
Hypothyroidism
Liver disease - alcoholism

Question 23

a protein present in blood serum that binds to and removes free hemoglobin from the bloodstream.

Answer 23

haptoglobin

Question 24

howell jolly bodies

Answer 24

autosplenectomy

due to sickle cell disease

Question 25

causes of megaloblastic anemia due to Vitamin B12 deficiency

Answer 25

usually seen in vegans
decreased absorption due to decreased intrinsic factor associated with gastrectomy or pernicious anemia
pancreatic insufficiency
intestinal malabsorption due to parasites

Crohn’s

Question 26

clinically how does a Vit B12 deficiency anemia present

Answer 26

weakness
beefy tongue
increased homocysteine

CNS effects–> (Diff than folate deficiency) –> demyelination of the posterior and lateral portion of the spinal cord

loss of vibration and position
spastic paralysis
arm and leg dystaxia