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Pathology > Anemias > Flashcards

Anemias Flashcards

1
Q

What is Plummer-Vinson syndrome?

A

Triad of:

  • iron-deficient anemia
  • esophageal webs
  • dysphagia (atrophic glossitis)
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2
Q

Lab findings in iron-deficient anemia:

A
  • low iron
  • low ferritin
  • high TIBC
  • high free erythrocyte protoporphyrin
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3
Q

Symptoms of iron deficient anemia:

A
  • conjunctival pallor
  • fatigue
  • spoon nails (koilonychia)
  • pica (eating non-food substances)
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4
Q

What is sideroblastic anemia caused by?

A

Defective protoporphyrin synthesis. Thus, the last step to produce heme cannot be completed.
–> Fe++ enters mitochondria and gets stuck because protoporphyrin unable to make heme

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5
Q

What are the histological findings for sideroblastic anemia?

A 
BONE MARROW SMEAR:
-Ringed sideroblasts
-iron-laiden, Prussian blue stained mitochondria
PERIPH SMEAR:
-basophilic stippling of RBCs
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6
Q

What are causes of sideroblastic anemia?

A

CONGENITAL:
-ALA synthase defect (X-linked)

ACQUIRED:

  • alcohol (mitochondrial poisoning)
  • lead poisoning (inhibits ferrochelatase)
  • Vit B6 deficiency (required as co-factor at beginning of heme synthesis)
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7
Q

What is anisocytosis?

A

Variance in size of RBC

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8
Q

What is poikilocytosis?

A

Variance in shape of RBC

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9
Q

What is anisopoikilocytosis?

A

Variance in size and shape of RBC

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10
Q

What is seen histologically with beta-thalassemia?

A
  • target RBCs
  • microcytic RBCs
  • hypochromic RBCs
  • increased anisopoikilocytosis
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11
Q

What does a lack of folate and vit B12 impair?

A

Synthesis of DNA precursors

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12
Q

What is megaloblastic anemia? Causes?

A

A type of macrocytic anemia (MC >100 fL) in which DNA synthesis is impaired.

  • folate deficiency
  • Vit B12 (cobalamine) deficiency
  • Orotic aciduria
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13
Q

What are causes of folate deficiency?

A
  • malnutrition (alcoholics)
  • malabsorption
  • drugs (methotrexate, trimethoprim, phenytoin)
  • increased requirement i.e. hemolytic anemia, pregnancy
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14
Q

What are clinical findings in Vit B12 deficiency?

A

Neurological symptoms:
- reversible dementia
-

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15
Q

Time progression of symptoms in Vit B12 deficiency vs folate deficiency, and why?

A

Vit B12 deficiency
- can take up to years to show symptoms because liver is able to store B12

Folate deficiency
-symptoms occur much earlier because there are not many large stores of folate present in the body

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16
Q

What is Schilling test used for?

A

Determine whether VitB12 deficiency is due to dietary insufficiency or malabsorption

17
Q

What causes non-megaloblastic anemia?

A

(Anemia where the DNA synthesis is not impaired)

  • alcoholism
  • liver disease
18
Q

Laboratory findings of folate deficiency?

A
  • low folate
  • high homocysteine
  • macrocytic RBCs
  • hypersegmented neutrophils
19
Q

What is the most common cause of Vit B12 deficiency?

A

Pernicious anemia

20
Q

What is pernicious anemia?

A

Autoimmune destruction of parietal cells –> leading to a deficiency in the production of intrinsic factor (IF) –> which leads to deficiency of Vit B12 as it cannot be absorbed without IF

21
Q

What can cause vit B12 deficiency?

A
  • pernicious anemia
  • Crohn’s disease –> damage to terminal ileum
    -pancreatic insufficiency
    (Intrinsic factor produced by parietal cells in stomach required for absorption of vit B12 in the ileum)
22
Q

Clinical/lab findings in Vit B12 deficiency?

A
  • macrocytic RBCs with hypersegmented neutrophils
  • glossitis
  • subcaute combined degeneration of spinal cord
  • neurological symptoms ( reversible dementia)
  • high serum homocysteine (increases risk for thrombosis)
23
Q

Clinical and lab findings of extravascular hemolysis in normocytic anemia?

A
  • splenomegaly
  • jaundice (from high unconjugated bilirubin)
  • risk for bilirubin gallstones
  • marrow hyperplasia
24
Q

Clinical and lab findings of intravascular hemolysis in normocytic anemia?

A
  • decreased serum haptoglobin
  • hemoglobinemia
  • hemoglobinuria
  • hemosiderinuria
  • urobilinogen in urine
  • schistocytes seen in blood smear
25
Q

What are Howell-Jolly bodies and which condition do we find them?

A

Nuclear remnants within RBCs.
Found in:
- sickle cell anemia
- hereditary spherocytosis

Pathology (13 decks)

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