Anemias GK Flashcards
2 types of microcytic anemia
iron def
thalassemias
causes of microcytic anemia
mestrual bleeding
GI blood loss
decreased Fe absorption (celiac, H pylori)
increased Fe requirement (preggo)
main sx of microcytic anemia
PICA
dx of microcytic anemia caused by Fe deficiency
MCV <80
Dec. MC.MCHC (hypocrhomic)
Increased RDW
Decreased Ferritin & serum Fe
Increased TIBC
bone marrow bx shows what in iron def anemia
absence of Fe stores (TF)
iron def anemia tx
ferrous sulfate until anemia corrected
how long do you continue ferrous sulfate post iron def anemia correction?
3-6 mos
what do you use Blood TF for in IDA? (iron def. anemia)
only use to replace Hgb
1 deletion of alpha in Thal
silent
2 alpha deletions Thalassemia
mild microcytic
3 alpha deletions Thal
hemolytic anemia (HgbH dz)
4 alpha deletions Thal
hydrops fetalis
minor Beta Thal CPx
asx
major (cooley’s anemia) = severe dysfunction of both B globin chains
fatal
Dx of Thalasseia
Low MCV & MCH
Nml RDW
Inc. Ferritin
peripheral smear of Thal
target cells
nucleated RBC
what detects type of hemoglobin in Thal?
hemoglobin electrophoresis
Thal tx
Blood transfusion is severe: iron chelation
DO NOT GIVE FE SUPP.
folic acid
splencectomy
Hematopoietic cell transplatation
macrocytic anemia is separated into what 2 categories
megaloblastic
non-megaloblastic
megaloblastic anemias
B12 def
folate def
avg daily requirement of folate in regular women vs pregnant women
regular: 200
preggo: 400-800
absorption of folate vs B12
folate: jejeunum
B12: ileum
are there neuro abnormalities in folate def?
NO
folate def anemia during pregnancy can cause what
neural tube defects
daily requirement of B12
1-2ug
causes of B12 def anemia
partial/complete gastrectomy
ileal dz or resection
bacterial overgrowth or intestinal parasites
pernicious anemia can lead to what?
atrophic gastritis which increases the risk of gastric CA
CPx of B12 anemia
NEURO:
- decreased vibratory/position sense
- ataxia
- paresthesias
- confusion/dementia
pathology of pernicious anemia
immune mediated
how can you get false MCV >100?
increased RBCs or RBC clumping mimicking larger RBCs
folate def labs
serum folate level <150
Inc. Homocysteine
normal methylmalonic acid
B12 def/pernicious anemia labs
leukopenia, thrombocytopenia
dec. B12
increased homocysteine & methylmalonic acid