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SBL > Anemias of Diminished Erythropoiesis > Flashcards

Anemias of Diminished Erythropoiesis Flashcards

1
Q

What causes Megaloblastic anemia?

A

Impaired DNA synthesis due to lack of B12 or Folate

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2
Q

With Megaloblastic anemia, growth factors signal for increased production of cell precursors. What then occurs?

A

Marrow hyperplasia and marrow hypercellularity because hematopoiesis is still ineffective

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3
Q

Megaloblastic anemia is _____ and has a ____ reticulocyte count

A

Macrocytic (high MCV)

LOW reticulocyte count

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4
Q

With megaloblastic anemia, RBCs are commonly what shape?

A

Ovalocytes

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5
Q

What specific cell has changes that will be seen with Megaloblastic Anemia?

A

Neutrophil nuclei are hypersegmented (>5 lobes)

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6
Q

If a neutrophil nucleus has greater than 5 lobes, what could that indicate?

A

Megaloblastic anemia

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7
Q

What is an autoimmune disorder that causes megaloblastic anemia?

A

Pernicious anemia

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8
Q

With Pernicious anemia, lymphocytes are targeted against?

A

Gastric parietal cells that normally secrete intrinsic factor that is needed for absorption of B12

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9
Q

With Pernicious anemia, loss of gastric parietal cells = loss of intrinsic factor =

A

Lack of B12 absorption

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10
Q

With Pernicious anemia, chronic atrophic gastritis will be seen. What 3 things does that cause?

A

Megaloblastic anemia
Atrophic glossitis = smooth tongue
Spinal demyelination

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11
Q

Pernicious anemia can lead to spinal demyelination. What symptoms will be present?

A

Paresthesias
Gait disturbances
Visual impairment
Neural issues

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12
Q

Cobalamin

A

B12

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13
Q

HIGH levels of homocysteine and MM CoA could indicate?

A

Pernicious anemia

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14
Q

What things can cause folate deficiency?

A 
Decreased intake, absorption, metabolism
Increased need (i.e. pregnancy)
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15
Q

Folate deficiency causes?

A

Neural tube defects

Megaloblastic anemia

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16
Q

HIGH levels of homocysteine could indicate?

A

Folate deficiency

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17
Q

_____ of iron is tightly controlled

A

Absorption

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18
Q

What controls absorption of iron?

A

Hepcidin

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19
Q

Low iron = ____ hepcidin and _____ absorption

A

LOW hepcidin

Increased absorption

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20
Q

High iron = ____ hepcidin and _____ absorption

A

HIGH hepcidin

Decreased absorption

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21
Q

How does hepcidin work?

A

If the iron is high, hepcidin will be high.

Hepcidin destroys the ferroportin 1 transporter which then causes no iron to be absorbed

22
Q

What else can cause an increase in hepcidin and thus a decrease in iron absorption?

A

Systemic inflammation

23
Q

What binds iron to carry it?

A

Transferrin

24
Q

Transferrin takes iron to either?

A

Storage

Bone marrow

25
Q

If iron is taken to storage, it is converted to?

26
Q

If iron is taken to bone marrow, it is incorporated into?

A

Hemoglobin in RBCs and sent to circulation

27
Q

Once RBCs die, the iron that was used in the Hgb is used to create?

A

More transferrin

28
Q

Microcytic, hypochromic and anisocytosis (variability in shape) is seen with what type of anemia?

A

Iron deficient anemia

29
Q

What type of blood loss can also cause iron deficient anemia?

A

Chronic blood loss

30
Q

Koilonychia

A

Fragile nails with vertical stripes

- seen with iron deficient anemia

31
Q

Alopecia

A

Hair loss

- seen with iron deficient anemia

32
Q

Angular chelitis

A

Red creases of the mouth

- seen with iron deficient anemia

33
Q

What are 4 symptoms of iron deficient anemia?

A

Alopecia
Angular chelitis
Atropic glossitis
Koilonychia

34
Q

Describe iron deficient anemia levels of iron, ferritin, total iron binding capacity and hepcidin

A 
Iron = LOW
Ferritin = LOW
TIBC = HIGH
Hepcidin = LOW
35
Q

Describe anemia of chronic disease levels of iron, ferritin, total iron binding capacity

A 
Iron = LOW
Ferritin = HIGH
TIBC = LOW
36
Q

What is Anemia of chronic disease?

A

Impaired RBC production or iron utilization due to chronic illness

37
Q

Infection, immune diseases or malignancy cause the body to horde iron instead of utilize it

A

Anemia of chronic disease

38
Q

With Anemia of chronic disease, levels of iron are low, yet hepcidin is high. How is this possible?

A

Inflammatory cytokines cause an increase in hepcidin = decreased absorption

39
Q

What usually causes aplastic anemia?

A

Drugs
Viral infection
Irradiation

40
Q

What is the inherited form of aplastic anemia?

A

Fanconi anemia (dna repair defect)

41
Q

How does Aplastic anemia present?

A

PANCYTOPENIA

42
Q

Anemia, thrombocytopenia, leukopenia all present together. What does that indicate?

A

Aplastic Anemia

43
Q

What is pure red cell aplasia?

A

Bone marrow shows decreased or abnormal erythroid precursors

44
Q

Bone marrow shows decreased or abnormal erythroid precursors

A

Pure red cell aplasia

45
Q

Pure red cell aplasia is uncommon. What is it often seen with?

A

Autoimmune phenomena like thymoma

46
Q

What is Myelophthisic anemia?

A

Space occupation in the marrow replaces normal hematopoietic cells
= Abnormal release of precursors (leukoerythroblastosis)

47
Q

Space occupation in the marrow that results in leukoerythroblastosis

A

Myelophthisic anemia

48
Q

What can occupy the space in the marrow that is normally where the hematopoietic cells would reside with Myelophthisic anemia?

A

Metastatic cancer

49
Q

Leukoerythroblastosis

A

Increased immature erythroid and myeloid cells

50
Q

Increased immature erythroid and myeloid cells

A

Leukoerythroblastosis

- result of myelophthisic anemia

SBL (48 decks)

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