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Hematology > Anemias Overview > Flashcards

Anemias Overview Flashcards

1
Q

When can you say that a person has anemia

A

If hemoglobin level low for what is expected for (based on gender, age, geographical location)

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2
Q

Global prevalence of anemia worlwide

A

32.9%

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3
Q

Normal Hb for men

A

> 13g/dl

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4
Q

Normal Hb for women

A

> 12g/dl

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5
Q

Pregnant women Hb

A

> 11g/dl

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6
Q

Infants from 2-6months Hb

A

> 9.5g/dl

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7
Q

Children from 6-24 months Hb

A

> 10.5g/dl

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8
Q

2yrs - 11yrs Hb

A

> 11.5g/dl

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9
Q

Children over 12yrs Hb

A

> 12g/dl

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10
Q

What happens when Hb decreases ?

A

Less O2 carrying capacity
Hypoxia
Hypoxia induced effect on organ function
Signs and symptoms of anemia

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11
Q

2 bases of classification of anemia

A

Etiologic classficaion

Morphologic classification

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12
Q

Anemia types based on etiology

A

Impaired RBC production
Excessive destruction of red cells
Blood loss

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13
Q

Type of anemia based on morphologic classification

A

Macrocytic anemia
Microcytic hypochromic anemia
Normocytic normochromic anemia

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14
Q

Causes of red blood cells production impairment

A 
Inadequate supply of nutrients essential for eryhtropoeisis 
Depression of erythropoeitic activity 
Chronic disorders
Aplastic anemia 
Replacement of bone marrow
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15
Q

What are some causes of inadequate supply of nutrient

A

Iron deficiency
Vit b12 deficiency
Folic acid deficiency
Protein calorie malnutrition

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16
Q

Chronic disorders that can lead to anemia

A

Infection
Connective tissue disorders
Disseminated malignancy
Renal disease

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17
Q

Disorder leading to replacement of bone marrow

A

Leukemia
Lymphoma
Myeloproliferative disroders like myelofibrosis
Myelodysplastic syndrome

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18
Q

Causes of excessive red cell destruction (hemolytic anemia )

A 
Intrinsic defects in RBCs 
- red cell membrane defect 
-hemoglobin defects 
- enzyme defects
Extrinsic defects
- immune mechanism 
- Non immune mechanism 
- miscellaneous
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19
Q

What are some disorders of red cell membrane defects

A

Hereditary spherocytosis

Herditory elliptocytosis

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20
Q

Disroders linked to Hemoglobin defect

A

Sickle cell disease
Unstable hemoglobin disease
Thalassemia

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21
Q

Disease linked to enzyme defects

A

Pyruvate kinase deficiency
G6PD deficiency
Paroxysmal nocturnal hemoglobinuria

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22
Q

Immune mechanism leading to anemia

A

Autoimmune acquired hemolytic anemia
Hemolytic disease of the newborn
Drug induced hemolytic anemia

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23
Q

Extrinsic Non immune mechanism leading to anemia

A

Microangiopathic hemolytic anemia

March hemolytic anemia

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24
Q

Extrinsic miscellaneous disorder leading to anemia

A

Hemolytic anemia due to chemical and drugs
Hemolytic anemia due to infections
Hemolytic anemia due to bruns
Lead poisoning

25
Q

Basis of morphological classification of anemia

A

Based on size of red cell

Based on hb content of red cell

26
Q

Normal red cell diameter

A

8 microns

27
Q

What can you compare size of red cell to in blood film

A

Nuleus of mature lymphocyte

28
Q

What is MEAN CELL VOLUME (MCV)

A

Average volume of red blood cell

29
Q

Mcv formula

A

Hematocrit / RBC

30
Q

Mean cell hemoglobin MCH

A

Average weight of hemoglobin in the RBC

31
Q

MCH formula

A

Hb/RBC

32
Q

Mean cell hemoglobin concentration

A

MCHC

33
Q

MCHC

A

Hb/ hematocrit

34
Q

What is hematocrit

A

Fractional volume of blood that the erythrocytes occupy

35
Q

Normal hematocrit for male

A

46%

36
Q

Normal hematocrit for female

A

42%

37
Q

What does it mean when the red cell distribution width is low

A

Mean that there’s uniformity in size of red blood cells

38
Q

What does a large value in the red cell distribution

A

Mixed populations of small and large RBC

Immature RBC are large

39
Q

Anisocytosis

A

High variation in RBC size

40
Q

Poikilocytosis

A

Variation in shape of RBC

41
Q

Formula for MCV

A

Hematocrit x 10/RBC count

42
Q

Normal range mcv

A

81-100 fL

43
Q

MCH formula

A

Hemoglobin x 10/RBC count

44
Q

Normal range MCH

A

26-34 pg

45
Q

MCHC formula

A

Hemoglobin x 100/hematocrit

46
Q

Normal range of MCHC

A

31-36%

47
Q

RDW formula

A

Standard deviation of MCV/MCV x100

48
Q

RDW normal range

A

11.5% - 14.5%

49
Q

Blood characteristic of normocytic normochromic anemia

A

Normal MCV
Normal MCHC
Normal MCH

50
Q

Causes of normocytic normochromic anemia

A 
Blood loss
Increased plasma volume in pregnancy or over hydration
Hemolytic anemia in certains causes
Aplastic anemia 
Kidney disease
Anemia of chronic disease
51
Q

Microcytic hypochromic anemia MCV, MCHC, MCH

A

Low everything

52
Q

Causes of Microcytic hypochromic anemia

A

Iron deficiency anemia
Thalassemia
Sideroblastic anemia
Lead poisoning

53
Q

MCV of Macrocytic anemia

A

Raised MCV

54
Q

Causes of Macrocytic anemia

A

Megaloblastic anemia Due to Folic acid deficiency and vit b12 deficiency

55
Q

History to take in anemia

A

Diet especially for children pregnant and lactating mothers

Unusual bleeding or bruising

Blood in stools

Ménorraghia

Number / frequency of pregnancy

Bleeding hemorrhoids

Dark urine -> Intravascular hemolysis

Family history of anemia

Comorbidities like acute infections, chronic inflammatory diseases, CKD, surgeries

56
Q

Physical examination

A

Pallor of mucous membranes
Mouth for glossitis , stomatitis , gum disease
Nails for koilonychia
Pedal edema for heart failure
Jaundice for hemolysis
Masses in Abdomen , pelvis, spleen, uterus
Rectal, scrotal and vaginal examination when appropriate

57
Q

Essential hematological test

A 
Test to know type of anemia 
Test to know cause of anemia 
Reticulocyte count
Blood film 
Sickling test 
Hb electrophoresis 
ESR 
CRP 
Thick and thin blood film 
G6PD defiance screening test 
Coombs test
58
Q

Hr

A

N

Hematology (24 decks)

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