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GK F3 E6 Heme/Onc > Anemias Popcorn > Flashcards

Anemias Popcorn Flashcards

1
Q

2 types of microcytic anemia

A

iron def

thalassemias

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2
Q

causes of microcytic anemia

A

mestrual bleeding

GI blood loss

decreased Fe absorption (celiac, H pylori)

increased Fe requirement (preggo)

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3
Q

main sx of microcytic anemia

A

PICA

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4
Q

dx of microcytic anemia caused by Fe deficiency

A

MCV <80

Dec. MC.MCHC (hypocrhomic)

Increased RDW

Decreased Ferritin & serum Fe

Increased TIBC

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5
Q

bone marrow bx shows what in iron def anemia

A

absence of Fe stores (TF)

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6
Q

iron def anemia tx

A

ferrous sulfate until anemia corrected

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7
Q

how long do you continue ferrous sulfate post iron def anemia correction?

A

3-6 mos

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8
Q

what do you use Blood TF for in IDA? (iron def. anemia)

A

only use to replace Hgb

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9
Q

1 deletion of alpha in Thal

A

silent

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10
Q

2 alpha deletions Thalassemia

A

mild microcytic

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11
Q

3 alpha deletions Thal

A

hemolytic anemia (HgbH dz)

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12
Q

4 alpha deletions Thal

A

hydrops fetalis

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13
Q

minor Beta Thal CPx

A

asx

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14
Q

major (cooley’s anemia) = severe dysfunction of both B globin chains

A

fatal

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15
Q

Dx of Thalasseia

A

Low MCV & MCH

Nml RDW

Inc. Ferritin

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16
Q

peripheral smear of Thal

A

target cells

nucleated RBC

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17
Q

what detects type of hemoglobin in Thal?

A

hemoglobin electrophoresis

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18
Q

Thal tx

A

Blood transfusion is severe: iron chelation

DO NOT GIVE FE SUPP.

folic acid

splencectomy

Hematopoietic cell transplatation

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19
Q

macrocytic anemia is separated into what 2 categories

A

megaloblastic

non-megaloblastic

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20
Q

megaloblastic anemias

A

B12 def

folate def

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21
Q

avg daily requirement of folate in regular women vs pregnant women

A

regular: 200
preggo: 400-800

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22
Q

absorption of folate vs B12

A

folate: jejeunum

B12: ileum

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23
Q

are there neuro abnormalities in folate def?

A

NO

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24
Q

folate def anemia during pregnancy can cause what

A

neural tube defects

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25
Q

daily requirement of B12

A

1-2ug

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26
Q

causes of B12 def anemia

A

partial/complete gastrectomy

ileal dz or resection

bacterial overgrowth or intestinal parasites

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27
Q

pernicious anemia can lead to what?

A

atrophic gastritis which increases the risk of gastric CA

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28
Q

CPx of B12 anemia

A

NEURO:

  • decreased vibratory/position sense
  • ataxia
  • paresthesias
  • confusion/dementia
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29
Q

pathology of pernicious anemia

A

immune mediated

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30
Q

how can you get false MCV >100?

A

increased RBCs or RBC clumping mimicking larger RBCs

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31
Q

folate def labs

A

serum folate level <150

Inc. Homocysteine

normal methylmalonic acid

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32
Q

B12 def/pernicious anemia labs

A

leukopenia, thrombocytopenia

dec. B12

increased homocysteine & methylmalonic acid

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33
Q

Peripheral smear of both Folate def & B12 def anemia

A

hypersegmented neutrophils >5 nuclear lobes

macroovalocytes

34
Q

test for pernicious anemia

A

positive schilling test

a-bodies to IF

35
Q

folate def tx

A

replace: 5mg in pts with malabsorption

36
Q

what do you want to rule out with folate def anemia?

37
Q

pernicious anemia tx

A

parenteral vit B12:

1000mg IM daily for 1 wk

wkly injections for 1 month

monthly injections for life

38
Q

B12 def tex

A

PO replacement

39
Q

why shouldnt you treat B12 def with folic acid alone?

A

can mask progressive worsening of Pernicious anemia that can cause neuro damage

40
Q

classifications of hemolytic anemia

A

acute vs chronic

acquired or inherited

41
Q

types of intravascular hemolytic anemias

A

macroangiopathic (prosthetic heart valve)

G6PD def

paroxysmal nocturnal hemoglobinemia

42
Q

CPx of hemolytic anemia in general

A

pallor

SOB

jaundice

gallstones (billirubin stones)

43
Q

G6PD def anemia cause

A

x-llinked

oxidative drugs/infections

44
Q

G6pd Cpx

A

episodic hemolysis = healthy, no splenomegaly

45
Q

G6PD labs

A

Increased reticulocytes

Increased indirect Bilirubin

Dec. G6PD levels

46
Q

G6PD Peripheral smear

A

bite cells & heinz bodies

47
Q

G6PD tx

A

episodes = self limited

avoid oxidative drugs

48
Q

hereditary spherocytosis

A

aut DOMINANT

49
Q

hereditary Spherocytosis CPx

A

asx

mild jaundice

scleral icterus

splenomegaly

50
Q

what happens in chronic hemolysis due to H. spherocytosis?

A

creates need for increased folaye

if intake is not adequate –> megaloblastic anemia develops (folate def)

51
Q

dx for H. Spherocytosis

A

osmotic fragility test: RBS increases hemolysis on exposrure to hypotonic sfluids

52
Q

H. Spherocytosis tx

A

splenectomy

give pneumovax in adulthood

53
Q

CPx sickle cell

A

develops in childhood: 4-6 mos

delayed growth & development

increased infections

54
Q

what 4 things worsen sickle cell sx?

A
  1. dehydration
  2. hypoxia
  3. intense exercise
  4. high altitude
55
Q

chronic hemolysis in sickle cell can result in what emergency

A

aplastic crisis: sudden drop in Hb & bilirubin rises

56
Q

vaso-occlusive ischemic tissue injury results in what emergency (seen in Sickle cell)

A

pain crisis: MC featue of this dz

57
Q

sickle cell pain crisis tx

A

analgesics & fluids

58
Q

what consists of a pain crisis in sick cell?

A

osteonecrosis of femoral and humeral heads (bone infarcts)

CVA, MI

splenic infarcts: functional asplenism

leg ulcers

59
Q

sickle cell dz labs

A

Hgb: 5-11

normochromic, normocytic

increased reticulocytes

60
Q

best test to confirm sickle cell

A

Hgb electrophoresis reveals Hbs

61
Q

peripheral smear of sickle cell

A

sickled RBCs, nucleated RBCs, target cells, howell-Jolly bodies

thrombocytosis

62
Q

Peripheral smear of Autoimmune hemolytic anemia (AIHA)

A

polychromasia, spherocytosis, nucleated RBCs

63
Q

autoimmune hemolytic anemia lab test

A

positive direct coombs test

64
Q

sickle cell tx

A

RBC tranfusions

pneumovax & folate supp

HYDROXY UREA (chemo) for painful crises

BM transplant

65
Q

what helps with hemolysis in general?

A

Corticosteroids

66
Q

describe anemia of chronic dz

A

normocytic, normochromic

Can be microcytic as well

67
Q

anemia of chronic dz labs

A

normla MCV

normal or Increased Ferritin

Dec. Iron & TIBC IF inflammation

DX OF EXCLUSION

68
Q

what may benefit anemia of chronic dz?

69
Q

causes of sideroblastic anemia

A

MDS

chronic alcoholism

lead poisoning

meds

chronic infections or inflammation

malignancy

70
Q

sideroblastic anemia labs

A

low/nml/high MCV

moderate anemia: Hct = 20-50%

nml or increased Ferritin

aniso & poikilo

systemic Fe overload

71
Q

siderblastic anemia dx

72
Q

WHat does the BM biopsy for sideroblastic anemia show?

A

erythroid hyperplasia

rringed sideroblasts

blue stained iron

stippled RBCs

73
Q

sideroblastic anemia tx

A

Fe overload: phlebotomy, chelation

Pyroxiden Vit B6 for congenital

74
Q

causes of aplastic anemia

A

drugs

viral

ionizing radiation

75
Q

CPx of aplastic anemia

A

weakness

infections

bleeding

76
Q

aplastic anemia labs

A

pancytopenia: thrombocytopenia, anemia, leukopenia

77
Q

dx test for aplastic anemia

78
Q

what does BM bx for aplastic anemia show?

A

normoblasts

granulocytes

megakaryocytes

79
Q

aplastic anemia tx

A

BM transplant

GK F3 E6 Heme/Onc (6 decks)

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