Anemie

Question 1

Recherchez l’anémie chez des pts (énoncé) 5

Answer 1

à risque de perte sanguine (femmes)

qui recoivent anticoagulopathie

old ppl with NSAIDS

pt atteints d’hémolyse - valvules mécanique!

nouveaux sx d’angine ou ICC

Question 2

comment on appelle une anémie secondaire à carence de B12

Answer 2

anémie perniciseuse

Question 3

carence de B12 faitr une anémie de quelle type

Answer 3

macrocytaire

Question 4

une transfusion de RBC rises levels by how much

Answer 4

10 (slmt…)

Question 5

risque aigus avec la transfusion

Answer 5

surcharge volémique (TACO : transfusion associated circulatory
overload),
TRALI (Transfusion related acute lung injury),

réaction hémolytique aigue,
sepsis,
fièvre,
allergie

Question 6

signes classiques d’anémie (5)

Answer 6

dyspnée, lipothymie/syncope, DRS/DT, palpitation, koilonychie

Question 7

A micro ddx (5)

Answer 7

ferriprive
chornic dz
thalassemie
lead (plomb) poisoning
sideroblastique

Question 8

A normocyt 2 categories

Answer 8

régénérative = high retic

arégénérative = low retic

Question 9

A normo 4 big subcat

Answer 9

Régénérative

1) BLEEDING

2) Hémolyse (inherited or acquired)

Arégénérative

1) Non pacytopénie

2) Pancytopénie

Question 10

A normo - Hémolyse examples (inherited) 3

Answer 10

sickle cell = anémie falciforme = drépanocytose

thalassémie

G6PD

Question 11

A normo - Hémolyse acruiqred 4

Answer 11

immune (coombs +)

infx (malaria)

microangiopatic - DIC, Thrombotic thrombocytopenic purpura (TTP), Hemolytic uremic syndrome (HUS), HELLP (pre-ecl)

drug related

Question 12

possible bleeding sites - An normo

Answer 12

GI

GU

PUD

Question 13

A normo - pancytopénie eg (2)

Answer 13

Aplastic anemia
cancer

drugs eg chimio

Question 14

normo - non pancyto 4

Answer 14

chronic dz

renal dz

liver dz

red cell aplasia

Question 15

2 big categories An macro

Answer 15

mégaloblastique (= disrepted DNA synthesis)

non mégaloblastique (membrane issue, cholest métabolism mostly)

Question 16

An macro causes ddx (broad) 7

Answer 16

ABCDEF
Alcoolism / liver dz
B12 deficiency
Compensatory retic
Drugs /dysplasie
Endocrine = hypoT4
Folate deficiency

Question 17

si on suspecte thalassemie (orgine de la persone) what to do

Answer 17

électrophorèse de l’Hb

Question 18

ddx anémie ferriprive

Answer 18

saignement - investiguer chez l’homme et la femme ménopausée!!!!!
GI
GU
diète végé
ménorrhagie
maladie céliaque! (malabsorption)
chir bariatrique

Question 19

anémie inflammatoire particularité bilans

Answer 19

ferritine augmentée
CRP et VSE hauts

Question 20

cause inflammatoire / chronic dz

Answer 20

cancer
maladie rhumato
infx chronique
maladie aigu
IRC ***
VIH
obésité

Question 21

Anémie normo bilan hémolytique

Answer 21

Bili conjug (augm)
bili non conjug (augm)
LDH (augm)
Haptoglobine (diminuée)

AVEC retic augmentées obv

Hb libre (augm)
uribilinog (augm)

Question 22

what does haptoglobin do and levels in hemolytique anémia

Answer 22

binding free hemoglobin from lysed red cells in vivo, preventing its toxic effects.

SO haptoglobin binds free hb = LOW levelc

Question 23

levels of bilirubin (cong et non cong) in hemolytic anemia and why

Answer 23

HIGH
BC when RBC is broken down it releases bili!!!!

mostly UNconjugated will be high

release bili + LDH

Question 24

levels of LDH in hemolytic anemia

Answer 24

LDH is found intracellularly, therefore when RBCs rupture, this value increases

comme bili!

Question 25

B!2 deficiency cause

Answer 25

1. diet (vegan) or veggie + pregnancy
2. gastric :
   mucosal atrophy aka autoimmun = pernicious anemia
   sp chir bariatrique
3. Intestinal
   chorn’s/celiac, H pylori (!)
4. genetique
5. Rx - METFORMIN + PPI

Question 26

B12 deficiency peut causer

Answer 26

neuropathie périphérique

sans anémie

Question 27

Rx qui peuvent contribuer àune anémie

Answer 27

mtf
PPi
hydroxyurée
antiléptiques!
chimio (duh)