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IBI Test 3 > B3-047 Hypoproliferative Anemia > Flashcards

B3-047 Hypoproliferative Anemia Flashcards

1
Q

causes of hypoproliferative anemia

A

bone marrow failure
bone marrow infiltration/replacement
nutritional deficiency
anemia of chronic disease
myelodysplastic syndrome

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2
Q

myeloid stem cell disorder due to marrow hypoplasia or pancytopenia

A

aplastic anemia

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3
Q

clinical features of aplastic anemia

A

anemia
leukopenia
thrombocytopenia

**no spelnomegaly

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4
Q

pathogenesis of aplastic anemia

A

primary stem cell abnormality
immune mediated stem cell destruction

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5
Q

genetic factors for aplastic anemia cause the potential for

A

additional mutations/ acute myeloid leukemia

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6
Q

etiology of aplastic anemia

A

immunologic
environmental
genetic

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7
Q

pathology of blood in aplastic anemia

A

pancytopenia
normochromic, normocytic RBCs
no poikilocytes
reticulocytopenia

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8
Q

pathology of bone marrow in aplastic anemia

A

hypocellular
decreased hematopoiesis
increased marrow fat

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9
Q
A

aplastic anemia

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10
Q

treatment: aplastic anemia

A

supportive transfusions
immunosuppression
androgens
hematopoietic stem cell transplant

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11
Q

prognosis: aplastic anemia

A

1 year without treatment

75% 5 year survival with successful transplant

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12
Q

disorder of erythroid progenitor cell causing decreased erythropoiesis

A

pure red cell aplasia

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13
Q

clinical features of pure red cell aplasia

A

anemia

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14
Q

paraneoplastic syndrome causing pure red cell aplasia

A

thymoma

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15
Q

viral infection causing pure red cell aplasia

A

parvovirus B19

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16
Q

other causes of pure red cell aplasia

A

drugs, autoimmune

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17
Q

pathology of blood pure red cell aplasia

A

normochromic, normocytic anemia, no poikilocytes
reticulocytopenia

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18
Q

pathology of bone marrow pure red cell aplasia

A

markedly decreased erythroid precursors
intranuclear inclusions in erythroblasts in parvo19 infection

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19
Q
A

pure red cell aplasia

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20
Q

treatment: pure red cell aplasia

A

thymectomy
plasmapheresis
androgens
supportive transfusions

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21
Q

prognosis: pure red cell aplasia

A

10 years without treatment

50% spontaneous remission
50% cure rate with thymectomy

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22
Q

decreased erythropoiesis die to bone marrow infiltration or replacement

A

myelophthisic anemia

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23
Q

clinical features: myelophthisic anemia

A

anemia
features of underlying disease

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24
Q

pathogenesis of myelophthisic anemia

A

metastatic cancer
fibrosis
hematopoietic neoplasms

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25
Q

blood pathology: myelophthisic anemia

A

normochromic, normocytic anemia
teardrop erythrocytes
circulating nulceated RBCs
granulocytic left shift
reticulocytopenia

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26
Q

bone marrow pathology: myelophthisic anemia

A

replacements of normal elements

27
Q
A

myelophthisic anemia

28
Q

macrocytic anemia due to deficiency of vitamin B12 or folic acid

A

megaloblastic anemia

29
Q

deficiency of B12 and folic acids impairs

A

DNA synthesis due to defective thymidine synthesis

30
Q

causes of B12 deficiency

A

vegan diet
impaired absorption

31
Q

causes of impaired absorption of B12

A

intrinsic factor deficiency (pernicious anemia, gastrectomy)
malabsorption
ileal resection
bacterial overgrowth in blind loops
fish tapeworm infection

32
Q

causes of folic acid deficiency

A

decreased intake (diet, alcoholism)
impaired absorption
increased loss
increased requirement
impaired utilization (folic acid antagonists)

33
Q

causes of impaired absorption of folic acid

A

malabsorption
intestinal disease
anticonvulsants, oral contraceptives

34
Q

causes of increased folic acid requirement

A

pregnancy
infancy
disseminated cancer
increased hematopoiesis

35
Q

clinical features: megaloblastic anemia

A

anemia
neurologic deficits (B12 only)

36
Q

vitamin B12 deficiency causes [neurologic deficits]

A

demyelination of dorsal and lateral spinal tracts
spastic paraparesis, sensory ataxia, severe parathesia

37
Q
A

periventricular white matter degeneration

B12 deficiency

38
Q
A

posterior column of spinal cord degeneration

B12 deficiency

39
Q

pathology: megaloblastic anemia

A

macrocytic anemia
hypersegmented neutrophils
megaloblastic hematopoietic precursors

40
Q
A

macro-ovalocyte

megaloblastic anemia

41
Q
A

megaloblastic erythroblasts in bone marrow

42
Q
A

hypersegmented neutrophils

megaloblastic anemia

43
Q

vitamin B12 deficiency causes brain and spinal cord

A

demyelination

44
Q

vitamin B12 deficiency causes _______________________ in pernicious anemia

A

intrinsic factor antibodies

45
Q

vitamin B12 deficiency causes intrinsic factor antibodies in _____________

A

pernicious anemia

46
Q

in megaloblastic anemia serum B12 is [low/high]

A

low

47
Q

in megaloblastic anemia serum methylmalonic acid is [high/low]

A

high

48
Q

in megaloblastic anemia, serum homocysteine is [high/low]

A

high

49
Q

in megaloblastic anemia, serum and RBC folate is [high/low]

A

low

50
Q

treatment: megaloblastic anemia

A

parenteral or oral B12
oral folic acid

51
Q

high dose folic acid supplementation can improve anemia in vitamin B12 deficiency, but will cause

A

exacerbated neurological defects

52
Q

markedly reduced cellularity, most space occupied by fat

A

aplastic anemia

53
Q

hypocellularity is characteristic of

A

aplastic anemia

54
Q

the bone marrow in megaloblastic and autoimmune hemolytic anemia would show

A

hypercellularity

55
Q

ACD is associated with a ……. reticulocyte count

A

low

56
Q

hemolytic or anemias due to blood loss would show a ……… reticulocyte count

A

high

57
Q

normocytic anemia with decreased reticulocyte count

A

hypoproliferative anemia

58
Q

most common cause of iron deficient anemia in US is

A

chronic blood loss

59
Q

most common cause of IDA worldwide

A

poor dietary intake

60
Q

elevated homocysteine

A

folic acid deficiency

61
Q

elevated serum methymalonic acid

A

B12 deficiency

parenteral B12

62
Q

elevated serum methymalonic acid

A

B12 deficiency

parenteral B12

63
Q

increased levels of hepcidin lead to

A

decreased absorption of iron from enterocyte into blood

64
Q

most iron in the body is present in

A

blood

hemoglobin

IBI Test 3 (20 decks)

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