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IBI Test 3 > B3.047 - Anemia > Flashcards

B3.047 - Anemia Flashcards

1
Q

what is aplastic anemia

A

myeloid stem cell disorder

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2
Q

what are causes of anemia due to inadequate production

A

bone marrow failure Bone marrow infilatration/replacement Nutritional deficiency anemia of chronic disease

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3
Q

what are causes of anemia due ti ineffective production

A

myelodisplastic snydromes

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4
Q

aplastic anemia is caused by

A

marrow hypoplasia and pancytopenia

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5
Q

clinical feature of aplastic anemia

A

anemia leukopenia thrombocytopenia no splenomegaly

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6
Q

pathogenesis of aplastic anemia

A

primarily a stem cell abnormaility

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7
Q

aplastic anemia is characterized by

A

immune mediated stem cell destruction

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8
Q

what drugs can cause aplastic anemia

A

Benzene Chloramphenicol

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9
Q

genetic factors leading to aplastic anemia

A

fanconis, telomerase, acquired stem cell defects

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10
Q

what are blood findings of aplastic anemia

A

pancytopenia normochromic reticulocytopenia

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11
Q

bone marrow findings in aplastic anemia

A

hypocellular Decreased hematopoiesis increased marrow fat

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12
Q

what is this

A

aplastic anemia

infiltrate of fat cells into bone marrow

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13
Q

treatment of aplastic anemia

A

supportive

immunosuppression - try an see

angrogens

stem cell plant

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14
Q

prognosis for aplastic anemia untreated

A

1 year

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15
Q

aplastic anemia with successful transplant

A

~75%

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16
Q

pure red cell aplasia is what

A

disorder of erythroid progenitor cell causing decreased erythropoiesis

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17
Q

clinical features of pure red cell aplasia

A

anemia, pallor, weakness, fatigue

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18
Q

what infection is associated with pure red cell aplasia and why

A

parvovirus B19 - leads to transient drop in red blood cell count about 2 mo later

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19
Q

parvovirus B19 can cause pure red cell aplasia in what population

A

people with hemolytic anemia

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20
Q

what are some things that thymoma patients can get as a paraneoplastic syndrome

A

Myasthena gravis

pure red cell aplasia

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21
Q

describe what the image is

A

parvovirus inclusions in pure red cell aplasia

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22
Q

treatement of pure red cell aplasia

A

treat underlying cause

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23
Q

myelophthisic anemia is

A

decreased erythropoiesis due to bone marrow infiltration or replacement

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24
Q

clinical features of myelophthisic anemia

A

anemia

Feature of underlying disease

25
Q

pathogenesis of myelophthisisc anemia

A

metastatic cancer

fibrosis

hematopoeitic neoplasms

26
Q

pathology of myelophthisisc anemia in blood,

what does it look like

A

normochromic/cytic

teardrop shaped erythrocytes

circulating nucleated RBCs

granulocytic left shift

reticulocytopenia

27
Q

bone marrow pathology of myelophthissic anemia

A

replacement of normal elements

28
Q

what causes the teardrop cells in myelophthisic anemia

A

fibrosis

29
Q

etiology of iroin deficiency anemia

A

insufficient dietary intake

impaired absorption

Increased requirement

chronic blood loss

30
Q

iron is stored as

A

ferritin

31
Q

what is ferroportin

A

a channel that allows iron to be transported across membranes

32
Q

what is hepcidin

A

suppresses ferroportin activity blocking the transport of iron across membranes

33
Q

what is TIBC

A

capacity of transferrin to bind iron, a measure (backwards) of how much iron has been bound

34
Q

anemia of chronic disease is associated with systemic infectin due to what

A

chronic infection

autoimmune disorders

cancer

35
Q

what is the pathogenesis of anemia of chronic disease

A

decreased proliferation of RBCs precursors

impaired iron utilization

36
Q

in anemia of chronic disease what is the impaired iron utilization due to

A

Increased hepcidin due to inflammatory mediators like IL-6

Decreased tranfer to iron to RBC precursoers in bone marrow

37
Q

which IL is associated with hepcidin

A

IL-6

38
Q

ferritin is an acute phase reactant, why is this clinically important

A

you can exclude iron deficiency based on ferrtin levels alone, they can be falsely increased if there is increased inflammation

39
Q

serum iron levels in iron deficiency, anemia of chronic disease, thalassemia

A
40
Q

transferrin/TIBC in

A
41
Q

transferrin/TIBC in iron deficiency, anemia of chronic disease, thalassemia

A
42
Q

% saturation in iron deificieny, anemia of chronic disease, thalassemia

A
43
Q

ferritin levels in iron deficieny, anemia of chronic disease, thalassemia

A
44
Q

soluble transferrin receptor in iron deficiency, anemia of chronic disease, thalassemia

A
45
Q

megaloblastic anemia is due to what

A

macrocytic anemia due to deficiency of vitamin B12 or folic acid

46
Q

if you give folate you can recover what

A

B12 or folic acid deficiency

47
Q

what is vitamin B12 involved in

A

production of myelin in CNS

48
Q

what is intrinsic factor

A

required for absorption of B12

49
Q

Vitamin B12 is poorly absorbed if theres something wrong with their absorption processes, to replace B12 how do you give it

A

IV/injection

50
Q

what can cause a B12 deficiency

impaired absorption

A

decreased intake - vegan diet

51
Q

impaired absorption of vitamin B12 causes

A

intrinsic factor deficiency

malabsorption

ileal resection

bacterial overgrowth/blind loops

fish tapeworm infection

52
Q

folic acid deficiency is due to

A

decreased intake - alcoholism

impared absorption

increased loss

increased requirement

impaired utilization

53
Q

clinical features of megaloblastic anemia

A

normal

Neurlogic deficits - with vitamin B 12 only

Demylenation of dorsal and lateral spinal tracts

54
Q

are the B12 neurologic deficienciy symptoms reversible

A

no

55
Q

features you can recognize in megaloblastic anemia

A

macrocytic - macroovalocytes

hypersegmented neutrophils

megaloblastic hematopoetic precursors

56
Q
A

top - macroovalocyte

bottom - hypersegnemted neutrophil

indicates megaloblastic anemia

57
Q

what type of anemia has intrinsic factor antibodies in pernicious anemia

A

vitamin B12 deficiency

58
Q

why is red cell folate a better measure of folate deficiency

A

serum folate can go up with just a good meal, v variable

59
Q

treatment of megaloblastic anemia

A

vitamin B12 supplementation (oral or parenteral)

oral folic acid supplementation

IBI Test 3 (16 decks)

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