B3.047 - Anemia Flashcards
what is aplastic anemia
myeloid stem cell disorder
what are causes of anemia due to inadequate production
bone marrow failure Bone marrow infilatration/replacement Nutritional deficiency anemia of chronic disease
what are causes of anemia due ti ineffective production
myelodisplastic snydromes
aplastic anemia is caused by
marrow hypoplasia and pancytopenia
clinical feature of aplastic anemia
anemia leukopenia thrombocytopenia no splenomegaly
pathogenesis of aplastic anemia
primarily a stem cell abnormaility
aplastic anemia is characterized by
immune mediated stem cell destruction
what drugs can cause aplastic anemia
Benzene Chloramphenicol
genetic factors leading to aplastic anemia
fanconis, telomerase, acquired stem cell defects
what are blood findings of aplastic anemia
pancytopenia normochromic reticulocytopenia
bone marrow findings in aplastic anemia
hypocellular Decreased hematopoiesis increased marrow fat
what is this
aplastic anemia
infiltrate of fat cells into bone marrow
treatment of aplastic anemia
supportive
immunosuppression - try an see
angrogens
stem cell plant
prognosis for aplastic anemia untreated
1 year
aplastic anemia with successful transplant
~75%
pure red cell aplasia is what
disorder of erythroid progenitor cell causing decreased erythropoiesis
clinical features of pure red cell aplasia
anemia, pallor, weakness, fatigue
what infection is associated with pure red cell aplasia and why
parvovirus B19 - leads to transient drop in red blood cell count about 2 mo later
parvovirus B19 can cause pure red cell aplasia in what population
people with hemolytic anemia
what are some things that thymoma patients can get as a paraneoplastic syndrome
Myasthena gravis
pure red cell aplasia
describe what the image is
parvovirus inclusions in pure red cell aplasia
treatement of pure red cell aplasia
treat underlying cause
myelophthisic anemia is
decreased erythropoiesis due to bone marrow infiltration or replacement
clinical features of myelophthisic anemia
anemia
Feature of underlying disease
pathogenesis of myelophthisisc anemia
metastatic cancer
fibrosis
hematopoeitic neoplasms
pathology of myelophthisisc anemia in blood,
what does it look like
normochromic/cytic
teardrop shaped erythrocytes
circulating nucleated RBCs
granulocytic left shift
reticulocytopenia
bone marrow pathology of myelophthissic anemia
replacement of normal elements
what causes the teardrop cells in myelophthisic anemia
fibrosis
etiology of iroin deficiency anemia
insufficient dietary intake
impaired absorption
Increased requirement
chronic blood loss
iron is stored as
ferritin
what is ferroportin
a channel that allows iron to be transported across membranes
what is hepcidin
suppresses ferroportin activity blocking the transport of iron across membranes
what is TIBC
capacity of transferrin to bind iron, a measure (backwards) of how much iron has been bound
anemia of chronic disease is associated with systemic infectin due to what
chronic infection
autoimmune disorders
cancer
what is the pathogenesis of anemia of chronic disease
decreased proliferation of RBCs precursors
impaired iron utilization
in anemia of chronic disease what is the impaired iron utilization due to
Increased hepcidin due to inflammatory mediators like IL-6
Decreased tranfer to iron to RBC precursoers in bone marrow
which IL is associated with hepcidin
IL-6
ferritin is an acute phase reactant, why is this clinically important
you can exclude iron deficiency based on ferrtin levels alone, they can be falsely increased if there is increased inflammation
serum iron levels in iron deficiency, anemia of chronic disease, thalassemia
transferrin/TIBC in
transferrin/TIBC in iron deficiency, anemia of chronic disease, thalassemia
% saturation in iron deificieny, anemia of chronic disease, thalassemia
ferritin levels in iron deficieny, anemia of chronic disease, thalassemia
soluble transferrin receptor in iron deficiency, anemia of chronic disease, thalassemia
megaloblastic anemia is due to what
macrocytic anemia due to deficiency of vitamin B12 or folic acid
if you give folate you can recover what
B12 or folic acid deficiency
what is vitamin B12 involved in
production of myelin in CNS
what is intrinsic factor
required for absorption of B12
Vitamin B12 is poorly absorbed if theres something wrong with their absorption processes, to replace B12 how do you give it
IV/injection
what can cause a B12 deficiency
impaired absorption
decreased intake - vegan diet
impaired absorption of vitamin B12 causes
intrinsic factor deficiency
malabsorption
ileal resection
bacterial overgrowth/blind loops
fish tapeworm infection
folic acid deficiency is due to
decreased intake - alcoholism
impared absorption
increased loss
increased requirement
impaired utilization
clinical features of megaloblastic anemia
normal
Neurlogic deficits - with vitamin B 12 only
Demylenation of dorsal and lateral spinal tracts
are the B12 neurologic deficienciy symptoms reversible
no
features you can recognize in megaloblastic anemia
macrocytic - macroovalocytes
hypersegmented neutrophils
megaloblastic hematopoetic precursors
top - macroovalocyte
bottom - hypersegnemted neutrophil
indicates megaloblastic anemia
what type of anemia has intrinsic factor antibodies in pernicious anemia
vitamin B12 deficiency
why is red cell folate a better measure of folate deficiency
serum folate can go up with just a good meal, v variable
treatment of megaloblastic anemia
vitamin B12 supplementation (oral or parenteral)
oral folic acid supplementation
