Basic Anemia Findings Flashcards
Iron deficiency
Microcytic
Low iron and low ferritin but high TIBC
high protoporphyrin precursor
Pica and spoon nails
Alpha thalassemia
DELETION
microcytic because less globin
Beta thalassemia
POINT MUTATION
target cells
Crew cut and chipmunk face because marrow expansion
Lead poisoning
Sideroblastic and microcytic anemia because cannot make heme
Also inhibit rRNA degradation so stippling
Lead lines, encephalopathy, wrist and foot drop
Sideroblastic anemia
Refers to excess iron in mitochondria because cannot make heme
May be due to ALA synthase deficiency, alcohol, vitamin B6 deficiency
Also stippling in peripheral smear
Folate deficiency
Inc homocysteine but normal methylmalonic acid and no neuro symptoms
Vitamin B12 Deficiency
Inc homocysteine and methylmalonic acid
Neuro symptoms from myelin problem
Fish tapeworm
Orotic Aciduria
Cannot convert orotic acid to UMP so less pyrimidine synthesis
Orotic acid in urine but no hyperammonia
Megaloblastic because DNA problem
Diamond Blackfan Anemia
Defect in erythropoietin precursor cells
Presents in first year
Inc fetal Hb w short stature and craniofacial abnormalities
Anemia of Chronic Disease
Inc hepcidin so binds ferroportin to prevent iron from leaving liver macrophages
Low iron in serum but high ferritin stores and low TIBC
Associated with autoimmune and chronic inflammatory states
Aplastic Anemia
Inc EPO but low reticulocyte count because no myeloid stem cells
Fanconi - DNA repair defect
Also drugs, chemo, virus, idiopathic autoimmune
Pyruvate Kinase Deficiency
Less ATP so rigid red blood cells leading to extravascular hemolysis and inc 2,3 BPG
Paroxysmal Nocturnal Hemoglobinuria
Impaired GPI anchor for DAF in RBCs so complement destruction (no longer protected)
CD55/59 negative
Coombs negative
HbC Disease
Replace glutamic acid with lysine which is positive
Hemoglobin crystals inside red blood cells
Target cells
Warm Agglutinins
IgG
SLE CLL and drugs like alpha methyldopa
