Blood 2 Flashcards by Rachael Beverage

what plays a major role in IDA?

menstrual blood loss

pregnancy

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what is the MC cause of IDA?

chronic blood loss (CBL)

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what are some other ways one can develop IDA?

chronic aspirin use

chronic hemoglobinuria

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what are some symptoms that differentiate IDA from generalized anemia?

progressive skin amd mucosal changes

Pica (for ice chips)

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what lab findings would you have with IDA?

decreased iron
decreased ferritin
increased TIBC
normal platelet count usually

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TIBC

total iron binding capacity
protein molecule to bind iron
if there is decreased iron, there is increased TIBC

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what kind of anemia is IDA?

microcytic hypochromic

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what other cells might someone with IDA have?

anisocytosis
poikilocytosis
target cells
microcytes

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what lab findings can one have with anemia of chronic disease?

normal/decreased iron
normal to increased ferritin
low TIBC

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DDx for IDA

thalassemia

anemia of chronic disease`

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what is the treatment for IDA?

treatment is directed at the cause

iron supplementation may be necessary

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ACD lab findings?

low serum iron
low TIBC
normal/increased ferritin

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what are examples of diseases that can be because of ACD?

chronic infection
inflammation
cancer
liver disease
RA
chronic renal disease (ARD)

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what is decreased in ACD?

RBC survival

bone marrow fails to compensate

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what type of anemia is ACD?

normocytic normochromic (MC)
microcytic hypochromic anemia

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inhibition of erythropoiesis and altered iron metabolism

(ACD)

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what are the treatments for ACD?

may not be necessary
transfuction
receive erythropoietin
patient could also become iron deficient

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what is thalassemia?

hereditary disorder

characterized by reduced synthesis of globulin chains of hemoglobin

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what kind of anemia is thalassemia

microcytic hypochromic anemia

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who primarily get alpha thalassemia?

china

southeast asia

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who primarily gets beta thalassemia?

mediterranean origin

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thalassemia minor

trait is present, don’t necessarily have it

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thalassemia major

lifethreatening anemia with other changes being notes

AKA cooley’s anemia

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what are the numerous problems that can be related with thalassemia?

growth failure
bone defomrities
marrow expansion
widened diploic space
calverium has a hair on end appearance
facial abnormalities
pathological fracutres
hepatosplenomegaly
jaundice
gallstones

ddx for thalassemia

other microcytic hypochromic anemias

what is the biggests difference between thalassemia and toher microcytic hypochromic anemias?

lower MCV than IDA normal TIBC, iron and ferritin decreased Hgb, Hct, MCV, MCH may have normal RBCsa

peripheral blood smear shows what for thalassemia?

anisocytosis, poikilocytosis, target cells, ovalocytes, basophilic stippling, nucleated RBCs marked hypochromia and microcytosis

what is needed to differentiate between alpha and beta thalassmia?

hemoglobin electrophoresis

what are the microcytic hypochromic anemias?

IDA thalassemia anemia of chornci disease chronic blood loss (really an IDA)

IDA serum iron, TIBC, serum ferritin

decreased increased decreased

ACD serum iron, TIBC, serum ferritin

decreased decreased normal to increased

thalassemia serum iron, TIBC, serum ferritin

normal normal normal

types of macrocytic normochromic anemias

``` vitamin B12 (megaloblastic) folic acid deficiency (megaloblastic) alcoholism (non megaloblastic) liver disease (non megaloblastic) ```

increased MCV means?

larger than normal RBC

describe macrocytic normochromic anemia

increased MCV vitamin B12 or B9 deficiency large RBCs cannot conform to small capillaries, so they fracture and have s hortened life span

describe megaloblastic anemia

changes in RBC and WBC precursors inhibition of DNA synthesis in RBC production may need marrow biopsy or B12/folate assay

how can there be nonmegaloblastic anemias?

due to liver disease, alcohol, etc

what is the use of B12 in the body?

converts folic acid to its active form needed in the fomration and function of RBCs

when might someone have decreased intake of B12?

poor diet strict vegetarian malabsorption syndromes fish tapeworm

when might someone need more B12?

pregnancy | malignancy

what is the most common cause of B12 deficiency?

deficiency of intrinsic factor

pernicious anemia?

deficiency of intrinsic factor, causing a B12 deficiency

auto-imune atrophic gastritis

autoantibodies are directed against parietal cells and intrinsic factor

what is the second MC cause of B12 deficiency

lack of gastric acid necessary to separate B12 from its binding proteins

what is the 3rd MC cause of B12 deficiency

diseases of terminal ilium (worm infestation, IBS, malabsorption syndromes, etc

symptoms of B12 defcicency

``` lemon-yellow skin color premature graying weakness sore tongue GI symptoms (diarrhea, abdominal apin) paresthesia loss of vibratory sensoation irritability emotional instability neuropsychiatric disorders ```

macrocytic normochromic pernicious anemia

conditioned nutritional deficiency of cobalamin B12 deficiency caused by gastric mucosa failure to secrete IF genetically determines

who gets macrocytic normochromic pernicious anemia?

older adults maybe in strict vegetarians 1 of 4 develop stomach cancer

what is folic acid needed for?

normal function of RBC and WBCs | depends on normal unction of intestinal mucosa

describe RBCs that are abnomrally large

shortened life span and decreased oxygen carrying capacity

what can cause a deficiency folic acid?

poor diet, insufficient vegetable intake, alcoholism, malabsorption syndromes

what makes you need more folic acid?

pragnancy infancy malignancy

symptoms of megaloblastic naemia from b12 or folic acid deficiencies

inflamation of mouth (stomatitis) inflammation of tongue (glossitis) psychiatric and neurologic problems (numbness, tingling, depression, memory loss, irritability

symptoms of pernicious anemia because of B12 deficiency

``` numbness tingling depression memory loss irritability ```

advanced nerve damage | because of B12 deficiency can cause?

``` loss of balance staggering confusion dementia spasticity loss of bladder control erectile dysfunction ```

folic acid deficiency symtpoms

irritable forgetful personality changes

describe macrocytic normochromic megaloblastic anemia

``` abnormally large RBCs decreased RBCs decreased hemoglobin increased MCV normal/increased MCH increased iron increased ferritin decreased B12 or folate hyper segmented neutrophils ```

describe macroytic normochromic nonmegaloblastic anemia

``` chronic liver disease, alcoholism increased MCV, abnormally large RBCs increased liver enzymes increased bilirubin signs and symptoms of liver disease and/or alcoholism ```