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Vis Dis > Blood 2 > Flashcards

Blood 2 Flashcards

1
Q

what plays a major role in IDA?

A

menstrual blood loss

pregnancy

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2
Q

what is the MC cause of IDA?

A

chronic blood loss (CBL)

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3
Q

what are some other ways one can develop IDA?

A

chronic aspirin use

chronic hemoglobinuria

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4
Q

what are some symptoms that differentiate IDA from generalized anemia?

A

progressive skin amd mucosal changes

Pica (for ice chips)

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5
Q

what lab findings would you have with IDA?

A

decreased iron
decreased ferritin
increased TIBC
normal platelet count usually

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6
Q

TIBC

A

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

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7
Q

what kind of anemia is IDA?

A

microcytic hypochromic

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8
Q

what other cells might someone with IDA have?

A

anisocytosis
poikilocytosis
target cells
microcytes

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9
Q

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

A

normal/decreased iron
normal to increased ferritin
low TIBC

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10
Q

DDx for IDA

A

thalassemia

anemia of chronic disease`

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11
Q

what is the treatment for IDA?

A

treatment is directed at the cause

iron supplementation may be necessary

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12
Q

ACD lab findings?

A

low serum iron
low TIBC
normal/increased ferritin

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13
Q

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

A 
chronic infection
inflammation
cancer
liver disease
RA
chronic renal disease (ARD)
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14
Q

what is decreased in ACD?

A

RBC survival

bone marrow fails to compensate

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15
Q

what type of anemia is ACD?

A 
normocytic normochromic (MC)
microcytic hypochromic anemia
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16
Q

inhibition of erythropoiesis and altered iron metabolism

A

(ACD)

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17
Q

what are the treatments for ACD?

A

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

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18
Q

what is thalassemia?

A

hereditary disorder

characterized by reduced synthesis of globulin chains of hemoglobin

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19
Q

what kind of anemia is thalassemia

A

microcytic hypochromic anemia

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20
Q

who primarily get alpha thalassemia?

A

china

southeast asia

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21
Q

who primarily gets beta thalassemia?

A

mediterranean origin

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22
Q

thalassemia minor

A

trait is present, don’t necessarily have it

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23
Q

thalassemia major

A

lifethreatening anemia with other changes being notes

AKA cooley’s anemia

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24
Q

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

A 
growth failure
bone defomrities
marrow expansion
widened diploic space
calverium has a hair on end appearance
facial abnormalities
pathological fracutres
hepatosplenomegaly
jaundice
gallstones
25
Q

ddx for thalassemia

A

other microcytic hypochromic anemias

26
Q

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

A

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

27
Q

peripheral blood smear shows what for thalassemia?

A

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

28
Q

what is needed to differentiate between alpha and beta thalassmia?

A

hemoglobin electrophoresis

29
Q

what are the microcytic hypochromic anemias?

A

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

30
Q

IDA serum iron, TIBC, serum ferritin

A

decreased
increased
decreased

31
Q

ACD serum iron, TIBC, serum ferritin

A

decreased
decreased
normal to increased

32
Q

thalassemia serum iron, TIBC, serum ferritin

A

normal
normal
normal

33
Q

types of macrocytic normochromic anemias

A 
vitamin B12 (megaloblastic)
folic acid deficiency (megaloblastic)
alcoholism (non megaloblastic)
liver disease (non megaloblastic)
34
Q

increased MCV means?

A

larger than normal RBC

35
Q

describe macrocytic normochromic anemia

A

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

36
Q

describe megaloblastic anemia

A

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

37
Q

how can there be nonmegaloblastic anemias?

A

due to liver disease, alcohol, etc

38
Q

what is the use of B12 in the body?

A

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

39
Q

when might someone have decreased intake of B12?

A

poor diet
strict vegetarian
malabsorption syndromes
fish tapeworm

40
Q

when might someone need more B12?

A

pregnancy

malignancy

41
Q

what is the most common cause of B12 deficiency?

A

deficiency of intrinsic factor

42
Q

pernicious anemia?

A

deficiency of intrinsic factor, causing a B12 deficiency

43
Q

auto-imune atrophic gastritis

A

autoantibodies are directed against parietal cells and intrinsic factor

44
Q

what is the second MC cause of B12 deficiency

A

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

45
Q

what is the 3rd MC cause of B12 deficiency

A

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

46
Q

symptoms of B12 defcicency

A 
lemon-yellow skin color
premature graying
weakness
sore tongue
GI symptoms (diarrhea, abdominal apin)
paresthesia
loss of vibratory sensoation
irritability 
emotional instability
neuropsychiatric disorders
47
Q

macrocytic normochromic pernicious anemia

A

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

48
Q

who gets macrocytic normochromic pernicious anemia?

A

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

49
Q

what is folic acid needed for?

A

normal function of RBC and WBCs

depends on normal unction of intestinal mucosa

50
Q

describe RBCs that are abnomrally large

A

shortened life span and decreased oxygen carrying capacity

51
Q

what can cause a deficiency folic acid?

A

poor diet, insufficient vegetable intake, alcoholism, malabsorption syndromes

52
Q

what makes you need more folic acid?

A

pragnancy
infancy
malignancy

53
Q

symptoms of megaloblastic naemia from b12 or folic acid deficiencies

A

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

54
Q

symptoms of pernicious anemia because of B12 deficiency

A 
numbness
tingling
depression
memory loss
irritability
55
Q

advanced nerve damage

because of B12 deficiency can cause?

A 
loss of balance
staggering
confusion
dementia
spasticity
loss of bladder control
erectile dysfunction
56
Q

folic acid deficiency symtpoms

A

irritable
forgetful
personality changes

57
Q

describe macrocytic normochromic megaloblastic anemia

A 
abnormally large RBCs
decreased RBCs
decreased hemoglobin
increased MCV
normal/increased MCH
increased iron
increased ferritin
decreased B12 or folate
hyper segmented neutrophils
58
Q

describe macroytic normochromic nonmegaloblastic anemia

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

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