Ch3: Overview of Anemias

Question 1

Definition of anemia in pts

Answer 1

if pt’s hemoglobin level or hematocrit is >2 standard deviations below the lower limit of normal for age and gender

Question 2

How do pt’s bodies adapt to anemia?

Answer 2

• enhanced shunting of blood to vital organs

- 2,3-DPG-mediated shifts in red cell O2 affinity –> increase delivery of O2 to tissues

Question 3

relationship b/n plasma erythropoietin levels and severity of anemia

Answer 3

directly proportional (more severe anemia –> higher plasma erythropoietin level)

Question 4

4 main categories of causes of anemia

Answer 4

1) underproduction of RBCs
2) increased destruction of RBCs (hemolysis)
3) blood loss
4) combinations of these ^

Question 5

3 categories of underproduction anemias

Answer 5

classified according to mean red cel volume (MCV):

• microcytic
• normocytic
• macrocytic

Question 6

macro-ovalocyte red cell morphology could be sign of:

Answer 6

megaloblastic anemia

Question 7

microcyte red cell morphology could be sign of:

Answer 7

• iron deficiency

- thalassemia

Question 8

target cell red cell morphology could be sign of:

Answer 8

• liver disease
• hemoglobinopathies
• post-splenectomy

Question 9

spherocyte red cell morphology could be sign of:

Answer 9

• hereditary spherocytosis

- autoimmune hemolytic anemia

Question 10

sickle cell red cell morphology could be sign of:

Answer 10

sickle cell anemia

Question 11

fragments red cell morphology could be sign of:

Answer 11

• microangiopathy (DIC, TTP, HUS)

- cardiac valve

Question 12

spur cell red cell morphology could be sign of:

Answer 12

severe liver disease

Question 13

signs/symptoms of mild/moderate anemia

Answer 13

• often asymptomatic
• maybe breathlessness and/or fatigue w/ strenuous exercise
• HR increase more than normal w/ exercise

Question 14

signs/symptoms of severe anemia

Answer 14

• dyspnea
• fatigue
• tachycardia at rest
• systolic “flow” murmur that is transmitted into neck
• pallor