Chapter 11- Anemias of Erythropoiesis

Question 1

Iron deficiency anemia (IDA)

Pathologic Cells

Answer 1

RBC, reduced

production

Question 2

Iron deficiency anemia (IDA)

Patients

Answer 2

Females of
reproductive age the
most frequently
involved in the U.S

Question 3

Iron deficiency anemia (IDA)

Unique Features

Answer 3

Most common cause of
anemia (iron is needed for Hg), most frequently due to chronic blood loss in the U.S. (e.g. colon cancer, leiomyomas),
low dietary intake is common
in developing nations,
microcytic and hypochromic
RBCs

Question 4

Iron deficiency anemia (IDA)

Prognosis

Answer 4

Patients may be asymptomatic or

manifest with mild anemia (fatigue, weakness, mildly reduced cognition), no impact is observed on lifespan

Question 5

Megaloblastic anemias

a. Folic acid deficiency
b. Vitamin B12 deficiency

Pathologic Cells

Answer 5

RBC, reduced production

Question 6

Megaloblastic anemias

a. Folic acid deficiency
b. Vitamin B12 deficiency

Patients

Answer 6

a) Folic acid:
anyone with a very poor diet or malabsorption

b) Vitamin B12:
older adults with pernicious anemia, strict vegans

Question 7

Megaloblastic anemias

a. Folic acid deficiency
b. Vitamin B12 deficiency

Unique Features

Answer 7

Dietary deficiency of folic acid or vitamin B12 produced defective DNA synthesis and megaloblasts are produces, which causes macrocytic and
hyperchromic RBCs, vitamin B12 produces neurologic abnormalities: CNS & PNS

Both respond well to nutrient supplementation

Question 8

Megaloblastic anemias

a. Folic acid deficiency
b. Vitamin B12 deficiency

Prognosis

Answer 8

Patients recover well from folic acid or Vitamin B12 supplementation
therapy, no impact is observed on lifespan

Question 9

Anemia of chronic disease

Pathologic Cells

Answer 9

RBC, reduced

production

Question 10

Anemia of chronic disease

Patients

Answer 10

Hospitalized patients
with chronic
inflammatory
conditions (e.g.
osteomyelitis, lung
abscess, RA, breast
cancer, lung cancer)

Question 11

Anemia of chronic disease

Unique Features

Answer 11

States of chronic inflammation
suppress erythropoiesis,
increased iron stores in bone marrow, increased serum ferritin, reduced iron-binding capacity (rule out IDA)

Question 12

Anemia of chronic disease

Prognosis

Answer 12

Mild anemia is the most frequent manifestation, but treatment of the
underlying cause of inflammation is
most important, underlying condition may impact survival (e.g.
cancer), most patients respond well to iron and EPO supplementation

Question 13

Aplastic anemia

Pathologic Cells

Answer 13

RBC, reduced

production

Question 14

Aplastic anemia

Patients

Answer 14

Anyone may succumb to this condition, since it is
most frequently idiopathic, but it
may also develop as an adverse drug reaction or toxic exposure to benzene

Question 15

Aplastic anemia

Unique Features

Answer 15

Bone marrow becomes
hypocellular and 90% of
marrow fills with yellow
marrow (fat), T cells are found within the bone marrow, reticulocytopenia in peripheral blood

Question 16

Aplastic anemia

Prognosis

Answer 16

Anemia is slowly progressive with weakness, pallor, dyspnea, thrombocytopenia causing petechiae, and granulocytopenia causing infection risk, prognosis is
unpredictable

Question 17

Myelopthisic anemia

Pathologic Cells

Answer 17

RBC, reduced

production

Question 18

Myelopthisic anemia

Patients

Answer 18

Patients cancer
mets: breast, lung,
prostate; patients
with chronic granulomatous
disease (e.g. TB)

Question 19

Myelopthisic anemia

Unique Features

Answer 19

Bone marrow is infiltrated, dacrocytes in peripheral blood,

Question 20

Myelopthisic anemia

Prognosis

Answer 20

Anemia is mild, but treatment of the underlying cause of marrow infiltration is most important (e.g.
breast cancer, TB)