Chapter 14 - RBC CIS Flashcards
Low MCV and high RDW is ___ anemia until proven otherwise
iron deficiency anemia (chronic blood loss anemia)
Chronic Blood Loss Anemia is most likely due to
colonic carcinoma
Normal RCW (red cell distribution width)
11.5-14.5
Normal Hgb
about 15
Normal Hct
about 45
normal platelet count
150,000 - 450,000
Ferritin is 10ug/L. Ferritin deficiency causes what? Why?
Chronic blood loss over time causes ferritin deficiency. Ferritin is for iron storage
Define Pica
People with (iron deficiency) anemia who eat anything – especially dirt or ice.
Normal MCV. What’s above/below?
80-100
Above=megaloblastic
Below = microcytic
Any disorder of ineffective erythropoiesis that starts as normocytic, can COT to what?
Microcytic
Normal MCHC
31-37%
Oral iron supplementation given to a person with chronic blood loss anemia prior to surgery for colon carcinoma. Reticulocytosis on PS noted in about one week. Why?
Person had IDA - pt is receiving oral iron and the marrow responds with reticulocytes (RDW will probably increase even more).
Will ACD repsond to Fe?
Probably not.
What type of anemia is asosciated with membrane defect?
extravascular hemolytic anemia.
RF+ and erosive, inflammatory arthritis of hands and elbow. WBC elevated, left shift, thrombocytosis. Hgb is 12 (so Hct is ~36) RBC has normocytic, normochromic anemia. What is this?
Anemia of Chronic Disease
Episodic manifestations of hemolysis. Acutely ill with severe anmeia. Precipitated bu infeciton or drugs
G6PD deficiency
High serum ferritin seen in
ACD
Significant thrombocytopenia, PS shows leukoerythroblastosis. Marrow transplant 10 year ago during radiation for papillary carcinoma of the thyroid. Presents with normocytic, normochromic anemia.
MDS or MPD
Parkinson-like neuro symptoms. Moderate leukopenia with MCV of 110 (high) and PS multiple hypersegmented PMNs (means megaloblastic). Labs indicate elevated homocysteine and methymalonate. Most likely?
Pernicious Anemia
Hypersegmented PMNs means
megaloblastic
Labs for homocysteine and methymalonate. in folate deficiency.
Elevated homocyteine, but not methymalonate.
24 year old woman with lethargy and low libido. Basophilic stippling is identified in some erythrocytes. Serum ferritin increased significantly. HbA2 is 7% (elevated) and small quantity of HbF detected upon electrophoresis. Most likely?
Beta-thalassemia minor (younger in life)
HbF in beta-thalassemia major v. minor
increased in major, not much in minor.
excess of beta globin chains form Beta 4 tetramers known, seen in newborns.
excess gamma chains form gamma 4 tetramers - this is?
HbH = severe microcytic anemia
Hydrops fetalis, Hemoglobin barts = death
Immunohemolytic anemia:
IgM antibody
Cold agglutinin(i.e. mono or mycoplasma infection)
Warm antibody associated with…
SLE, diret coombs IGG
Most common hematologic manifestation of HIV
thrombocytopenia
- A 37 year old white female. 12gm/dl Hgb, MCV of 75fl and RDW of 16. Plts 30,000. Sparse petechiae, weak, pale pallor, pale conjuctivae, ferritin low. Most likely which of the following?
Primary Chronic ITP
Modestly increased marrow megakaryocytes. PS has abnormally large platelets.
TTP
Target cells and spherocytes
Thalassemias
Haptoglobin decrease indicates
Hemolytic anemia (both intravascualr or extravascular)
6 year old male hx of easy bruising with casual physical contact. PT normal, PTT elevated. What is most likely?
Hemophilia A and B
IDA v. ACD levels:
- Free iron
- Transferrin saturation
- TIBC
- Serum ferritin
- Hepcidin
- Free iron - low, low
- Transferrin saturation - low, high
- TIBC - high, low
- Serum ferritin - low, high
- Hepcidin - low, high
Low plt count, PTT/PT prolonged, fibrin split products identified, microangiopathic fragmented red cell forms.
DIC
low MCV, low Hct/Hg. IDA. PBS=
hypochromasia
nucleated RBC suggest?
hemolysis or a disease infiltrating and replacing bone marrow (hymolysis=hyperBr)
anisocytosis and poikilocytosis
alpha thalasemia
high HCt v low Hct
high = polycythemia low = anemia
