Erythrocyte Disorders Flashcards
Anemia
What are 3 main causes?
- Underproduction
- Destruction
- Blood loss
Anemia
How to differentiate between underproduction and destruction?
Reticulocyte
Anemia
What is the corrected reticulocyte formulation?
Reticulocyte production index
Anemia
What does MCV stand for?
Differentiate microcytic and macrocytic
Anemia
Anemia with MCV <80fL?
- Iron deficiency;
2. Thalassemia
Anemia
Anemia with MCV wnl?
- Inflammatory anemia;
- Anemia of kidney disease;
- Hereditory spherocytosis;
- Sickle cell disease
Anemia with MCV>100?
- Vitamin B12 or folate deficiency;
- Autoimmune hemolytic anemia;
- Liver disease;
- Hypothyroidism;
- Myelodysplastic syndrome;
- Sideroblastic anemia;
- Alcohol;
- Drugs (HU, ZDV)
Iron deficiency anemia
Where is iron absorbed in the GI?
Duodenum
Iron deficiency anemia
What is hepcidin?
It is a peptide hormone produced in the liver, main regulator of iron homeostasis.
Iron deficiency anemia
How does hepcidin work?
Decreases intestinal iron absorption and release of iron stores.
Iron deficiency anemia
When is hepcidin produced?
When iron is abundant and in inflammatory anemia.
Iron deficiency anemia
When is hepcidin suppressed?
In iron deficiency anemia.
Iron deficiency anemia
What are the common causes?
- Loss of iron from bleeding: menstruation; phlebotomy, GI or GU bleeding
- Decreased intake:
- Decreased absorption: after gastric/duodenal surgery; celiac disease; H.pylori infection; autoimmune atrophic gastritis
- Increased iron requirement: pregnancy and lactation
Iron deficiency anemia
Clinical manifestations:
SOB, dizziness, fatigue, pica (ice, dirt, clay, paper, and laundry starch);
Restless leg syndrome;
Hair loss.
Iron deficiency anemia
What is transferrin saturation?
Serum iron/TIBC
Iron deficiency anemia
What is the value of transferrin saturation?
<15%
Iron deficiency anemia
Value of ferritin?
<=12ng/mL (ug/L)
Iron deficiency anemia
How to differentiate IDA from inflammatory anemia?
Ferritin can be normal if both IDA and inflammatory anemia.
Ferritin will be >100 exclude IDA.
Iron deficiency anemia
If in premenopausal women what is the cause?
Usually from menstrual blood loss.
Iron deficiency anemia
If older men and women what is the cause?
Very likely colon cancer or premalignant polyps–>colonoscopy
Iron deficiency anemia
Rx
What are 3 ways?
- PRBC
- Oral replacement
- IV replacement
Iron deficiency anemia
Rx-how much iron does 1 unit of blood contain?
225-250mg of iron
Iron deficiency anemia
Rx-how much iron dose oral supplement contain?
Ferrous sulfate-65mg per 325mg tablet (least expensive)
Ferrous gluconate-36mg per 300-mg tablet
Ferrous fumarate-33mg per 100-mg tablet
Iron deficiency anemia
Rx-What is the indication of oral supplement?
IDA not due to impaired intestinal absorption.