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Hematology and Oncology > EXAM #1: ANEMIA 2.0 > Flashcards

EXAM #1: ANEMIA 2.0 Flashcards

1
Q

What is polycythemia?

A

An abnormal increase in Hb concentration in the blood

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2
Q

What is the RBC count in thalassemia?

A

High

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3
Q

How do you calculate an absolute retic. count?

A

(RBC# x %reticulocytes)/ 100

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4
Q

What do you know if the absolute retic. count is less than 100,000 microL?

A

NO retirculocytosis

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5
Q

What are the two primary causes of megaloblastic anemia?

A
  • Vitamin B12 deficiency
  • Folic acid deficiency

*Drugs can also cause megaloblastic anemia

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6
Q

What are the causes of nonmegaloblastic macrocytic anemia?

A

1) Hypothyroidism
2) Liver disease
3) Alcoholism
4) Myelodysplastic syndromes

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7
Q

Outline the BIG FAT RED CELLS mnemonic.

A 
B= B12
I= Inherited
G= GI disease/ surgery
F= Folic acid
A= Alcholism
T= Thiamine response
R= Reticlocyte miscount
E= Endocrine
D= Dietary
C= chemotherapy
E= Erythro
L= Liver
L= Lesch-Nyhan Syndrome
S= Splenectomy
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8
Q

What are the signs of anemia?

A

Pallor
Pica
Koilonychia

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9
Q

What are the PBS hallmarks of megaloblastic anemia?

A

1) MCV greater than 100

2) Hypersegmented neutrophils

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10
Q

How do the total body stores of B12 and Folate compare?

A 
B12= 2-5mg 
Folate= 5-10mg
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11
Q

How does the daily requirement of B12 and Folate compare?

A

B12= 1-3 micrograms

Folate= 50-100 mircograms

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12
Q

What is the source of B12? What is the source of Folate?

A 
B12= animals 
Folate= plants
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13
Q

Compare the sites of absorption for B12 and Folate.

A

B12= terminal ileum

Folate= proximal jejunum

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14
Q

What is the main difference in symptomatic outcomes of B12 deficiency and Folate deficiency?

A

B12= neurologic complications

Folate= NTD

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15
Q

List the specific causes of B12 deficiency.

A

1) Vegans–veggie man
2) Pernicious anemia–prune anemone
3) Gastric bypass–stomach stapler
4) Malabsorption–mallet
5) Celiac spure–sprouts
6) Enteritis–enter intestines
7) Diphyllobathrium latum–fish tapeworm
8) Chron’s Disease

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16
Q

What is the functional role of Vitamin B12?

A

Vitaminc B12 is an important cofactor for for conversion of:

1) Methylmalonic acid to succinly-CoA (Methylmalonyl-CoA mutase)
2) Methylation of homocysteine to methionine (methionine synthase)

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17
Q

How does B12 deficiency lead to neruologic symptoms?

A

Build-up of methylmalonic acid

18
Q

What is difference between folate and B12 deficiency in regards to methylmalonic acid?

A

B12= methylmalonic acid increase

Folate= no increase

BOTH will be high in homocysteine

19
Q

What is the presentation of Congenital Transcobalamin II Deficiency?

A

Infantile anemia in a few weeks of birth

20
Q

What is the presentation of Congenital Methylmalonic Acidemia?

A

Infants ill from birth

21
Q

What is the presentation of excessive NO inhalation?

A
  • Irreversible oxidation of methylcobalamin*

- Presents like B12 deficiency

22
Q

What is the major difference between the symptoms of B12 deficiency and folate deficiency?

A

Neurological symptoms

23
Q

What lab values are diagnostic for B12 deficiency?

A

1) Increased MCV
2) Decresed retic.
3) High methylmalonic acid
4) High homocysteine

24
Q

How is B12 deficiency treated?

A

1) Find the cause

2) Supplement w/ 1,000 micrograms SC or IM for a month, then monthly

25
Q

What electrolyte needs to be monitored with B12 deficiency?

A

Potassium

26
Q

What are the complications of B12 deficiency?

A

1) Demyelination of the posterior spinal column and lateral corticospinal tract
2) Infertility
3) Cervical smear abnormalities

27
Q

What post-op patient populations must be B12 supplemented?

A

Total gastrectomy

28
Q

What is pernicious anemia?

A
  • Autoimmune disorder directed against gastric parietal cells
  • Results in absent gastric acid and IF
29
Q

What test can be done to diagnose Pernicious Anemia?

A

Schilling Test

30
Q

What lab values are diagnostic for Pernicious Anemia?

A

1) Parietal cells and IF antibody positive
2) High serum gastrin
3) Low pepsingoen

31
Q

What are the major causes of folate deficiency?

A

Remember, causes a macrocytic, megaloblastic anemia b/c

1) Malabsorption–mallet
2) Poor dietary intake– my chart
3) Elderly–tea and toast diet
4) Methotrexate- moth-T-rex ate
5) Trimethoprim–tampon
6) Increased need:
- Hemolytic anemia
- Pregnancy

32
Q

What lab values are diagnostic for Folate Deficiency?

A

NORMAL Methylmalonic acid

33
Q

How is a Folate Deficiency treated?

A

1) Consume foods rich in folic acid

2) Supplement

34
Q

What is aplastic anemia?

A

Bone marrow failure to produce RBCs, WBCs, platelets

i.e. bone marrow failure leading to PANCYTOPENIA

35
Q

What are the major causes of aplastic anemia?

A

1) SLE

2) Drugs

36
Q

What are the symptoms of aplastic anemia?

A

Symptoms are related to the three blood cell line defects:

1) Anemia= weakness/fatigue
2) Neurtopenia= bacterial/fungal infection
3) Thrombocytopenia= bleeding

37
Q

What are the signs of aplastic anemia?

A
  • Pallor, petechaie, purpura

- HSM?

38
Q

Is bone pain a normal finding in aplastic anemia?

A

NO–this is indicative of underlying cancer

39
Q

What lab values are diagnostic for aplastic anemia?

A

1) PANCYTOPENIA

2) Reticulocytopenia

40
Q

How is aplastic anemia treated?

A

1) Stop offending agent and supportive care

2) Severe cases are treated with bone marrow transplant

Hematology and Oncology (38 decks)

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