FINALS - ANEMIA P1 Flashcards
According to WHO ______ is a condition in which number of RBC or Hgb concentration is lower than the normal.
ANEMIA
is a manifestation of a certain disease associated with a
decrease in the red blood cell, decrease in hematocrit and
a decrease in hemoglobin.
anemia
is anemia a primary disease?
no
Anaimia
an =
haima =
an = lack
haima = blood
Functional def of anemia
decrease in the oxygen carrying capacity of the blood.
Operational definition of anemia
reduction from the baseline value for the total
number of RBCs, amount of circulating hemoglobin,
and RBC mass for a particular patient.
Conventional definition of rbc
decrease in RBCs, Hb and Hct below the previously established reference values for healthy individuals of the same age, gender, and race and under similar environmental conditions.
Clinical Findings of Anemia
- History
- Physical examination
- Signs and symptoms
- Laboratory procedures
most common symptoms of anemia
Shortness of breath
Fatique
Weakness
clinical findings that are not covered by medtechs
- History
- Physical examination
- Signs and symptoms
Laboratory procedures for anemia
CBC, iron studies, hemoglobin electrophoresis
backbone of anemia
iron studies
In History of Patient, we check for the _
Diet
Bleeding history
Drug ingestion
Occupation
Exposure to chemicals
Travel
Previous medication
Ethnic group
Family history of disease
Hobbies
Neurologic symptoms
how many iron we lose every day
1mg of iron per day
In physical examination, we check for the ___
Skin: pallor
Eyes (hemorrhage)
Mouth (mucosal bleeding)
Sternal tenderness
Lymphadenopathy
Cardiac murmurs
Splenomegaly- enlargement of spleen
Hepatomegaly- enlargement of liver
Vital signs-
pallor in skin means
decrease in oxyhemoglobin
jaundice is an indicator of___
hemolysis
a skin symptoms which means there’s a breakage of capillaries
petechia/petique
vital signs includes
temperature, blood pressure, heart rate
General causes of Anemia
- Decreased red blood cell production (BONE MARROW FAILURE)
- Increased red blood cell destruction (extrinsic or intrinsic)
- Blood loss (acute or chronic)
Anemia due to decreased production of RBC
- Iron Deficiency Anemia, IDA
- Anemia due to Chronic Inflammation/ chronic disease, ACI or ACD
- Sideroblastic Anemia (blockage in heme synthesis)
- Megaloblastic Anemia (deficiency in vitamin B12)
- Aplastic Anemia (sa bone marrow)
- Thalassemia (walang alpha or beta)
- Anemia due to Chronic Renal Failure
- Anemia due to Endocrine Disorder (cushing syndrome, addison’s disease)
- Anemia due to Marrow Infiltration (myelophthisic anemia)
(most common type and easiest to treat)
iron deficiency anemia, IDA
decrease production of WBC, RBC and platelets
Pancytopenia-
diseases under endocrine disorder
cushing syndrome, addison’s disease
example of anemia due to marrow infiltration
(myelophthisic anemia)
classification of Anemia due to increased destruction of RBC
A. Intracorpuscular Abnormality (Intrinsic)
B. Extracorpuscular Abnormality (Extrinsic)
Intracorpuscular Abnormality (Intrinsic)
has 2 classifications as well, what are they/
Membrane Defect (problem sa membrane ng RBC, sa lipid, carbohydrate and protein)
Enzyme deficiency
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Globin abnormality
Extracorpuscular Abnormality (Extrinsic)
has 2 classifications as well, what are they?
- Mechanical
- Infection
- Chemical and Physical Agents
- Antibody-mediated Anemia (AMA)
conditions under membrane defect (intrinsic)
a) hereditary spherocytosis
b) hereditary elliptocytosis
c) hereditary pyropoikilocytosis
d) hereditary stomatocytosis
e) hereditary acanthocytosis
f) hereditary Rh null disease
conditions under enzyme deficiency (intrinsic)
a) G6PD deficiency
b) Pyruvate kinase deficiency
c) Porphyria
conditions under the globin abnormality (intrinsic)
Hemoglobinopathies (Hb SS, CC, SC)
Sgal, Cgal, Egal
conditions under the mechanical (extrinsic)
a) Microangiopathic hemolytic anemia (MAHA)
b) Traumatic cardiac hemolytic anemia
if there’s MAHA, other conditions are can be associated as well such as
thrombotic thrombocytopenic purpura
(TTP)
hemolytic uremic syndrome (HUS)
Disseminated intravascular coagulation
(DIC)
additional
Hemolysis, Elevated Liver enzymes and
Low Platelets count (HELLP)- seen in
pregnant patient
a mechanical extrinsic condition seen in pregnant women
Hemolysis, Elevated Liver enzymes and
Low Platelets count (HELLP)
conditions associated in INFECTION - EXTRINSIC
hemolytic anemia
- malaria
- babesia
- bartonella
- ehrlicia
causes of chemical and physical agents under the EXTRINSIC factors
caused by drugs, toxins, and burns
condition associated to antibody-mediated anemia (ANEMIA) - EXTRINSIC
acquired hemolytic anemia
examples of anemia due to blood loss
acute post hemorrhagic anemia
chronic post hemorrhagic anemia
laboratory test for anemia
- CBC (Manual: Hgb, Hct, RBC, WBC, DC)
- Reticulocyte count (checking of electrophoretic activity ng bone marrow)
- Peripheral smear (for morphology ng cells kung abnormal or normal cells)
- Bone marrow examination
- Iron studies (ang backbone which includes serum, iron, ferritin, total iron binding capacity/TIBC)
- Blood Chemistry (KFT/kidney function test, LFT/liver function test)
- Urinalysis
- Fecalysis
- Hematological special test procedures (Hgb electrophoresis)
iron studies is the backbone of anemia which includes the study of ___
serum, iron,
ferritin, total iron binding capacity/TIBC
a laboratory test that is for morphology ng cells kung abnormal or normal cells
peripheral smear
checking of electrophoetic activity ng
bone marrow
reticulocyte
Blood Chemistry done in anemia such as __
(KFT/kidney function test, LFT/liver
function test)
Morphological Classification of Anemia
1 Microcytic hypochromic anemia (found in SIGA)
2. Macrocytic normochromic anemia
3. Normocytic normochromic anemia
best anemia example of normocytic normochromic anemia
aplastic anemia
small rbc and low concentration of hgb
microcytic hypochromic anemia
big rbc and normal concentration of anemia
macrocytic normochromic anemia
based on the morphological classification of anemia (mcv based)
what is under the microcytic anemia
SIGA
Sideroblastic anemia
iron deficiency
anemia, chronic diseases
globin deficiency (thalassemia)
based on the morphological classification of anemia (mcv based)
what is under the macrocytic anemia
Non megaloblastic anemia
megaloblastic anemia
based on the morphological classification of anemia (mcv based)
what is under the normocytic anemia
in increased retics:
hemolytic anemia
in normal or low retics:
aplastic anemia
hypercellular (myeloma, myelofibrosis, 1st refractory anemia)
normal cellular (neoplasm, uremia)
Non megaloblastic anemia has a disease under called
chronic liver disease
megaloblastic anemia has a disease under called
vitamin b12 deficiency
folic acid deficiency
neither * malignant growth
hemolytic anemia has 2 factors involved
intrinsic or extrinsic
intrinsic factors of hemolytic anemia are
membrane
enzyme
hemoglobin
PNH
EXTRINSIC factors of hemolytic anemia are
antibody mediated
infection (malaria)
chemical and physical agents (drugs, toxins, burns)
mechanical (MAHA, TTP, DIC, HUS)
- cardiac valve prosthesis
- march hemoglobinuria
microcytic hypochromic has decrease of ___
all erythrocyte indices: mcv, mchc, mch
microcytic hypochromic is found in what conditions
thalassemia and severe iron deficiency anemia
it determine the different type of anemia
rbc indices : mcv, mchc, mch
microcytic hypchromic is found in
SIGA
the most common type of anemia
iron deficiency anemia
easiest anemia to treat
IRON DEFICIENCY ANEMIA
what are the causes of IDA
- inadequate intake of iron
- Increased need of iron
- Chronic blood loss
how many mg of iron is lost everyday
1 mg
conditions that will increased the need of iron in Iron deficiency anemia
infancy, childhood, adolescence, and pregnancy
chronic blood loss in IDA are caused by
- heavy menstrual bleeding
- GI bleeding from ulcers or tumors.
- urinary trach with kidney stones
- Iatrogenic cause
In IDA, the 3 cause which is the chronic blood loss, what is an example of Iatrogenic cause
ikaw at ikaw ang nagvovolunteer for sample
In pathogenesis of Iron deficiency anemia
what are the 3 stages
- Stage I- Iron Depletion
- Stage II – Exhaustion of the storage pool of iron
- Stage III – Frank Anemia
In stage 1 iron deficiency
Hgb =
serum iron =
total binding capacity =
ferritin =
Hgb = normal
serum iron = normal
total binding capacity = normal
ferritin = low
what is the one affected in stage 1 Iro depletion of IDA
Ferritin - the value is low
will measure the circulating iron that is bound to transferring
serum iron