First Aid Review -- Part 2 Flashcards
Sickle cells are seen in…
Sickle cell anemia.
Sickling of RBCs in sickle cell anemia is precipitated by…
- Dehydration
- Deoxygenation
- Ascension to high altitude
Spherocytes are observed in…
- Hereditary spherocytosis
2. Drug- and infection-induced hemolytic anemia
Dacrocytes (“teardrop cells”) are characteristic of…
Bone marrow infiltration (e.g., myelofibrosis)
Target cells are seen in…
- HbC disease
- Asplenia
- Liver disease
- Thalassemia
REMEMBER: “HALT” said the hunter to his target.
Oxidation of Hb -SH groups results in Hb precipitation in the form of…
Heinz bodies.
Heinz bodies are observed in…
G6PD deficiency. Heinz body-like inclusions are also seen in alpha-thalassemia.
Basophilic nuclear remnants found in RBCs are called…
Howell-Jolly bodies.
Howell-Jolly bodies are normally removed from RBCs by…
Splenic macrophages.
Howell-Jolly bodies are seen in patients with…
Functional hyposplenia or asplenia.
Causes of macrocytic, non-megaloblastic anemia
- Liver disease
- Alcoholism
- Reticulocytosis
Causes of macrocytic, megaloblastic anemia
- Folate deficiency
- B12 deficiency
- Orotic aciduria
Macrocytic anemia involves…
MCV > 100 fL
Anemia of chronic disease and iron deficiency anemia may first present as…and then progress to…
Normocytic anemia; microcytic anemia
Copper deficiency can cause…
Microcytic sideroblastic anemia.
Microcytic anemia involves…
MCV
Causes of microcytic anemia
- Iron deficiency (late)
- Anemia of chronic disease
- Thalassemias
- Lead poisoning
- Sideroblastic anemia
Causes of normocytic, nonhemolytic anemia
- Anemia of chronic disease
- Aplastic anemia
- Chronic kidney disease
- Iron deficiency (early)
Intrinsic causes of normocytic, hemolytic anemia
- RBC membrane defect: hereditary spherocytosis
- RBC enzyme deficiency: G6PD, pyruvate kinase
- HbC defect
- Paroxysmal nocturnal hemoglobinuria
- Sickle cell anemia
Extrinsic causes of normocytic, hemolytic anemia
- Autoimmune
- Microangiopathic
- Macroangiopathic
- Infections
Clinical findings in iron deficiency
- Decreased serum iron
- Increased TIBC
- Decreased serum ferritin
- Fatigue
- Conjunctival pallor
- Spoon nails (koilonychia)
- Microcytosis and hypochromia
Plummer-Vinson syndrome consists of a triad of:
- Iron deficiency anemia
- Esophageal webs
- Atrophic glossitis
Alpha-thalassemia is characterized by…
Decreased alpha-globin synthesis.
Hb Barts
Excess gamma globin forms gamma4. Results from no alpha-globin production due to four allele deletion. Incompatible with life (causes hydrops fetalis).
HbH disease involves…
three allele deletion of alpha globin. Very little alpha globin is produced. Excess beta globin forms beta4 (HbH).
Beta thalassemia involves…
Decreased beta globin synthesis
Beta thalassemia minor (pt is heterozygote)
Beta chain is underproduced. Usually asymptomatic. Diagnosis is confirmed by increased HbA2 (>3.5%) on electrophoresis.
Schistocytes “helmet cells” are observed in…
- DIC
- TTP/HUS
- HELLP syndrome
- Mechanical hemolysis (e.g., heart valve prosthesis)
