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hematologic diseases: anemia Flashcards

1
Q

a condition characterized by a decrease in hemoglobin or RBC mass, which results to decreased oxygen-carrying capacity of the blood

A

anemia

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2
Q

3 possible causes of anemia

A
  • blood loss
  • destruction of RBCs
  • decreased production of RBCs
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3
Q

the protein within red blood cells that carries oxygen from the lungs to the body’s tissues

A

hemoglobin

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4
Q

anemia is measured according to the amount of _____

A

hemoglobin

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5
Q

factors that decreases RBC production

A

• inadequate erythropoietin
• inadequate dietary intake
• hypothyrodism

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6
Q

a genetic disease of RBC

A

sickle cell anemia

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7
Q

condition where crescent shaped-like RBCs gives flexibility to travel through even the smallest blood vessel which makes them sticky and rigid and prone to getting trapped in small vessels; it blocks the blood which causes pain and tissue damage

A

sickle cell anemia

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8
Q

an autosomal recessive condition where hemoglobin in RBC is easily displace

A

sickle cell anemia

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9
Q

most common type of SCD; severe anemia

A

Hb SS

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10
Q

2nd most common SCD; less severe anemia

A

Hb SC

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11
Q

defected beta globin gene production resulted to reduced cell size; not a severe anemia

A

Hb SB+ thalassemia

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12
Q

defected beta globin gene; same with Hb SS, a severe anemia

A

Hb SB 0 thalassemia

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13
Q

morphologic classifications are based on cell size

A

iron deficiency anemia

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14
Q

cells are smaller than normal and are associated with IDA

A

microcytic cells

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15
Q

may be associated with recent blood loss or chronic disease

A

normocytic anemia

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16
Q

cells are larger than normal and are associated with deficiencies of vitamin B12 or folate

A

macrocytic cells

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17
Q

anemia that can be caused by inadequate dietary intake, decreased absorption, and inadequate utilization

A

Vitamin B12- and folate-deficiency anemia

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18
Q

ANEMIA

genetic etiology

A
  • hemoglobinopathies
  • thalassemias
  • enzyme abnormalities of the glycolytic pathways
  • RBC cytoskeleton defects
  • congenital dyserthropoietic anemia
  • Rh null disease
  • hereditary xerocytocis
  • abetalipoproteinemia
  • fanconi anemia
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19
Q

ANEMIA

nutritional and chronic disease etiologies

A
  • iron deficiency
  • vitamin B12 deficiency
  • starvation, generalized malnutrition
  • renal disease
  • hepatic disease
  • chromic infections
  • neoplasia
  • collagen vascular disease
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20
Q

ANEMIA

physical etiology

A
  • trauma
  • burns
  • frostbite
  • prosthetic valve and surface
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21
Q

ANEMIA

infectious
etiologies

A

viral
* hepa
* infectious mononucleosis
* cytomegalovirus

bacterial
* clostridia
* GM(-) sepsis

protozoal
* malaria
* leishmaniasis
* toxoplamosis

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22
Q

TRUE OR FALSE

RBCs are higly deformable and increase size from 7um to 13um when they transverse capillaries with 3um diameter

A

true

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23
Q

TRUE OR FALSE

RBCs have positive charge on their surface which deflects the phagocytosis

A

false

RBCs have negative charge

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24
Q

TRUE OR FALSE

RBCs have nucleus and can undergo the Kreb’s cycle

A

false

do not have nucleus, do not undergo Kreb’s cycle

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25
# TRUE OR FALSE RBC relies on glycolysis via **Embden-Meyerhof** and **Pentose Phosphate Pathway**
true
26
# ANEMIA factors the increase RBC production
* hemorrhaging * endometriosis * accidents * GI lesions * menstruation * childbirth * excessive uterine bleeding * surgery * cirrhosis * fibrosis * hemolysis * spleen and liver disorder * genetic disorders (G6PD, thalassemia, sickle cell anemia)
27
# ANEMIA daily nutritional requirements | ages over 14 years old
* men - 400 mcg * women - 400 mcg * during pregnancy - 600 mcg * while breastfeeding - 500 mcg
28
# ANEMIA daily nutritional requirements | for adults
* adult men and women - 2.4 mcg * during pregnancy - 2.6 mcg * while breastfeeding - 2.8 mcg
29
# ANEMIA clinical manifestations
* palor * feeling of coldness * lightheadedness or dizziness * unusual cravings * trouble concentrating * constipation
30
the most serious complications of severe anemia arise from _____
tissue hypoxia
31
# TRUE OR FALSE **shock, hypotension or coronary and pulmonary insufficiency** can occur in severe anemia
true
32
# TRUE OR FALSE severe anemia is more common in older individuals with underlying pulmonary and cardiovascular disease
true
33
# ANEMIA clinical manifestations | severe form
* brittle nails * shortness of breath * chest pains * fainting
34
# ANEMIA diagnosis
* personal health history * family health history * physical exam * laboratory assessment
35
# ANEMIA physical diagnosis
- optic fundi evaluation - blood pressure - heart rate - heart murmur - enlarged lymph nodes, spleen and liver - atrophic glossitis of tongue - color of the skin (pale, jaundice)
36
# ANEMIA laboratory assessments
1. CBC 2. serum iron levels 3. ferritin test 4. vitamin B12 test 5. folic acid test 6. stool test for occult 7. measuring of RBC mass
37
# TRUE OR FALSE measuring of RBC mass as a laboratory assessment is time consuming and expensive as it requires transfusion of radiolabeled erythrocytes
true
38
# ANEMIA additional assessments
1. upper GI 2. barium enema 3. chest X-rays 4. CT scan of abdomen
39
# ANEMIA clinical interventions
* nutritional supplements * IV of vitamin B12 * erythroprotein * blood transfusion
40
4 main types of SCD
1. hemoglobin SS 2. hemoglobin SC 3. hemoglobin SB+ (beta) thalassemia 4. hemoglobin SB 0 (beta-zero) thalassemia
41
# SICKLE CELL ANEMIA clinical manifestations | in babies, as early as 4 months but usually around 6 months
1. excessive fatigue or irritability 2. fussiness 3. bed wetting (due to kidney problems)
42
# SICKLE CELL ANEMIA clinical manifestations
1. jaundice (yellow eyes and skin) 2. swelling and pain in hands and feet 3. frequent infections 4. chest pain, backpain, pain in arm and legs
43
# SICKLE CELL ANEMIA who are at risk?
1. children with both parent carrier 2. those in regions that have endemic malaria * africa * india * mediterranean * saudi arabia
44
# SICKLE CELL ANEMIA circumstances that can induce SCD
- illness - changes in temperature - stress - poor hydration - altitude
45
# SICKLE CELL ANEMIA complications that induce SCD
* severe anemia * hand-foot syndrome * splenic sequestration * delayed growth * neurological complication * eye problems * skin ulcers * heart disease and chest syndrome * lung disease * priapism * gallstones * sickle cell chest syndrome
46
# SICKLE CELL ANEMIA diagnosis
1. hemoglobin electrophoresis (Hgb level) 2. sickle cell gene from amniotic fluid 3. detailed patient history 4. blood test
47
# SICKLE CELL ANEMIA clinical intervention
* rehydration * symptomatic management * blood transfusion * supplemental oxygen * pain medication * bone marrow transplant
48
# SICKLE CELL ANEMIA non-pharmacologic intervention
* heating pads for pain * folic acid-rich food * diet regulation * more fluids * exercise * less stress * contact your family doctor
49
morphologic classifications are based on cell size
iron-deficiency anemia
50
# IRON-DEFICIENCY ANEMIA clinical presentations
1. glossal pain 2. smooth tongue 3. reduced salivary flow 4. pica 5. pagophagia 6. Hgb <9 g/dL
51
# IRON-DEFICIENCY ANEMIA diagnosis
1. serum ferritin level 2. transferrin saturation 3. TIBC 4. Hgb, Hct, RBC remains normal until later stages of IDA
52
# IRON-DEFICIENCY ANEMIA treatment
1. oral iron therapy (w soluble ferrous iron salts) 2. parenteral iron
53
# IRON-DEFICIENCY ANEMIA evaluation of outcomes
therapeutic outcomes: * reticulocytosis (in 5-7 days) * Hgb level (by 2-4 g/dL q 3 weeks)
54
this can cause a decreased absorption of vitamin B12
deficiency of intrinsic factor | VITAMIN-DEFICIENCY ANEMIA
55
# TRUE OR FALSE both Vitamin B12- and folate-deficiency anemia are characterized by **pallor, icterus, and gastric mucosal atrophy**
true
56
is distinguished by neuropsychiatric abnormalities, which are absent in patients with folate-deficiency anemia
Vitamin B12 anemia
57
# VITAMIN-DEFICIENCY ANEMIA diagnosis
* macrocytic anemia (↑MCV 110 to 140 fL) * hyper-segmented polymorphonuclear leukocytes * vitamin B12 <150 pg/mL * RBC folate conc < 150 ng/mL
58
# VITAMIN-DEFICIENCY ANEMIA treatment
1. oral cobalamin supplementation 2. oral folate
59
# VITAMIN-DEFICIENCY ANEMIA therapeutic outcomes
* signs and symptoms usually improve within a few days after starting therapy (for megaloblastic anemia) * neurologic symptoms can take longer to improve or can be irreversible * reticulocytosis * Hgb, Hct, leukocyte & platelet
60
how many alpha and beta chains does hemoglobin have in sickle cell anemia?
2 each
61
example of vitamin-deficiency anemia caused by intrinsic factor
pernicious anemia

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