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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
Q

TRUE OR FALSE

RBC relies on glycolysis via Embden-Meyerhof and Pentose Phosphate Pathway

A

true

26
Q

ANEMIA

factors the increase RBC production

A
  • 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
Q

ANEMIA

daily nutritional requirements

ages over 14 years old

A
  • men - 400 mcg
  • women - 400 mcg
  • during pregnancy - 600 mcg
  • while breastfeeding - 500 mcg
28
Q

ANEMIA

daily nutritional requirements

for adults

A
  • adult men and women - 2.4 mcg
  • during pregnancy - 2.6 mcg
  • while breastfeeding - 2.8 mcg
29
Q

ANEMIA

clinical manifestations

A
  • palor
  • feeling of coldness
  • lightheadedness or dizziness
  • unusual cravings
  • trouble concentrating
  • constipation
30
Q

the most serious complications of severe anemia arise from _____

A

tissue hypoxia

31
Q

TRUE OR FALSE

shock, hypotension or coronary and pulmonary insufficiency can occur in severe anemia

A

true

32
Q

TRUE OR FALSE

severe anemia is more common in older individuals with underlying pulmonary and cardiovascular disease

A

true

33
Q

ANEMIA

clinical manifestations

severe form

A
  • brittle nails
  • shortness of breath
  • chest pains
  • fainting
34
Q

ANEMIA

diagnosis

A
  • personal health history
  • family health history
  • physical exam
  • laboratory assessment
35
Q

ANEMIA

physical diagnosis

A
  • 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
Q

ANEMIA

laboratory assessments

A
  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
Q

TRUE OR FALSE

measuring of RBC mass as a laboratory assessment is time consuming and expensive as it requires transfusion of radiolabeled erythrocytes

A

true

38
Q

ANEMIA

additional assessments

A
  1. upper GI
  2. barium enema
  3. chest X-rays
  4. CT scan of abdomen
39
Q

ANEMIA

clinical interventions

A
  • nutritional supplements
  • IV of vitamin B12
  • erythroprotein
  • blood transfusion
40
Q

4 main types of SCD

A
  1. hemoglobin SS
  2. hemoglobin SC
  3. hemoglobin SB+ (beta) thalassemia
  4. hemoglobin SB 0 (beta-zero) thalassemia
41
Q

SICKLE CELL ANEMIA

clinical manifestations

in babies, as early as 4 months but usually around 6 months

A
  1. excessive fatigue or irritability
  2. fussiness
  3. bed wetting (due to kidney problems)
42
Q

SICKLE CELL ANEMIA

clinical manifestations

A
  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
Q

SICKLE CELL ANEMIA

who are at risk?

A
  1. children with both parent carrier
  2. those in regions that have endemic malaria
    * africa
    * india
    * mediterranean
    * saudi arabia
44
Q

SICKLE CELL ANEMIA

circumstances that can induce SCD

A
  • illness
  • changes in temperature
  • stress
  • poor hydration
  • altitude
45
Q

SICKLE CELL ANEMIA

complications that induce SCD

A
  • 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
Q

SICKLE CELL ANEMIA

diagnosis

A
  1. hemoglobin electrophoresis (Hgb level)
  2. sickle cell gene from amniotic fluid
  3. detailed patient history
  4. blood test
47
Q

SICKLE CELL ANEMIA

clinical intervention

A
  • rehydration
  • symptomatic management
  • blood transfusion
  • supplemental oxygen
  • pain medication
  • bone marrow transplant
48
Q

SICKLE CELL ANEMIA

non-pharmacologic intervention

A
  • heating pads for pain
  • folic acid-rich food
  • diet regulation
  • more fluids
  • exercise
  • less stress
  • contact your family doctor
49
Q

morphologic classifications are based on cell size

A

iron-deficiency anemia

50
Q

IRON-DEFICIENCY ANEMIA

clinical presentations

A
  1. glossal pain
  2. smooth tongue
  3. reduced salivary flow
  4. pica
  5. pagophagia
  6. Hgb <9 g/dL
51
Q

IRON-DEFICIENCY ANEMIA

diagnosis

A
  1. serum ferritin level
  2. transferrin saturation
  3. TIBC
  4. Hgb, Hct, RBC remains normal until later stages of IDA
52
Q

IRON-DEFICIENCY ANEMIA

treatment

A
  1. oral iron therapy (w soluble ferrous iron salts)
  2. parenteral iron
53
Q

IRON-DEFICIENCY ANEMIA

evaluation of outcomes

A

therapeutic outcomes:
* reticulocytosis (in 5-7 days)
* Hgb level (by 2-4 g/dL q 3 weeks)

54
Q

this can cause a decreased absorption of vitamin B12

A

deficiency of intrinsic factor

VITAMIN-DEFICIENCY ANEMIA

55
Q

TRUE OR FALSE

both Vitamin B12- and folate-deficiency anemia are characterized by pallor, icterus, and gastric mucosal atrophy

A

true

56
Q

is distinguished by neuropsychiatric abnormalities, which are absent in patients with folate-deficiency anemia

A

Vitamin B12 anemia

57
Q

VITAMIN-DEFICIENCY ANEMIA

diagnosis

A
  • macrocytic anemia (↑MCV 110 to 140 fL)
  • hyper-segmented polymorphonuclear leukocytes
  • vitamin B12 <150 pg/mL
  • RBC folate conc < 150 ng/mL
58
Q

VITAMIN-DEFICIENCY ANEMIA

treatment

A
  1. oral cobalamin supplementation
  2. oral folate
59
Q

VITAMIN-DEFICIENCY ANEMIA

therapeutic outcomes

A
  • 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
Q

how many alpha and beta chains does hemoglobin have in sickle cell anemia?

A

2 each

61
Q

example of vitamin-deficiency anemia caused by intrinsic factor

A

pernicious anemia

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