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MI Internal Medicine and Infectious Disease > Hematology > Flashcards

Hematology Flashcards

1
Q

Autoimmune hemolytic anemias, typically

A

Normocytic anemia

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2
Q

Acute blood loss anemia, typically

A

Normocytic anemia

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3
Q

G6PD anemia type

A

Hemolytic anemia, normocytic

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4
Q

Disseminated intravascular coagulopathy (DIC) anemia type

A

Hemolytic anemia, normocytic

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5
Q

Hemolytic-uremic syndrome anemia type

A

Hemolytic anemia, normocytic

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6
Q

Thrombotic thrombocytopenic purpura anemia type

A

Hemolytic anemia, normocytic

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7
Q

General (3) mechanisms of normocytic anemia

A

1) Increase destruction or loss
2) Decreased production
3) Overexpansion of plasma volume

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8
Q

Primary (4) causes of decreased RBC production

A

1) Marrow hypoplasia
2) Myelopathies
3) Myeloproliferative disease
4) Pure RBC aplasia

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9
Q

Secondary (5) causes of decreased RBC production

A

1) CKD
2) Liver disease
3) Endocrine deficiency
4) Anemia of chronic disease
5) Sideroblastic anemias

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10
Q

(2) Causes of overexpansion of plasma volume

A

1) Pregnancy

2) Hypervolemia

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11
Q

Initially nearly all anemias are of what type?

A

Normocytic normochromic

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12
Q

Most common cause of normocytic anemia?

A

Anemia of chronic disease/inflammation

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13
Q

Hallmark ferrokinetic profile of anemia of chronic disease?

A

Present but inaccessible iron: decreased serum Fe, decreased transferrin, normal or elevated ferritin

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14
Q

Endocrine (4) disorders resulting in normocytic anemia

A

1) Hypothyroidism
2) Adrenal or pituitary insufficiency
3) Hypogonadism
4) Hyperthyroidism

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15
Q

How might endocrine deficiency result in secondary bone marrow failure?

A

Reduced stimulation of EPO secretion

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16
Q

Anemia of chronic kidney disease is typically normocytic but may also be…?

A

Microcytic

17
Q

How do AKI and CKD result in anemia?

A

Increased uremic metabolites decrease RBC lifespan and reduce erythropoiesis

18
Q

EPO levels in anemia of CKD (2/2 uremia) vs. EPO levels in most other causes of anemia

A

Decreased vs. elevated

19
Q

G6PD deficiency anemia type

A

Transitory hemolytic anemia, normocytic

20
Q

Mechanism of G6PD hemolysis

A

Exposure to oxidative drug

21
Q

Anemia in hypersplenism, conditions?

A

Seen after spleen reaches 3-4x normal size, as in liver cirrhosis, chronic infection, myeloproliferative diseases

22
Q

Anemia in hypersplenism mechanism?

A

Primarily caused by removal of RBC from circulation (sequestering) but also increased RBC destruction

23
Q

Most common causes of microcytic anemia

A

1) Iron deficiency anemia
2) Anemia of chronic inflammation/disease
3) Thalassemia trait
4) Pregnancy
5) Lead poisoning

24
Q

Mechanisms of iron deficiency anemia

A

1) Occult blood loss
2) Decreased GI absorption as in Celiac disease and H. pylori infection
3) Menstrual blood loss
4) Malignancy
5) Poor intake/malnutrition

25
Q

Why is ferritin elevated in anemia of chronic disease

A

Acute phase reactant

26
Q

Acute phase reactants are either ____ or ____.

A

Positive or negative

27
Q

Role of ferritin as acute phase reactant

A

Sequester circulating/free iron to make less available to tumor cells or reduce microbial iron scavenging.

28
Q

Role of fibrinogen as acute phase reactant

A

Promote endothelial repair; correlates with ESR

29
Q

Erythrocyte sedimentation rate is a proxy for…?

A

Fibrinogen levels (as an acute phase reactant)

30
Q

What sort of acute phase reactant is albumin?

A

Negative

31
Q

During acute phase albumin production is reduced to conserve____ for positive acute phase proteins

A

Amino acids

32
Q

C-reactive protein’s function as an acute phase protein

A

Microbial opsonization, binding to degenerating cells, activate compliment pathways

33
Q

Pathophysiology of alcohol-related macrocytosis/anemia

A

Believed to be 2/2 direct marrow toxicity to hematopoeitic cells; doesn’t result directly in folate deficiency though these often co-occur

34
Q

DDx: high RBC, normal-low Hgb, low MCV, normal-high RDW

A

Thalassemia; polycythemia with iron deficiency anemia

35
Q

DDx: normal-low RBC, low Hgb, normal-low MCV, normal-low MCH, normal-high RDW

A

Iron deficiency anemia (more normal in early disease); advancing anemia of chronic inflammation (resulting in iron deficiency anemia)

36
Q

Mechanism: anemia of chronic kidney disease

A

Chronic inflammation; decreased EPO production

37
Q

Mechanism: anemia of chronic disease/inflammation

A

Chronic release of cytokine interleukin-6 (IL-6) stimulates production of hepcidin leading to increased intracellular iron sequestration; also the chronic condition contributes to anemia, as in CKD

MI Internal Medicine and Infectious Disease (35 decks)

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