Hematology Flashcards
what is pernicious anemia
Pernicious anemia is a type of vitamin B12 anemia. The body needs vitamin B12 to make red blood cells. You get this vitamin from eating foods such as meat, poultry, shellfish, eggs, and dairy products. A special protein, called intrinsic factor (IF), binds vitamin B12 so that it can be absorbed in the intestines.
Why do you not need an iron/tibc in most cases?
ferritin <15 is 100% predictive of iron deficiency. dont need a tibc unless you suspect that the ferritin is an acute phase reactant.
how do homocysteine levels change when B12 is low?
homocysteine will be elevated because b12 is a cofactor for turning homocysteine into methylmalonyl coA
ddx for microcytic anemia
iron deficinecy, thalassemia, anemia of chronic disease, lead poisoning, sideroblastic anemia.
how does alcohol affect bone marrow
suppressed bone marrow. also is an antagonist for folate and thus can cause macrocytic anemia.
8yo boy from Cuba presents to ER with leg pain, jaundice, pale conjunctiva. Hb 82, MCV 89, platelets 321, wbc 8.0 and reitculocyte count of 8.
top diagnoses?
jaundice= hemolysis/bilirubin from blood breakdown.
sickle cell, g6pd hemolysis/spherocytosis/elliptocytosis,
need Hb electrophoresis (look for hemaglobinopathy) May need life long folate therapy.
what does haptoglobin tell you
Haptoglobin is used as an acute-phase marker of red blood cell (RBC) destruction. Its value decreases and may even be absent when RBCs are destroyed at twice the normal rate.
what iron studies would you see in anemia of chronic disease
normal ferritin, normal MCV
low/Normal iron
normal/low tibc
low/normal transferrin saturation
do you have splenomegaly in g5pd deficiency
no. It is an acute hemolytic process set off by drugs or fava beans or genetic.
low retic count anemia would indicate
hemolysis, bleeding, bone marrow issuse.
multiple myeloma classic symptoms
CRAB : calcium elevated, renal dysfunction, anemia, bone disease.
factor 5 leidin, protein c and s deficiencies are considered diseases of
hypercoagulability
PRIMARY vs secondary hemostasis
- platelet plug at site of injury
- coagulation cascade stabilizes and forms a clot and scab.
how does protein C and S deficiency cause hypercoaguability
protien C (vitamin K dependent) typically slows down coagulation by acting on thrombo-modulin to reduce thrombin activity. if there is not enough protein C, thormbin will be consistently activated and can cause clots to form.
explain the pathophysiology of factor v leidin
a misshapen binding site prevents the INactivation of factor 5, so it stays active and activates the coagulation cascade, and there is increased blood clot formation, causing deep vein thrombosis.
