Hematology Flashcards
1
Q
Iron Deficiency Anemia
A
- main cause in older adults = blood loss, especially from GI tract
- MCC of anemia worldwide
- Clinical features
- Pallor, easy fatigability, irritability, anorexia, tachycardia, tachypnea on exertion, and poor weight gain
- Pica = hallmark
- Diagnosis
- Hemoglobin and hematocrit are decreased
-
Peripheral smear
- Hypochromic microcytic red cells, anisocytosis, and poikilocytosis
- Plasma ferritin <20 ug/L
- Management
- Ferrous sulfate 325mg TID orally
- Hgb/Hct within normal range in 2 months BUT therapy should be continued for up to 6 months or longer
2
Q
Anemia of Chronic Dz
A
- Etiologies
- Chronic inflammatory conditions – infxn, malignancy, autoimmune disorders
- Normochromic, Normocytic anemia
- ¯Serum Fe, increased ferritin
- Diagnosis
- Normal or increased ferritin + decreased TIBC, decreased serum Fe
- Management
- Tx underlying dz
- EPO if d/t renal dz
3
Q
Vitamin B12 Deficiency
A
- MCC is inability to digest B12 in food dt dec gastric secretion of hydrochloric acid and pepsin
- Tx: oral crystalline B12
- Drug induced def is increasingly common, especially with use of PPIs and metformin
- May cause dementia
- MCC = pernicious anemia d/t lack of intrinsic factor which is needed for vitamin B12 absorption
- Clinical features
- Smooth tongue, glossitis, cheilosis
- Stocking-glove parasthesias, loss of vibratory and position sense, balance problems and ataxia, dementia
- Diagnosis
- Serum Vit B12 is low
- Management
- Vitamin B12 (Cobalamin) 1000 ug monthly supplementation
- Neurologic signs and symptoms are reversible if treated within 6 months
4
Q
Folic Acid Deficiency
A
- Caused by poor dietary intake
- Inadequate intake common in alcoholics
- Clinical features
- Sore tongue (glossitis)
- Vague GI symptoms
- NO NEURO SYMPTOMS
- Diagnosis
- Macro-ovalocytes + Hypersegmented polymorphonuclear cells = pathognomonic
- Howell-Jolly bodies
- Management
- Oral replacement (1g/day) w/ folic acid = 1st line
