Hematology Flashcards
Normocytic anemias
Bleeding
Low EPO
Abnormal bone marrow
Hemolytic anemias
Microcytic anemias
Iron deficiency Anemia of chronic disease Thalassemia Lead poisoning Sideroblastic anemia
Macrocytic anemias
Folate/B12 deficiency
Orotic aciduria
Liver disease/alcoholism
Reticulocy tosis
Iron transporter found on duodenum enterocytes
ferroportin
Iron binding proteins
Transferrin: transports iron in blood
Ferritin: stores iron in macrophages of liver/bone
Causes of iron deficiency anemia
Gastrectomy, proton pump inhibitors, bleeding (menorrhagia, peptic ulcers, colon cancer), hookworms, Plummer-Vinson syndrome
Cause increased plasma transferrin
Pregnancy
OCPs
Labs for iron deficiency anemia
Low serum iron
Low ferritin
Increased transferrin (Increased TIBC)
Decreased % Sat
Labs for anemia of chronic disease
Low serum iron
Increased ferritin
Decreased TIBC
% Sat usually normal
Labs for lead poisoning anemia
High levels of delta-ALA and protoporphyrin
Basophilic stippling
Abdominal pain, constipation, lead lines (blue pigment on gum-tooth line)
Labs for sideroblastic anemia
Increased serum iron
Increased ferritin
Low TIBC
Causes of sideroblastic anemia
Alcohol
Vit B6 deficiency
Lead poisoning
Can be an X-lined deficiency of ALA synthase
Paroxysmal Nocturnal Hemoglobinuria
Mut. leads to loss of GPI anchor –> loss of protective proteins on RBCs (CD55/CD59) –> destruction by complement system –> intravascular hemolysis
Low iron, abdominal pain, thrombosis
Triggers of G6PD deficiency
Infections
Drugs (Sulfa, antimalarials, dapsone)
Fava beans
Acute hemolytic transfusion reaction
Type II HSR due to transfusion of wrong blood type
Formed antibodies in host react with donor RBCs
Direct Coombs test is positive
