Hematology Flashcards
What is the normal range for an MCV level?
80-100 fl
microcytic MCV is?
80fl
macrocytic MCV is?
100fl
normochromic levels of hemoglobin are?
32-36
MCV measures what?
the average volume and size of individual erythrocytes
RCDW od RDW measures what?
red cell distribution width
what does reticulocyte count tell you?
number of new RBC in circulation
what is a normal reticulocyte count?
1-2%
what happens to the reticulocyte count with iron deficiency anemia?
DOWN
possibly 0%
A child presents as microcytic and hypochromic you know this could be what kinds of anemia?
Iron deficiency, thalassemia or lead poisoning
normocytic/ normochromic may be related to what kind of anemia?
acute blood loss, early IDA, anemia of chronic disease
AND SICKLE CELL
macrocytic, normochromic anemia maybe related to what?
vitamin B12 deficiency, folate deficiency, pernicious anemia
what can cause iron deficiency anemia?
solely breastfed, drinking cows milk by 9 mo, heavy menarche
Is iron-binding capacity increased or decreased with iron def anemia?
Increased
hemoglobin is 7, HCT is , MCV is 75, RBC is 3, RDW is increased, low retic count, serum ferritin <30ug, increased TIBC What is your diagnosis?
Iron deficiency anemia
d/t Inc RDW, Inc TIBC, low ferritin, low retic count
orange juice increases or decreases absorption of iron?
increases absorption
pt presents with decreased hgb, decreased MCV, hypochromic RBC, Increased retic count, increased ferritin. What is your diagnosis?
Thalassemia
Increased retric AND inc ferritin
what is the management for sicklecell anemia?
hydroxyurea (this stimulates fetal hgb which doesnt sickle), immunize with pneumovax.
also prophylactic penicillin form ages 3mo-5y (to be managed by hematologist)
Most commone hemophilia is a loss of factor?
Factor 8
does hemophillia A occur in M or F, who carries it M or F?
M are affected
F are carriers
Lead poisioning is definied at more than \_\_\_ per d/? A.4 B. 10. C.2 D.5
D
5
however do not refer until 10 or higher
(also capillary samples can be higher than venous so good in real practice to recheck venous)
what is the burtonian line?
blue discoloration of gingival border, that would indicate lead poisoning
what level of of lead poisoning required chelation therapy?
Greater than 45
what labs would allow you to differentiate between thalassemia and IDA?
TIBC (high in IDA)
ferritin (high in thalessemia)
Retic (high in thalassemia)
Labs show the patient has Howell-Jolly bodies, what condition does this patient have?
Sickle cell anemia
what lead level requires referral to a hematologist?
level 10 or higher
Do sickle cell patients have a high, low or normal MCH?
Normal- or normochromic
normal labs for thalessemia?
low hgb, low mcv, high ferritin, high total bili, high retic
Pikilocytes and target cells are seen in what disorder?
thalessemia
what is the most frequent period of iron deficiency in pediatrics?
times of rapid growth, often in childhood and adolescense
is iron better absorbed with food or on an empty stomach.
EMPTY this helps absorb twice as fast
give with food only with GI upset, Orange juice helps in aid of iron absorption
2 y/o with hypochromic, microcytic anemia differntial is? A. pernicious anemia B. lead poisoning C. hemophilia D. folic acid deficiency
B
lead poisoning cause hypochromic, microcytic anemia
