Hematology - Anemia

Question 1

What are symptoms common to all anemia?

Answer 1

Anemia is generally asymptomatic unless severe. The common symptoms are pallor, fatigue, dyspnea, muscle weakness, syncope, palpitations, angina.

Severe Anemia can lead to confusion, lethargy, arrhythmias, MI, heart failure, shock

Question 2

Why might anemia accompany each of these conditions?
A. GI Disease
B. Kidney Disease
C. Heart valve disease
D. Inflammatory disorders

Answer 2

A. Loss of blood due to gastric bleeding.
B. Kidneys make EPO, if kidneys are diseased and can’t function properly, they don’t stimulate erythropoiesis.
C. Leaky heart valves can cause hemolytic anemia
D. The body shuts down iron transport and absorption to reduce the risk of free radials and oxidative damage occurring.

Question 3

What dietary deficiencies might contribute to the development of anemia?

Answer 3

Iron deficiency anemia:
Iron

Macrocytic anemia:
B12
Folate

Vegetarian/vegan concerns with low protein intake - we get the above nutrients most often from meat.

Question 4

Why is it important to ask about the following lifestyle factors in a workup for anemia?
A. Alcohol use
B. IV drug use
C. Marathon Running
D. Toxic exposures: lead and benzene

Answer 4

A. The bone marrow does not function well with alcohol use.
B. IV drug use (endocarditis –> valve disease)
C. RBC are lysed while we run.
D. Lead interferes with heme synthesis and decreases RBC survival time. Benzene can decrease RBC levels by disrupting the bone marrow production.

Question 5

What are the diagnostic criteria for anemia?

Answer 5

CBC with peripheral smear
Lab levels: Men Women
Hemoglobin:

Question 6

What is the most common form of anemia?

Answer 6

Iron Deficiency Anemia

Question 7

What is the most likely cause of iron deficiency in premenopausal women?

Answer 7

Menstruation, pregnancy, lactation

Question 8

What is the most likely cause of iron deficiency in postmenopausal and adult males?

Answer 8

Occult blood loss: Usually GI

Question 9

What signs and symptoms are more likely to be found in iron deficiency than other anemias?

Answer 9

Glossitis, Cheilosis, concave nails, restless legs, dry mouth, alopecia, pica.

Question 10

How will each of the following lab results be affected by Fe deficiency?
A. MCV
B. MCHC
C. Ferritin
D. TIBC

Answer 10

A. Low, microcytic
B. Low, Hypochromic
C. Low
D. High

Question 11

What are some causes of acquired sideroblastic anemia?

Answer 11

Inadequate or abnormal utilization of marrow iron, in spite of adequate stores.
Etiology: genetics, exposure to drugs or toxins (lead), Alcohol abuse, copper deficiency, hypothermia

Question 12

How will the labs be different for sideroblastic anemia than for Fe deficiency?

Answer 12

MCV: Low
MCHC: Low or normal
Ferritin: High
TIBC: High
RDW: High

Question 13

When might you suspect anemia of chronic disease?

Answer 13

When you have low serum iron despite high ferritin (iron stores).

Might occur with: infection, inflammation, cancer, severe trauma, heart failure, DM,