Hematology - Atlas - Anemias

Question 1

Erythroid cells showing central pallor occupying …

Answer 1

More than 1/3 of the size of the RBC are termed HYPOCHROMIC.

Question 2

Unlike thal minor, the red cell changes in Fe def. anemia manifest only when …

Answer 2

Hb is <10g/dL.

Question 3

Normal (Western) diet provides approximately … of Fe/d of which …-…% is absorbed in duodenum and upper jejunum.

Answer 3

15mg Fe/d.

5-10%.

Question 4

Total body iron store:

Answer 4

4g.

Question 5

Around … of Fe/d is lost in urine — feces — sweat — cells shed from the skin and GIT.

Answer 5

1mg Fe/d.

Question 6

Iron def is more common in the reproductive age since menstrual losses account for … mg Fe/month and in pregnancy an additional …-… mg Fe may be lost.

Answer 6

20mg Fe/mo.

500-1000mg.

Question 7

In general, iron metabolism is balanced between absorption of … and loss of … .

Answer 7

1mg/d.

1mg/d.

Question 8

Pregnancy may also upset the iron balance, since requirements increase to …-… of Fe/d during pregnancy and lactation.

Answer 8

2-5mg Fe/d.

Question 9

Atrophic gastritis may also result from …

Answer 9

Fe deficiency.

Question 10

Worldwide MCC of Fe def anemia:

Answer 10

Hookworm infestation.

Question 11

Oral Fe therapy should begin with …

Answer 11

Ferrous iron salt — taken separately from meals in 3-4 divided doses and supplying a daily total of 150-200mg of elemental iron in adults.

Or 3mg /kg of body weight in children.

Question 12

An appropriate response in iron def anemia Tx is a return of the hematocrit level toward normal within …

Answer 12

3 weeks with full return to baseline after 2 months.

==> Iron therapy should continue for 3-6mo after restoration of normal hematologic values to replenish iron stores.

Question 13

Total dose of parenteral iron required is calculated by the following formula:

Answer 13

Body weight (kg) x 2.3 x (15 - pt’s hemoglobin, g/dl) + 500 or 1000mg (for stores).

Question 14

What are the forms in which iron is available for IV use?

Answer 14

1. Iron sucrose (Venofer).

2. Iron dextran preparation.

Question 15

Sideroblastic anemia:

Answer 15

Heterogeneous group of disorders characterized by anemia of varying severity and diagnosed by finding RING SIDEROBLASTS in BM.

Question 16

Ring sideroblasts are defined as …

Answer 16

Siderotic granules arranged in a perinuclear collar distribution surrounding 1/3 or more of the nuclear perimeter.

Question 17

Iron overload is the common clinical feature and in severe cases may lead to …

Answer 17

2o HEMOSIDEROSIS.

Question 18

Classification of sideroblastic anemia:

4

Answer 18

1. Hereditary.
2. Acquired.
3. Drugs.
4. Rare causes.

Question 19

Sideroblastic anemia - Hereditary:

Answer 19

1. X-linked.

2. AD or AR.

Question 20

Classification of sideroblastic anemia — Acquired:

Answer 20

1. Idiopathic acquired (RARS).

2. A/w previous chemotherapy, irradiation or in “transitional” MDS or MPNs.

Question 21

Classification of sideroblastic anemia — Drugs:

Answer 21

1. Alcohol.
2. Isoniazid.
3. Chloramphenicol.
4. Other drugs.

Question 22

Classification of sideroblastic anemia — Rare causes:

Answer 22

1. Erythropoietic protoporphyria.
2. Pearson syndrome.
3. Cu def or Zn overload.
4. Thiamine responsive megaloblastic anemia.
5. Hypothermia.

Question 23

Hypersegmented neutrophils means:

Answer 23

1/100 PMNs with > or equal to 6 lobes.

5/100 PMNs with 5 lobes.

Question 24

In advanced cases of megaloblastic anemia, the hematocrit may be as low as …

Answer 24

10-15%.

Accompanied by leukopenia and thrombocytopenia.

Question 25

Patients with megaloblastic anemia are usually:

Answer 25

1. Pale.
2. Mildly icteric.
3. Pigmentation of skins.

Question 26

Dimorphic anemia:

Answer 26

At times IDA coexists with megaloblastic anemia.

==> Microcytic as well as macrocytic red cells.