Heme 2 Flashcards
IDA - what lab values are increased
TIBC
plt count
glossitis (sore and shiny red tongue), angular cheilitis (irritated skin or fissures at the corners of the mouth), pica
IDA
IDA med
ferrous sulfate 325 mg PO TID between meals or with OJ
IDA - hgb/hct are often normalized by when
6-8 weeks, continue therapy until ferritin level increases to normal levels (can take 3-6 months to replace)
thalassemia - RBC count, MCHC, serum ferritin, iron levels
RBC count increased
MCHC low
serum ferritin normal
serum iron normal
Thalassemia tx
individualized; some may require transfusion for anemia to reduce symptoms or during periods of stress; minor does not need treatment most often
anemia of chronic disease - MCV, MCHC, ESR, CRP
normal MCV, MCHC
elevated ESR or CRP
anemia in CKD occurs due to
decreased EPO production secondary to CKD, which reduces the production of reticulocytes and RBCs and causes worsening anemia
most common cause of B12 def
pernicious anemia
pernicious anemia
a type of B12 anemia - an autoimmune disorder caused by the destruction of parietal cells in the fundus, resulting in cessation of intrinsic factor production
a type of B12 anemia - an autoimmune disorder caused by the destruction of parietal cells in the fundus, resulting in cessation of intrinsic factor production
pernicious anemia
intrinsic factor is necessary for
absorption of vitamin B12 from the small intestines
b12 def anemia tx
vitamin B12 Sq or IM qwk for 1 month then once per month; oral b12 1000-2000 daily if adherence is not a concern
a vitamin b12 level below what value is consistent with b12 def
<200
the screening test for all anemias is
the CBC
folate def tx
folic acid PO for 1-4 months or until RBC indicators and anemia are normal
aplastic anemia is caused by
destruction of the pluripotent stem cells inside the bone marrow
erythrocytosis
aka polycythemia - refers to an abnormal elevation of hgb and/or hct
an increase of RBC mass caused by a mutation is categorized as
primary polycythemia
who have a higher incidence of secondary polycythemia/erythrocytosis
chronic smokers
COPD
EPO tx
hereditary hemochromatosis is a
genetic disorder in which the intestinal absorption of iron increases, leading to total-body iron overload
genetic disorder in which the intestinal absorption of iron increases, leading to total-body iron overload
hereditary hemochromatosis
hereditary hemochromatosis - symptoms include
4
chronic fatigue
skin hyperpigmentation (bronze)
swelling of the second and third metacarpal joints (fingers)
joint stiffness
hereditary hemochromatosis - abnormal lab results include
4
elevated AST, ALT
high serum ferritin
high transferrin saturation
the main tx for symptomatic pts with very high ferritin levels is
therapeutic phlebotomy
hemolytic anemias are a group of
genetic disease that decrease RBC life span w/ increased lysis - SCA and glucose-6-phophate dehydrogenase deficiency G6PD
acute hemolysis of RBCs causes what
a drop in hgb and hct, reticulocytes and elevation of indirect bilirubin (causes jaundice)
G6PD
x linked recessive genetic disorder that more commonly affects males; about 2-4 days after drug ingestion, will have hemolytic episode
dx of SCA can be made by
3
high performance liquid chromatography HPLC
isoelectric focusing IEF
gel electrophoresis techniques
what two test provide the definitive dx of sickle cell disorder in older children and adults
HPLC and IEF
ferritin level - IDA vs thalassemia
low in iron
normal in thalassemia
serum iron - IDA vs thalassemia
decrease id IDA
normal in thala
TIBC - IDA vs thalassemia
elevated in IDA
normal in thala
MCHC - IDA vs thalassemia
decrease in IDA
decrease in thala
hgb electrophoresis - IDA vs thalassemia
normal in IDA
abnormal in thala
