HEME Flashcards
Signs and Sxs:
- Weakness, faintness, vertigo
- HA
- Tachycardia, orthostatic HoTN
- Cold sensitivity
- Jaundice
- Petechiae, pallor, ecchymosis
Anemia
Signs and Sxs:
- Tachycardia, orthostatic HoTN
- Cold sensitivity
- Jaundice
- Petechiae, pallor, ecchymosis
- Paresthesia, abnormal reflexes, confusion
- Decreased vibration sense
vit B12 deficiency (b/c of neuro sxs)
Signs and Sxs:
- Mucocutaneous or perioperative bleeding
- Hx of bleeding after tooth extraction or surgery
vonWillebrand dz
Signs and Sxs:
- Previous thrombosis
- FHx thrombosis
- Thrombosis in unusual locations like sagittal sinus, mesentery, portal systems
Factor V Leiden
Signs and Sxs:
- platelets decrease by 50%
- skin necrosis, ischemic changes, bleeding
HIT heparin induced thrombocytopenia
Lab Workup for Anemia
- CBC with indices
- Retic count
- Peripheral smear
- Stool sample for occult blood
Normal Hgb Values
- M: 13-17
- F: 12-15
Normal HCT Values
- M: 39-49
- F: 35-45
Normal WBC Count
4000-11000
Normal Platelet Count
150,000-400,000
Normal Retic Count
2.5
3 Examples of Microcytic (MVC under 80) Anemias
- iron deficiency
- anemia of chronic dz (late)
- sickle cell and thalassemia
3 Examples of Normocytic (MVC 80-100) Anemias
- anemia of chronic dz (early)
- renal failure
- autoimmune hemolytic
2 Examples of Macrocytic (MVC over 80) Anemias
- vit B12 deficiency
- folate deficiency
Causes of Iron Deficiency
- women: menstruation or pregnancy
- men: GI bleed
Causes of Anemia of Chronic Dz
- malignancy
- renal failure
- arthritis
Causes of Vit B12 Deficiency
- malabsorption (MC)
- pernicious anemia
- Crohn’s
- surgical resection
Causes of Folate Deficiency
- malnutrition
- alcoholism
How is iron deficiency anemia diagnosed?
expected lab results
- microcytic
- low serum iron
- increased TIBC
- low ferritin
- low transferrin
- no reticulocytosis
How is anemia of chronic dz diagnosed?
expected lab results
- increased ferritin
- normal or low TIBC
- low transferrin
- low retic count
How is vit B12 deficiency diagnosed?
expected lab results
- comes on slowly
- macrocytic
- hypersegmented PMNs
- smooth red tongue (glossitis)
- neurologic abnormalities
- low serum B12
- Schilling test
How is folate deficiency diagnosed?
expected lab results
- macrocytic
- hypersegmented PMNs
- smooth red tongue (glossitis)
- NO neuro sxs
- low serum folate
- normal serum B12
How is hemolytic anemia diagnosed?
expected lab results
- high retic count
- warm or cold antibody
- normochromic, normocytic
- spherocytes and schistocytes on smear (helmet cells)
- direct Coomb’s test (positive)
Lab Findings for vonWillebrand’s Dz
- platelet count normal
- PT/INR normal
- PRR and bleeding time usually prolonged
