Heme

Question 1

What causes physiologic anemia of infancy?

Answer 1

1. Erythropoiesis stops with respiration
2. Dec. survival of fetal RBCs
3. Expansion of blood volume in first 3 months

Question 2

In what diseases do you see spherocytes? (2)

Answer 2

Hereditary spherocytosis

Autoimmune HA

Question 3

In what do you see target cells?

Answer 3

Hemoglobinopathies
Thalassemia
Post-spenectomy
Liver Disease

Question 4

When do you see teardrop shaped RBCs (dacrocyte)

Answer 4

Myelofibrosis

Question 5

When do you see schistocytes

Answer 5

G6Pd deficiency
DIC
HUS
Vasculitis

Question 6

What causes basophilic stippling?

Answer 6

Lead poisoning
Sideroblastic anemia
Myelodysplastic syndrome

Question 7

When do you see Howell-Jolly bodies?

Answer 7

HA
Megaloblastic anemia
No spleen

Question 8

When do you see Heinz bodies?

Answer 8

Oxidative meds/chemicals

G6PD deficiency

Question 9

How do you treat lead poisoning?

Answer 9

70 = Dimercaprol, then EDTA
45-69 = EDTA or Succimer
20-45 = EDTA chelation test
10-19 = Education

Question 10

What is your retic count in IDA, lead poisoning, folate deficiency

Answer 10

Low

Question 11

What changes do you see in megaloblastic anemia?

Answer 11

Φ Folate or B12
PMN segmented
Low retic
High homocysteine (and methylmalonic acid - B12)

Question 12

What can cause folate deficiency?

Answer 12

Vitamin C deficiency - green veggies, fruits, liver
VLBW
MTX & Phenytoin

Question 13

If you give someone with B12 deficiency folate, what happens?

Answer 13

Improve anemia, but neurologic symptoms progress

Question 14

Dec vibration/proprioception
Spastic paraparesis
Paresthesias
Incontinence
Impotence

Answer 14

Neuro symptoms in B12 deficiency

Question 15

Refractory anemia + osteoporosis + ataxia

Answer 15

Copper deficiency