Heme - Anemia Flashcards
Normal reticulocyte count?
1%
Anemia cutoffs?
Hemoglobin <12 in women
Most common cause of Fe deficiency anemia in men? Woman?
G.I. bleeding. Menstrual loss
Causes of G.I. blood loss?
Upper G.I. tract – esophageal varices, peptic ulcer disease, gastritis, small bowel polyp
Lower G.I. tract – colonic angiodysplasia, colon cancer, IBD, hookworm infestation
Causes of uterine blood loss?
Menstruation, uterine fibroids
Malabsorption syndromes that can lead to iron deficiency anemia?
Gastrectomy, celiac disease, IBD
Symptoms of chronic severe iron deficiency?
- Cravings for dirt or paint (pica), or ice (pagophagia)
- Glossitis, cheilosis, koilonychia (spoon nails)
- Dysphasia due to the esophageal web (Plummer-Vinson syndrome)
Microcytic anemia with increased RDW versus normal RDW?
Fe deficiency anemia versus chronic disease, thalassemia
Microcytic anemias?
TAILS
Thalassemia Anemia of chronic disease Iron deficiency Lead poisoning Sideroblastic
Normocytic anemias?
#Hemolysis #anemia of chronic disease #renal failure #myelodysplastic syndromes
Macrocytic anemia?
#Folate/B12 deficiency #Drug toxicity (6-MP, azathioprine, hydroxyurea) #Drugs (zidovudine, phenytoin) #Chronic liver disease/alcoholism #hypothyroidism #MDS
Normal absolute reticulocyte count?
50,000 to 70,000
Low reticulocyte count versus High reticulocyte count?
Hypoproliferated bone marrow disorders versus blood loss/hemolysis
High ferritin levels with?
Chronic inflammatory disease (Rheumatoid arthritis), malignancy, liver injury
Fe studies in sideroblastic anemia?
Increased serum iron
Increased serum ferritin
Treatment of iron deficiency anemia?
Oral ferrous sulfate 325 mg three times daily for six months
Why iron deficiency anemia in pregnancy?
Expanded blood volume
FFP cannot be given to patients with?
#Hemophilia A or B #von Willebrand's disease
Causes of sideroblastic anemia?
#Alcohol #Lead poisoning #isoniazid #Vitamin B6 deficiency
Ferritin during inflammatory process?
Elevated (acute phase reactant)
TIBC?
Unbound sites on transferrin
Only type of alpha thalassemia that has an elevated reticulocyte count?
3-gene deletion
Patient only drinks goat’s milk – dietary deficiency?
Folate deficiency
Elevated homocysteine level versus elevated methylmalonic acid signifies?
B12 or folate deficiency versus B12 deficiency
Why can be B12 be normal in patients with b12 deficiency?
Transcobalamin (B12 carrier protein) is an acute phase reactant
Repletion in B12 or folate can result in?
Hypokalemia (hyperactive marrow packages up potassium lowering serum level)
Peripheral smear finding in:
- Sideroblastic anemia
- G6PD
- Sickle cell
- Basophilic stippling
- Bite cells
- Howell-Jolly bodies