Heme - Anemia

Question 0

Normal reticulocyte count?

Answer 0

1%

Question 1

Anemia cutoffs?

Answer 1

Hemoglobin <12 in women

Question 2

Most common cause of Fe deficiency anemia in men? Woman?

Answer 2

G.I. bleeding. Menstrual loss

Question 3

Causes of G.I. blood loss?

Answer 3

Upper G.I. tract – esophageal varices, peptic ulcer disease, gastritis, small bowel polyp

Lower G.I. tract – colonic angiodysplasia, colon cancer, IBD, hookworm infestation

Question 4

Causes of uterine blood loss?

Answer 4

Menstruation, uterine fibroids

Question 5

Malabsorption syndromes that can lead to iron deficiency anemia?

Answer 5

Gastrectomy, celiac disease, IBD

Question 6

Symptoms of chronic severe iron deficiency?

Answer 6

1. Cravings for dirt or paint (pica), or ice (pagophagia)
2. Glossitis, cheilosis, koilonychia (spoon nails)
3. Dysphasia due to the esophageal web (Plummer-Vinson syndrome)

Question 7

Microcytic anemia with increased RDW versus normal RDW?

Answer 7

Fe deficiency anemia versus chronic disease, thalassemia

Question 8

Microcytic anemias?

Answer 8

TAILS

Thalassemia
Anemia of chronic disease
Iron deficiency
Lead poisoning
Sideroblastic

Question 9

Normocytic anemias?

Answer 9

#Hemolysis
#anemia of chronic disease
#renal failure
#myelodysplastic syndromes

Question 10

Macrocytic anemia?

Answer 10

#Folate/B12 deficiency
#Drug toxicity (6-MP, azathioprine, hydroxyurea)
#Drugs (zidovudine, phenytoin)
#Chronic liver disease/alcoholism
#hypothyroidism
#MDS

Question 11

Normal absolute reticulocyte count?

Answer 11

50,000 to 70,000

Question 12

Low reticulocyte count versus High reticulocyte count?

Answer 12

Hypoproliferated bone marrow disorders versus blood loss/hemolysis

Question 13

High ferritin levels with?

Answer 13

Chronic inflammatory disease (Rheumatoid arthritis), malignancy, liver injury

Question 14

Fe studies in sideroblastic anemia?

Answer 14

Increased serum iron

Increased serum ferritin

Question 15

Treatment of iron deficiency anemia?

Answer 15

Oral ferrous sulfate 325 mg three times daily for six months

Question 16

Why iron deficiency anemia in pregnancy?

Answer 16

Expanded blood volume

Question 17

FFP cannot be given to patients with?

Answer 17

#Hemophilia A or B
#von Willebrand's disease

Question 18

Causes of sideroblastic anemia?

Answer 18

#Alcohol
#Lead poisoning
#isoniazid
#Vitamin B6 deficiency

Question 19

Ferritin during inflammatory process?

Answer 19

Elevated (acute phase reactant)

Question 20

TIBC?

Answer 20

Unbound sites on transferrin

Question 21

Only type of alpha thalassemia that has an elevated reticulocyte count?

Answer 21

3-gene deletion

Question 22

Patient only drinks goat’s milk – dietary deficiency?

Answer 22

Folate deficiency

Question 23

Elevated homocysteine level versus elevated methylmalonic acid signifies?

Answer 23

B12 or folate deficiency versus B12 deficiency

Question 24

Why can be B12 be normal in patients with b12 deficiency?

Answer 24

Transcobalamin (B12 carrier protein) is an acute phase reactant

Question 25

Repletion in B12 or folate can result in?

Answer 25

Hypokalemia (hyperactive marrow packages up potassium lowering serum level)

Question 26

Peripheral smear finding in: 1. Sideroblastic anemia 2. G6PD 3. Sickle cell

Answer 26

1. Basophilic stippling 2. Bite cells 3. Howell-Jolly bodies