Heme Onc Flashcards
What is the most common cause of iron deficiency anemia in elderly?
colon polyps/carcinoma. Ancylostoma duodenale and necator americaus inthe devloping world
In adults, what is the most common cause of iron deficiency anemia?
males: peptic ulcer disease
females: menorrhagia or pregnancy
gastrectomy–iron is absorbed best in acidic environements
What is the most common cause of iron deficiency anemia in infants
breastmilk has low iron
Lab findings of iron deficiency anemia?
Size, color, RDW, ferritin, TIBC, serum iron, %sat, FEP?
microcytic, hypochromic, inc RDW, dec ferritin, inc TIBC, dec serum iron, dec % sat, inc FEP
Where does the final step of heme synthesis take place and what enzyme?
in the mitochondria. Ferrochetalase attaches protporphyrin to iron to make heme
First line treatment for lead poisoning?
Dimercaprol and EDTA. Succimer in children
Where is folate absorbed?
jejunum
Where is B12 absorbed?
ileum
Where is iron absorbed?
duodenum
What two reactions require B12?
- Homocysteine conversion to methionine
- Fatty acid metabolis: methylcalonic acid to succinyl CoA
Describe the breakdown products of heme?
Heme is broken down into iron and protporphyrin. Iron is recycled and protoporyphyrin is broken down into UCG bilirubin, which is delivered to the liver for conjugation and excretion into the bile.
What is the most common cause of death in children with sickle cell anemia?
infections due to autosplenectomy (S. pneumo, H. flu)
What is the most common cause of death in adult patients with sickle cell anemia?
acute chest syndrome
What is the complication commonly seen in sickle cell trait?
sickling in the renal medulla leading to microinfarction that lead to microscipic hematuria and eventually decreased ability to concentrate urine
What cancers produce excessive EPO?
- RCC
- Pheo
- HCC
- Hemangioblastoma
When do you see HbH?
tetramers of beta globin chains. Seen in 3 gene deletions in alpha-thalassemia
When do you see Hb Barts and what are they made of?
4 gene deletion in alpha-thalassemia. Made of gamma tetramers (from fetal hemoglobin)
What drugs cause aplastic anemia?
Can’t Make New Blood Cells Properly
Carbamazepine
Methimazole
NSAIDs
Benzene
Chloramphenicol
Propylthiouracil
What is a common complication of paroxysmal nocturnal hemglobinuria?
acute myeloid leukemia
?What is the main cause of death in PNH
thombosis of the hepatic, portal or cerebral veins
What is the defect in paroxysmal nocturnal hemoglobinuria?
acquired defect in myeloid stem cells resulting in absense of GPI so no DAF or MIRL (CD55)
