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Heme 2 > Hypoproliferative Anemia Study guide > Flashcards

Hypoproliferative Anemia Study guide Flashcards

1
Q

How are anemias categorized morphologically?

A

Classification: Morphology

  1. Microcytic
  2. Normocytic
  3. Macrocytic
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2
Q

How are anemias categorized functionall?

A
  1. Anemia of blood loss (acute or chronic)
  2. Hemolytic anemias
  3. Hypoproliferative anemias
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3
Q

characterized by ineffective erythropoiesis +/- hematopoiesis.

A

Hypoproliferative anemias

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4
Q

General categories within this group
of anemias includes: nutritional deficiency-related anemias, marrow failure syndromes, and anemias of chronic disease and renal failure.

A

Hypoproliferative anemias

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5
Q

is considered to be the most frequent cause of anemia overall in hospitalized patients.

A

ACD

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6
Q

The severity of ACD is related to the ______ of the chronic inflammatory disorder or the
______ in malignancy.

A

level of disease activity

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7
Q

In ACD, the anemia is generally _____ with

hemoglobin levels usually not lower than __ g/dL in uncomplicated cases.

A

mild or moderate,

9

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8
Q

What do we see on PBsmear in ACD?

A

mild to moderate anemia without noticeable polychromasia or anisocytosis (understimulation of erythropoiesis ) IG normochromic, normocytic

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9
Q

iron transport to the erythroid precursors is characteristically diminished in ACD, resulting in functionally iron-deficient conditions even in light of the already reduced stimulation of erythropoiesis associated with ACD. As a result, anemia becomes

A

hypochromic and microcytic in approximately 10-20% of cases.

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10
Q

Why would a prussion blue stain help Dx ACD?

A

Iron stored as hemosiderin within macrophages will be normal or, more commonly increased, whereas nucleated red cells with iron-containing granules (i.e.
sideroblasts) will be absent…The lack of sideroblasts indirectly reflects diminished delivery of iron to
erythroid precursors, which is typical of ACD

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11
Q 
Labs in ACD;
Bone marrow iron stores
serum ferritin
serum Fe
TIBC
Transferin saturation
A 
BM stores have increased stored iron and decreased sideroblastic iron
Increased serum ferritin
Decreased serum Fe
TIBC is decreased or normal
Transferin sat: decreased or normal
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12
Q

due to decreased erythropoietin production by the damaged kidneys.

A

Anemia of renal failure

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13
Q

It is a normocytic, normochromic anemia and is usually

responsive to recombinant erythropoietin therapy.

A

anemia of renal failure

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14
Q

i. Marrow infiltration by carcinoma

ii. Tear drop cells and leukoerythroblastic reaction

A

Myelophthisic Anemia

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15
Q

multifactorial and mechanisms are not
entirely clear. It is seen in chronic conditions, including chronic hepatitis or cirrhosis. Pancytopenia may be observed.

A

Anemia of liver disease

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16
Q

The RBCs tend to be_____ due to abnormal lipid processing in liver disease and the incorporation of lipids within the RBC membrane

A

macrocytic

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17
Q

rare condition in which there is selective inhibition of

erythropoiesis. Other lineages are not affected.

A

Pure red cell aplasia (PRCA)

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18
Q

Pure red cell aplasia (PRCA) produces ____, _____anemia due to no erythroid precursors in the marrow.

A

normocytic, normochromic

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19
Q

What is PRCA associated with?

A

It may be associated with thymic hyperplasia/thymomas, large granular lymphocytic leukemia, drugs, or autoimmune diseases.

20
Q

What is the pathophysiology of PRCA?

A

autoimmune destruction of erythroid

precursors.

21
Q

Pathophysiology of IDA

A

Iron is depleted in the diet,lost in chronic blood loss or by
malabsorption leading todecreased iron stores and
incorporation into hemoglobin

22
Q

 Microcytic, hypochromic anemia with pronounced anisopoikilocytosis
 ↓ serum ferritin, marrow iron stores, % saturation
 ↑TIBC

A

IDA

23
Q

Most common nutritional disorder worldwide

A

IDA

24
Q

IDA see in >50 yo is ______

A

gastrointestinal carcinoma until proven otherwise

25
Q

Anemia of chronic disease:
Increased_____ levels, caused by inflammatory mediators:
blocks the transfer of iron from _______ to sideroblasts
(red cell precursors)

A

hepcidin

marrow macrophages

26
Q 
ACD:
serum ferritin
TIBC
Marrow in iron stores
Sideroblastic iron
A

Increased serum ferritin
decreased TIBC
Increased marrow iron stores
decreased sideroblastic iron

27
Q

Most common anemia of hospitalized patients

Seen in inflammatory,infectious, and neoplastic conditions

A

Anemia of chronic disease

28
Q

 Normocytic, normochromic

 Echinocytes

A

Anemia or renal fail

29
Q

Decreased erythropoietin production secondary to

kidney disease leads to decreased erythropoiesis

A

Anemia of renal fail

30
Q

Folate or vitamin B12 deficiency leading to impaired

DNA synthesis see in what type of anemia

A

Megaloblastic anemia

31
Q

What is the result of Folate or Vit B 12 deficiency that causes impaired DNA synthesis

A

produces nuclear to cytoplasmic asynchrony in erythroid and granulocytic maturation

32
Q

Macrocytic anemia
 Macroovalocytes
 Hypersegmented neutrophils
 Nuclear to cytoplasmic asynchrony in marrow

A

Megaloblastic anemia

33
Q

Unique cause of Vit B12 deficiency seen in Megaloblastic anemia

A 
Pernicious anemia (atrophicvgastritis leading to vitamin
B12 deficiency due to intrinsic factor deficiency)
34
Q

In Megaloblastic anemia, what deficiet is associated with neurologic deficiets?

A

Neurologic deficits in vitamin B12 deficiency

35
Q

Suppression of bone marrow
pluripotent stem cells likely by
autoreactive T cells

A

Aplastic Anemia

36
Q

Cytopenias related to marrow infiltration by a carcinoma or

storage disorder

A

Myelophthisic anemia

37
Q

 Tear drop cells
 Leukoerythroblastic reaction
seen in what type of hypoproliferative anemia?

A

Myelophthisic anemia

38
Q

Anemia of the liver is macro or mircocytic

A

macrocytic

39
Q

Unknown but hypothesized to be autoimmune destruction of erythroid precursors in the marrow

A

Pure red cell aplasia

40
Q

PRCA is
 Normocytic, microcytic, macrocytic
Hypochromic or normochromic

A

Normocytic

normochromic

41
Q 
May be associated with
thymic hyperplasia or
thymoma, large granular
lymphocytic leukemia, or
autoimmune diseases
A

PRCA

42
Q

Why is serum Fe low in IDA and TIBC high?

A

serum Fe is low for obvious reasons, Fe is low

TIBC will increase (totol iron binding capacity) because teh body is TRYING to extract more iron

43
Q

Why is Fe low in ACD?

A

Because ACD is an inflammation situation. You make hepcidin which encourages Fe to stay stored in Bone marrow instead of being released (thus the lack of sideroblats)

44
Q

If Fe is low in ACD, why doesn’t TIBC increase?

A

TIBC won’t increase because the body doesn’t want to increase serum iron, it assumes that because there is inflammation it will make more FE available for bugs!

45
Q

Why is ferritin increased in ACD?

A

because ferittin is an acute phase reactant and ACD is inflammatatory process

Heme 2 (14 decks)

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