Hypoproliferative anemias Flashcards
Lab signs of hypoproliferative anemia?
anemia
low RC
Why is hypersplenism causes in hypoproliferative anemia?
takes on rose of extramedullary hematopoiesis
Stem cell disorders w/pancytopenia DD?
aplastic anemia
PNH
Ineffective hematopoiesis w/pancytopenia DD?
MDS
megaloblastic anemia
Marrow infiltration w/pancytopenia DD?
leukemia/lymphoma
metastatic carcinoma
myelofibrosis
Splenic sequestration w/pancytopenia DD?
leukemia/lymphoma
MPNs
storage disorders
Portal hypertension
Drugs/tx w/pancytopenia DD?
chem/rad
immunosuppression
other
PB changes in megaloblastic anemia?
hypersegments PMNs
macrocytic anemia with oval macrocytes
anisopoikilocytosis
BM changes in megaloblastic anemia?
hypercelllularity
giant bands
muclear to cytoplasmic dyssynchrony (megaloblastic change) in erythroids, grans
What effect does 5-FU (5-fluorouracil) have on purine synthesis?
inhibits thymidylate synthesis
What do chief cells secrete?
Acid
What do parietal cells secrete?
intrinsic factor
Causes of vitamin B12 deficiency
impared absorption -IF deficiency, ileal resection, pancreatic insuff increased req decreased intake tapeworm
Symptoms of pernicious anemia?
megaloblastic anemia
demyelination/parasthesias/other neurologic effects
Most common reason for IF problem?
autoantibodies against IF (req for dx of pernicious anemia)
Vit B12 def labs
low vitB12
low RC
autoantibodies to IF or parietal cells
elevated methylmlonic acid
Causes of folate deficiency
decreased intake (EtOH, poverty) increased reqs (growth, pregnancy) defective absorption -jejunal resection, malabsorption folic acid antagonists
Symptoms of folate deficiency?
megaloblastic anemia
neural tube defects (spina bifida, anencephaly)
Can you treat a B12 deficiency with folate?
no, anemia will reverse but neuro prolems will not
DD fro microcytic hypochromia anemia?
IDA
thalassemia
ACD
Causes of iron deficiency?
dietary lack
imparied absorption
increaed req
chronic blood loss (GI, menstrual)
Another name for hte transferrin receptor?
CD71
How to dx IDA?
microcytic, hypochromic anemia iron studies (esp serum ferritin <12ugL)
Iron stduies for IDA
RC decreased Marrow Iron decreased Serum ferritin decreased Serum iron decreased TIBC increased % sat decreased
Iron studies for thalassemia
RC increased or decreased Marrow Iron no change/increased Serum ferritin no change/increased Serum iron no change/increased TIBC no change/decreased % sat no change/increased
Iron studies for ACD
RC decreased Marrow Iron increased Serum ferritin increased Serum iron decreased TIBC no change/decreased % sat no change/increased
How long does it take to find increased reticulocytes in the blood?
5-7 days
