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GI part 2 > icr: ANEMIA > Flashcards

icr: ANEMIA Flashcards

1
Q

pancytopenia

A

decrease in RBC, WBC, and platelets

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2
Q

normal HB

A

12-16 for female; 14-18 for males

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3
Q

normal HCT

A

37-47 female; 40-54 male

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4
Q

African American hb and hct is…

A

lower than caucasians

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5
Q

leukopenia

A

decreased WBC

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6
Q

thrombocytopenia

A

decreased platelets

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7
Q

aerobic exercise tends to _____ hb and hct

A

lower

by increasing plasma volume and increasing erythrocyte 2,3DPG synthesis

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8
Q

in pregnancy, what increases? what falls?

A

plasma volume, RBC mass increase

MCV and Hb fall

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9
Q

O2 delivery =

A

cardiac output x O2 carrying capacity

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10
Q

symptoms of insufficient oxygen delivery

A

fatigue, irritability, confusion, poor focus, dyspnea on exertion, angina, mental status changes, pallor,(all indicate anemia)

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11
Q

if MCV is increased…

A

large RBC = nuclear problems

megaloblastic anemia, myelodysplastic anemia, chemo induced

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12
Q

if MCV is low ..

A

small RBCs = cytoplasmic problem

iron deficiency anemia, abnormal Hb

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13
Q

HCT

A

the percentage of blood occupied by RBC

CALCULATED, NOT measured

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14
Q

what is the best measure of oxygen carrying capacity?

A

Hemoglobin

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15
Q

MCV

A

size of individual RBC; allows categorization of macrocytic, normocytic, or microcytic

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16
Q

high RDW means…

A

there is more than one population of RBCs

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17
Q

saturation %

A

iron/transferrin ratio

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18
Q

iron deficiency vs chronic disease vs pregnancy

A

distinguished by transferrin

increases in iron deficiency, decreases in anemia of chronic disease, and slightly increased in pregnancy

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19
Q

iron is increased

A

in hemolytic anemia; when serum iron turnover is fast

20
Q

reticulocytes (ARC)

A

slightly blue due to residual RNA;

hypo 100,000

21
Q

HIGH reticulocytes means

A

acute blood loss or RBC destruction

22
Q

causes of iron deficiency anemia

A

iron malabsorption
transferrin deficiency
loss of iron

23
Q

ferritin vs transferrin

A

f stores iron; t transports it

24
Q

symptoms of iron deficiency

A 
headache
glossitis
pica
leg cramping
somatitis
25
Q

B12 deficiency

A

via lack of intake(meat/dairy) or impaired absorption (r binder, intrinsic factor from parietal cells)
marrow arrested in S phase –> increased RBC size
***inverse relationship of severity of anemia and neurologic disease
SYmptoms: anemic signs, glossitis, dementia, ipersonality change, loss of vibratory and position sense

larger MCV, oval, hypersegmented neutrophils

26
Q

B12 is necessary for

A

DNA synthesis

27
Q

normal B12 absoprtion

A

b12 binds to gastric r binder
parietal cells release intrinsic factor
b12-r binder dissociate in duodenum due to pancreatic proteases
B12 and IF bind –> absorbed in distal ileum

28
Q

sickle cell anemia

A 
abnormal Hb (glutamate instead of valine at 6th position of beta chain)
HbS becomes polymerized in times of low Oxygen--> sickling--> microvascular infarcts and severe anemia

sickle cells and target cells

29
Q 
1- acanthocyte
2- echinocyte
3 - elliptocyte
4 - schistocyte 
5 - sickle cells
 6 - spherocyte
7 - stomatocyte
8 - codocyte/target cell
9 - dacrocyte
A 
1 spines w irregular lengths and spacing
2 short rounded even spaced spines
3 oval and elongated
4 fragmented, crescent with a few spines
5 crescent, pointy ends
6 small spheres with no central pallor
7 slit like center
8 thin cell, increased diameter Hb
9 tear drop
30
Q

what disease has a majority of TARGET cells

A

thalassemia

31
Q

bite cells –>

A

G6PD deficiency

32
Q

Hgb is measured

A

directly

33
Q

microcytic anemias

A 
CELTICS
chronic disease
eHgb
lead poisoning
thalassemis
iron deficiency
cancer
sideroblastic
34
Q

normocytic anemias

A

early renal or early chronic disease
sickle cell
hemolytic
hemorrhage

35
Q

macrocytic anemias

A

b12/folate, alcohol, meds, thyroid, reticulocytosis, aplastic anemia,

36
Q

hepcidin

A

iron absorption regulator

37
Q

iron deficient anemia synptoms

A

pica
pallor
glossitis
koilonychias of nails

38
Q

in IDA, TIBC is? ferritin is?

A 
tibc high
ferritin low (
39
Q

when is ferritin high?

A

not IDA

it is in inflammatory states

40
Q

in anemia of chronic disease, MCV is

A

initially normocytic, but become microcytic

41
Q

labs of anemia of chronic disease

A 
high esr or crp
normal or high ferritin
normal or low tibc
normal or low iron
increased IL6
increased hepcidin
42
Q

in anemia due to chronic kidney disease…

A

underproduction of EPO (produced in the kidneys in adults)

low reticulocyte count and increased inflammation

43
Q

pernicious anemia

A

destruction of parietal cells -> b12 cant be absorbed (no intrinsic factor)

44
Q

B12 is a cofactor for two rxns

A

1) methylation of homocyteine to methionine by homocsteine methyltransferase
2) methylmalonyl coa –> succinyl coa by methylmalonyl coa mutase

45
Q

b12 molecules has

A

cobalt (cobalamin) - picks up the methyl from FH4

46
Q

folate vs b12 def

A 
foalte = low folate, high homocysteine (NO NEURO symptoms)
b12 = normal folate, low b12, high homocycteina and methylmalonic acid

GI part 2 (8 decks)

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