IDA Lab Test Flashcards
aim to detect the anemia before it becomes severe.
A _______is typically used, revealing changes in red blood cells (RBCs) that indicate iron deficiency
Screening tests
complete blood count (CBC)
IDA screening
- Indicators in the CBC:: Variation in RBC size.: Smaller-than-normal RBCs.: Pale RBCs due to low hemoglobin.: Early sign showing variability in RBC size, often exceeding 15%.
: Indicators that the anemia is worsening.
- Anisocytosis
- Microcytosis
- Hypochromia
- Increased RDW (Red Cell Distribution Width)
- Declining Hemoglobin, MCV, MCH, and MCHC
Screening Tests
Screening for IDA focuses on changes in red blood cell (RBC) indices, morphology, and other hematologic findings:
- Hemoglobin Concentration
• _______hemoglobin is a key indicator of anemia.
• Helps assess the severity of IDA. - Red Cell Distribution Width (RDW)
• RDW____ indicates significant variation in RBC size (______).
• RDW increases early in IDA as new smaller cells (_______RBCs) are produced. - Progressive Decline of RBC Indices
• ______: Smaller-than-normal RBCs (decreased Mean Corpuscular Volume, MCV).
• _______: Paler RBCs due to reduced hemoglobin content (decreased Mean Corpuscular Hemoglobin, MCH). - RBC Count
• ______slowly as the anemia progresses. - Polychromasia
• Increased _______may appear early in IDA but is not a prominent feature. - ________
• Abnormal shapes of RBCs may be present, but no specific shape is characteristic of IDA. - _____-
• Elevated platelet count is often observed, especially in cases of chronic bleeding. - White Blood Cell (WBC) Count
• Remains______ in most cases of IDA.
Decreased
> 15%; anisocytosis; microcytic
Microcytosis; Hypochromia
Decreases
reticulocytes (young RBCs)
Poikilocytosis
Thrombocytosis
normal
Diagnostic Testing: Confirming Iron Deficiency
Serum Iron
Total Iron-Binding Capacity (TIBC)
Transferrin Saturation
Serum Ferritin
Diagnostic testing
• ASSAYS:
1.______: measure of the amount of iron bound to transferrin (transport iron) in the serum
2._______
• Indirect measure of transferrin and the available binding sites for iron
3.______:
• % of transferrin binding sites occupied by iron
4. _______
• Intracellular storage repository for metabolically active iron
SERUM IRON
TIBC (TOTAL IRON-BINDING CAPACITY)
TRANSFERRIN SATURATION
SERUM FERRITIN
Measures the amount of iron bound to transferrin (a protein that transports iron).
Serum Iron:
Reflects the availability of transferrin binding sites for iron.
TIBC (Total Iron Binding Capacity):
: Percentage of transferrin binding sites occupied by iron; this value decreases in iron deficiency.
Transferrin Saturation
: Indicates the body’s stored iron.
A low ferritin level strongly suggests iron deficiency.
Serum Ferritin
IDA Diagnostic
- Key Patterns in Results:
- Low____ and _____
- High_____ and low _____as the liver tries to compensate for the deficiency.
serum ferritin and serum iron levels.
TIBC
transferrin saturation
• NOT COMMONLY USED
• Show abnormalities that become important in the differential diagnosis of similar conditions
• Accumulated porphyrin to heme are elevated
SPECIALIZED TEST
SPECIALIZED TEST (4)
- FREE ERYTHROCYTE PROTOPORPHYRIN (FEP)
- SOLUBLE TRANSFERRIN RECEPTORS (sTfR)
- BONE MARROW ASSESSMENT
- THERAPEUTIC TRIAN
• Accumulates when iron is unavailable
• Chelates with zinc => zinc protoporphyrin (ZPP).
• Assayed fluorometrically
FREE ERYTHROCYTE PROTOPORPHYRIN (FEP)
• Can be assayed using immunoassays
• Levels decrease as the disease progresses
• Cells seek to take in as much as possible
SOLUBLE TRANSFERRIN RECEPTORS (sTfR)
• Is NOT indicated for suspected uncomplicated iron deficiency
• Routinely performed when BM specimen is collected for other reasons
BONE MARROW ASSESSMENT
• IRON DEFICIENCY IN BONE MARROW:
•: hyperplastic, decrease M:E ratio due to increase erythropoiesis
•: hyperplasia subsides, deficient iron leads to slowed RBC production
EARLY
PROGRESSION
IDA in BM
• ______show the most dramatic morphologic changes
• ______maturation lagging behind nuclear maturation
• Cytoplasm remains_____ after the nucleus had begun to condense
• Cell membrane appear irregular and usually describe as “_____”
Polychromatic normoblasts
Nuclear-cytoplasmic
bluish
shaggy
• Provides a less invasive and less expensive diagnostic assessment
THERAPEUTIC TRIAN
Measures the amount of hemoglobin in young RBCs (reticulocytes).
It detects iron deficiency early, even before anemia develops.
Reticulocyte Hemoglobin Content
: In iron deficiency, the body uses zinc instead of iron to form hemoglobin, leading to higher ZPP levels.
Zinc Protoporphyrin (ZPP)
are immature RBCs that indicate how well the body is producing new RBCs.
If their hemoglobin content is low, it suggests iron-restricted erythropoiesis.
This tests are particularly useful for identifying iron deficiency during its latent (early) stage.
Reticulocytes
are immature RBCs that indicate how well the body is producing new RBCs.
If their hemoglobin content is low, it suggests iron-restricted erythropoiesis.
These tests are particularly useful for identifying iron deficiency during its latent (early) stage.
Reticulocytes
