Intro to Anemia Flashcards

1
Q

Define Anemia?

A

Inability of the blood to supply tissue W/adequate oxygen for proper metabolic function.

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2
Q

Clinical Definition of Anemia?

A

A decrease in the normal concentration of Hb or Eryths.

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3
Q

Anemia is not a disease, but a?

A

Expression of an underlying disorder or disease.

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4
Q

Important components of making a clinical diagnosis of anemia?

A

History and physical exam

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5
Q

Decrease in Oxygen delivery to the tissues decreases the PTs?

A

Energy for day to day activities (Fatigue).

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6
Q

Classic symptoms associated W/ anemia?

A

Fatigue & Shortness of breath (SOB)

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7
Q

Common signs and symptoms of Anemia?

A

Petechiae of the skin
Eye-pallor, jaundice, hemorrhage
Mouth-mucosal bleeding

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8
Q

Why is jaundice important in the assessment anemia?

A

B/c it may be due to increased RBC destruction.
This would suggest a hemolytic component of the anemia.

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9
Q

True Anemia

A

Decreased RBC mass
Normal plasma volume
Hgb 10.0 g/dL
Hct 30.0%

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10
Q

Pseudo/Dilutional Anemia

A

Normal RBC Mass
Increased plasma volume
(Pregnancy, Volume Overload, Congestive Heart Failure).
Hgb: 10.0 g/dL
Hct: 30.0%

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11
Q

8 Causes of Anemia

A

Hemorrhage

Accelerated RBC destruction (Immune or Non-Immune)

Nutritional Deficiency (Iron, B-12, Folate)

BM Replacement (Cancer)

Infection

Toxicity

Hematopoietic SC arrest/damage

Hereditary/Acquired Defect

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12
Q

Accelerated BM Erythropoiesis signs?

A

BM hypercellular
NRBCs may be released W/ retic.
(Correlates W/ severe anemia)
Demand exceeds max BM activity
(Extramedullary sites production).

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13
Q

Morphological classification of anemia?

A

Erythrocyte indices

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14
Q

Erythrocyte Indices

A

MCV
MCH
MCHC

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15
Q

Types of Morph Classifications of Anemias? Diseases associated?

A

Macrocytic, Normochromic
(Megaloblastic Anemias)
Normochromic, Normocytic
(BM Failure, Chronic Renal Failure, Leukemias)
Microcytic, Hypochromic (Most Common)
(IDA, SA, Thalassemias, Chronic Diseases)

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16
Q

Etiologic Classifications of Anemia? Diseases associated?

A
  • Maturation Defect:
    • Decreased Hgb Synth
      • Microcytic/Hypochromic
      • Normal-Low Retics
      • Diagnosis:
      • IDA, Thalassemias, SA, Chronic
        Disease
    • Decreased DNA Synth
      • “Macrocytic” Megaloblastic
      • Normal-Low Retics
      • Diagnosis:
      • Vitamin B-12, Folate Deficiencies
  • Production Defect:
    • BM Injury, Decreased Erythropoietin,
      Marrow infiltration
      • Normocytic, Normochromic
      • Normal-Low Retics
      • Diagnosis:
        • Aplastic Anemia, Renal Disease,
          Malignant Cells
  • RBCs loss from Circulation:
    • Hemorrhage
      • Normocytic, Normochromic
      • High Retics
      • Acute Blood Loss
  • RBC Survival Defect:
    • Increased RBC Destruction
    • Normocytic, Normochromic
    • High Retics
    • Hereditary-Acquired Hemolytic
      Anemias
17
Q

Lab Investigation for anemia begins W/?

A

CBC W/ Differential

18
Q

CBC findings of Anemia?

A

Decreased Hgb

RBC Indices classify anemia

RBC morph abnormalities (can be diagnostic or suggest further testing).

WBCs and PLTs are normal-Increased in most anemias (Low in aplastic anemias).

19
Q

Reticulocyte is useful in determining the?

A

Response to the anemia

20
Q

RPI < 2

A

Inadequate BM response

21
Q

RPI > 2

A

Good BM response

22
Q

Iron Studies

A

Differentiate Microcytic/Iron Overload

SI, TIBC, SF

23
Q

Increased Transferrin Synth
Increased TIBC
Low Iron
Low Ferritin

A

Iron Deficient state (IDA)

24
Q

Decreased Transferrin Synth
Decreased TIBC
Increased Iron
Increased Ferritin

A

Iron Overload state (SA)

25
Q

Normal Transferrin Level
Normal TIBC
Normal Iron
Normal Ferritin

A

Thalassemia Minor

26
Q

RBC Destruction Tests

A

Serum Bilirubin
Urine Urobilinogen

27
Q

Extravascular RBC Destruction

A

Increased Urobilinogen in Urine.

28
Q

Intravascular RBC Destruction

A

Hemoglobinuria

29
Q

When are RBC destruction tests useful?

A

Hemolytic Anemias

30
Q

RBC destruction tests in Anemia results:

A

Increased Serum Bilirubin

Increased Urine Urobilinogen

Increased Plasma Hgb

(Free Hgb in Blood)

Decreased Haptoglobin

Increased LD ( RBCs released)

31
Q

Hgb Electrophoresis

A

Detects & quantitates normal and abnormal Hgb types.

32
Q

When do we use Hgb Electrophoresis?

A

Thalassemias and Hemoglobinopathies

33
Q

Vitamin B-12 and Folate Levels

A

ID Macrocytic anemias

34
Q

Direct Antiglobulin Test (DAT)

A

Detects ABs and/or complement coated RBCs.

35
Q

DATs are useful for?

A

Immune Hemolytic Anemias

36
Q

BM Exam?

A

Evaluates the # & type of precursor cells.

37
Q

When are BM exams utilized?

A

Only in anemias due to production defects.

38
Q

What stain is used to assess the BM Iron stores?

A

Prussian Blue Iron Stain