Krafts Anemia 2 Flashcards
Best test for hemoglobinopathy?
Hgb electrophoresis
Most important hemoglobinopathy?
Sickle cell
Genetic cause of sickle cell?
point mutation in Beta chain gene
“Post-splenectomy blood picture” of sickle cell?
- nucleated RBCs
- targets
- Howell-Jolly bodies
- Pappenheimer bodies
- incr. platelets
Bugs to vaccinate against in sickle cell?
encapsulated:
S. pneumo
H. influenzae
4 thing you must know about Thalassemia?
- QUANTITATIVE defect in hgb
- can’t make enough alpha or beta chains
- variable severity
- hypochromatic, microcytic anemia with incr. RBC and targets
What’s worse, alpha thalasemia or beta?
alpha: if no alpha chains, can’t make hgb
no beta can still have some alpha-delta (HgbA2)
Morphology of Thalasemia:
- hypochromic, microcytic anemia
- target cells
- basophilic stippling
- depending on severity: may have minimal anisocytosis/poikilocytosis or marked of both
a-thalasemia common demographics:
asians, blacks
b-thalasemia common demographics:
mediterranian and blacks
How does G6PD deficiency cause anemia?
no glutathione (NADP can’t get reduced to NADPH) to clear radical peroxides –> cell lysis
Bite cells are characteristic of?
G6PD deficiency
*removal of Heinz bodies in Spleen
Whats a Heinz body?
clump of globin stuck to RBC membrane
Triggers of G6PD def?
- fava beans
- drugs (abx, asa)
Whats a big red flag for microangiopathic hemolytic anemia?
Schistocytes (deformed RBCs)
-physical trauma to RBCs
***better find out why!!!
Triangle cells classic for:
MAHA (microangiopathic hemolytic anemia)
Why is hgb normal at first in acute blood loss anemia?
hgb is a ratio and pt will be volume depleted
-must check after fluid resuscitation
***Reticulocytes show up after 2-3 days
Does anemia of chronic disease have reticulocytes?
NO
Things you must know about anemia of chronic disease?
- infx, inflammation, malignancy
- Fe metabolism disturbed (incr. hepcidin)
- normocytic, normochromatic anemia
- usually mild anemia
Cause of anemia of renal disease?
lack of EPO
What are echinocytes and when would you see them?
“spiny” cells
seen in anemia of renal disease
Things to know about anemia of liver disease:
common (3/4 of pts with liver disease are anemic)
many causes
“uncomplicated” cases rare
acanthocytes, targets
Things to know about aplastic anemia?
pancytopenia
empty marrow
most are idiopathic
