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Heme/Onc > Labs & Anemias of Deficiency > Flashcards

Labs & Anemias of Deficiency Flashcards

1
Q

List some things that can cause leukopenia

A
  • viral infection
  • sepsis
  • leukemia
  • meds that suppress bone marrow (chemo)
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1
Q

List some things that can cause leukocytosis

A
  • infection/inflammation
  • bacterial infection (with left shift)
  • leukemia
  • meds (steroids)
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2
Q

List some things that can affect basophil absolute count

A
  • increased in leukemia
  • stippling seen in anemias
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3
Q

List some things that can cause lymphocytosis

A
  • infection
  • leukemia/lymphoma
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4
Q

List some things that can affect monocyte absolute count

A
  • infection & recovery
  • hematologic cancers
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5
Q

List some things that can cause thrombocytosis

A
  • leukemia
  • acute infection
  • iron deficiency anemia
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6
Q

List some things that can cause thrombocytopenia

A
  • hematologic disorders
  • some infections
  • liver disease/cirrhosis
  • clotting of the sample
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7
Q

What kinds of things can cause erythrocytosis

A
  • polycythemia vera
  • chronic lung disease
  • living at high altitude
  • EPO use (doping)
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8
Q

List the important elements of hemoglobin production

A
  • Transferrin
  • Dietary iron, B12, Folate
  • Hepcidin hormone
  • erythropoietin
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9
Q

Describe the role of transferrin in hemoglobin production

A

carries iron from intestines to site of use and storage (bone marrow & muscle)

(high in iron deficiency)

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10
Q

Describe hepcidin’s role in hemoglobin production

A
  • iron regulatory hormone produced by the liver

(increases with inflammation and decreases with erythropoiesis)

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11
Q

Describe the role of erythropoietin in hemoglobin production

A

hormone produced by the kidneys in response to cellular hypoxia which stimulates bone marrow to make RBC & inhibit apoptosis

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12
Q

What test can describe how much hemoglobin is present, what the RBC looks like, and how many immature cells are present

A

CBC

(directly measures: MCV, Hgb, RBC count, RDW) (Calculates: Hct, MCH, MCHC)

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13
Q

What is a normal hemoglobin for a female

A

12-15.5 g/dL

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14
Q

What is a normal hemoglobin for a male

A

13.5-17.5

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15
Q

Describe what mean corpuscular volume is assessing (MCV)

A
  • size of average RBC
  • looked at in anemia
  • low: microcytic (<80)
  • normal: normocytic (80-100)
  • high: macrocytic (>100)
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16
Q

List some causes of microcytosis

A
  • chronic blood loss
  • iron deficiency
  • thalassemia
  • lead tox
  • anemia of chronic disease
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17
Q

Which conditions are typically normocytic

A
  • acute blood loss
  • kidney disease
  • anemia of chronic disease
  • most forms of mild anemia
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18
Q

Which conditions cause macrocytosis

A
  • B12 deficiency
  • folate deficiency
  • liver dz/alc overuse
  • meds
  • obesity
  • HoThyroidism
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19
Q

What does Mean corpuscular hemoglobin (MCH) measure

A

amount of Hgb per RBC & color

(If MVC is low, MCH is low. if MVC is high, MCH is high)

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20
Q

What does MCHC measure (mean corpuscular hemoglobin concentration)

A

average concentration of Hgb inside a single RBC (Hgb divided by Hct)

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21
Q

What does red cell distribution width measure (RDW)

A

measure of degree of variation in RBC size
- if high (Anisocytosis), greater variation
- usually high in iron/B12/folate deficiency anemias

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22
Q

What does anisocytosis mean

A

variation in RBC size, high RDW

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23
Q

What does Poikilocytosis mean

A

variation in RBC shape (on peripheral smear)

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24
Describe a reticulocyte count
measures immature RBCs in circulation - normal/decreased if there is a production problem - elevated in accelerated loss if RBCs are being replaced (like when we start treating iron/B12/folate deficiency anemias)
25
What may cause a low-normal retic count
- iron/B12/folate deficiency anemias - anemia of chronic disease - cancers - bone marrow failure/sarcoidosis
26
What may cause a high retic count
- blood loss - hypersplenism - malaria - C. perfringens - liver disease - hemolysis (sickle cell, hemolytic-uremic syndrome, mechanical cardiac valve)
27
Describe what a serum ferritin is measuring
water soluble protein complex that stores iron - low in iron deficiency anemia - high in iron overload, inflammation
28
Describe what a serum iron is measuring
amount of iron bound to transferrin - low in iron deficiency anemia - high in hemochromatosis & liver disease
29
Describe what a TIBC is measuring (#)
total iron binding capacity - capacity for transferrin to accept iron **- high in iron deficiency anemia**
30
Describe what transferrin saturation is measuring (%)
- tells you how much serum iron is bound to transferrin - low in iron deficiency anemia - high in iron overload, hemochromatosis
31
What can hemoglobin electrophoresis help diagnose
- thalassemia - sickle cell anemia
32
What can a serum red cell fragility test tell us
- percent of hemolysis - spherocytes are more fragile (hereditary or thalassemia) - target cells, hypochromic cells less fragile
33
What does a serum coombs test (antiglobulin test) help identify
- helpful in hemolytic anemia - identifies Abs on surface of RBC indicates likelihood of destruction
34
What can flow cytometry tell us
qual/quant data about RBC size, complexity, DNA/RNA content, description of proteins within
35
Define erythrocytosis
increase in red cell mass (caused by polycythemia vera)
36
Define anemia
decrease in red cell mass (many causes)
37
What is the most common etiology of anemia d/t malnutrition worldwide? a. Anemia of chronic disease b. B12 anemia c. Cow's milk anemia d. Iron deficiency anemia
d. Iron deficiency anemia
38
Approximately what percent of heme dietary iron is absorbed
10-20% (1-5mg/day needs to be absorbed)
39
What can cause anemia of lead toxicity
chronic repeated exposure (ammo, plumbing, pottery, paint, batteries, occupation, immigration, home remodelling)
40
What is the USPSTF rec for screening for anemia of lead toxicity
routine at age 1 and 5 for lead level, then risk based
41
What is the treatment for anemia of chronic disease
- treat underlying condition - give EPO if Hgb <10 - consider concomitant Fe, folic acid deficiency
42
Treat the source
43
Small amounts of bleeding in the GI tract or too full on milk which affects absorption/inadequate diet
44
a. constipation
45
a. ground beef
46
d. pregnancy
47
C
48
c. presence of neuro sxs
49
D. vitamin B12 deficiency
50
A. vitamin B12
51
B. kidney
52
ice
53
Describe the etiology of polycythemia vera
54
Describe the presentation of polycythemia vera
55
What are some general symptoms of anemia
56
Describe the etiology of iron deficiency anemia
57
Describe the presentation of iron deficiency anemia
58
Describe the labs for iron deficiency anemia
59
Describe the treatment for iron deficiency anemia
60
Describe the USPSTF recommendations for iron deficiency anemia screening
61
Describe the etiology of B12 deficiency anemia
62
Describe the presentation of B12 deficiency anemia
63
Describe the labs for B12 deficiency anemia
64
Describe the treatment for B12 deficiency anemia
65
Describe the etiology of folate deficiency anemia
66
Describe the presentation of folate deficiency anemia
67
Describe the labs for folate deficiency anemia
68
Describe the treatment & prevention of folate deficiency anemia
69
Describe the etiology of anemia of inflammation
70
Describe the labs for anemia of inflammation
71
Describe the etiology of anemia of organ failure

Heme/Onc (16 decks)

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