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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
Q

Describe a reticulocyte count

A

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)

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25
Q

What may cause a low-normal retic count

A
  • iron/B12/folate deficiency anemias
  • anemia of chronic disease
  • cancers
  • bone marrow failure/sarcoidosis
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26
Q

What may cause a high retic count

A
  • blood loss
  • hypersplenism
  • malaria
  • C. perfringens
  • liver disease
  • hemolysis (sickle cell, hemolytic-uremic syndrome, mechanical cardiac valve)
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27
Q

Describe what a serum ferritin is measuring

A

water soluble protein complex that stores iron
- low in iron deficiency anemia
- high in iron overload, inflammation

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28
Q

Describe what a serum iron is measuring

A

amount of iron bound to transferrin
- low in iron deficiency anemia
- high in hemochromatosis & liver disease

29
Q

Describe what a TIBC is measuring (#)

A

total iron binding capacity
- capacity for transferrin to accept iron
- high in iron deficiency anemia

30
Q

Describe what transferrin saturation is measuring (%)

A
  • tells you how much serum iron is bound to transferrin
  • low in iron deficiency anemia
  • high in iron overload, hemochromatosis
31
Q

What can hemoglobin electrophoresis help diagnose

A
  • thalassemia
  • sickle cell anemia
32
Q

What can a serum red cell fragility test tell us

A
  • percent of hemolysis
  • spherocytes are more fragile (hereditary or thalassemia)
  • target cells, hypochromic cells less fragile
33
Q

What does a serum coombs test (antiglobulin test) help identify

A
  • helpful in hemolytic anemia
  • identifies Abs on surface of RBC indicates likelihood of destruction
34
Q

What can flow cytometry tell us

A

qual/quant data about RBC size, complexity, DNA/RNA content, description of proteins within

35
Q

Define erythrocytosis

A

increase in red cell mass (caused by polycythemia vera)

36
Q

Define anemia

A

decrease in red cell mass (many causes)

37
Q

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

A

d. Iron deficiency anemia

38
Q

Approximately what percent of heme dietary iron is absorbed

A

10-20% (1-5mg/day needs to be absorbed)

39
Q

What can cause anemia of lead toxicity

A

chronic repeated exposure (ammo, plumbing, pottery, paint, batteries, occupation, immigration, home remodelling)

40
Q

What is the USPSTF rec for screening for anemia of lead toxicity

A

routine at age 1 and 5 for lead level, then risk based

41
Q

What is the treatment for anemia of chronic disease

A
  • treat underlying condition
  • give EPO if Hgb <10
  • consider concomitant Fe, folic acid deficiency
42
Q
A

Treat the source

43
Q
A

Small amounts of bleeding in the GI tract or too full on milk which affects absorption/inadequate diet

44
Q
A

a. constipation

45
Q
A

a. ground beef

46
Q
A

d. pregnancy

48
Q
A

c. presence of neuro sxs

49
Q
A

D. vitamin B12 deficiency

50
Q
A

A. vitamin B12

51
Q
53
Q

Describe the etiology of polycythemia vera

54
Q

Describe the presentation of polycythemia vera

55
Q

What are some general symptoms of anemia

56
Q

Describe the etiology of iron deficiency anemia

57
Q

Describe the presentation of iron deficiency anemia

58
Q

Describe the labs for iron deficiency anemia

59
Q

Describe the treatment for iron deficiency anemia

60
Q

Describe the USPSTF recommendations for iron deficiency anemia screening

61
Q

Describe the etiology of B12 deficiency anemia

62
Q

Describe the presentation of B12 deficiency anemia

63
Q

Describe the labs for B12 deficiency anemia

64
Q

Describe the treatment for B12 deficiency anemia

65
Q

Describe the etiology of folate deficiency anemia

66
Q

Describe the presentation of folate deficiency anemia

67
Q

Describe the labs for folate deficiency anemia

68
Q

Describe the treatment & prevention of folate deficiency anemia

69
Q

Describe the etiology of anemia of inflammation

70
Q

Describe the labs for anemia of inflammation

71
Q

Describe the etiology of anemia of organ failure

Heme/Onc (16 decks)

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