Lecture 2 - Approach to anemias Flashcards
what kind of anemia does iron deficiency cause?
what is the classic symptom?
microcytic (and hypochromic);
PICA (and koilonychia-spoon nails)
where are these three things absorbed in the GI tract?
Fe =
B12 =
Folate =
duodenum;
terminal illeum;
jejunum
of folate and B12 deficiency, which has neurological symptoms?
B12
what lab differentiates between decreased production and shortened red cell survival?
reticulocyte count
ie production probs = decreased RC;
shortened survival=increased RC
equation for absolute reticulocyte count
ABR= %RC * RBC count
equation for MCV:
low MCV indicates problem with ____
high MCV indicates problem with _____
MCV = HCT/RBC;
Hb amount;
DNA synthesis
anemia of chronic disease is due to increased ____
hepcidin (traps iron in MQ, decreases absorption)
sideroblastic anemia is due to a defect in ____ synthesis. Iron gets trapped in the _____
protoporphyrin;
mitochondria
lead denatures _____ and ALA dehydratase. what kind of anemia does it cause?
characteristic finding on blood smear?
ferrochelatase;
microcytic;
basophilic stippling
thalassemias show what on blood smears?
target cells
low serum iron, high TIBC, low ferritin.
diagnosis?
iron deficiency
low serum iron, low TIBC, high ferritin.
diagnosis?
Anemia of chronic disease
2 main causes of non-megaloblastic macrocytic anemia:
liver disease, alcohol
characteristic finding on blood smear in megaloblastic anemia?
hypersegmented PMNs;
also pancytopenia
characteristic finding on blood smear in myelodysplastic syndrome?
what kind of anemia?
pelger-huet anomaly (bilobed PMN);
megaloblastic (also weird shaped RBCs)
pernicious anemia typically causes megaloblastic anemia due to ____ deficiency.
alcoholics may have megaloblastic anemia due to _____ deficiency
B12, folate
in aplastic anemia, RC is ____ and MCV is ____
low, normal
2 viruses that can case bone marrow failure
parvovirus B19;
HIV
an anemia with high reticulocyte count is due to one of 2 general reasons:
blood loss, hemolysis
in hemolysis:
____ RC;
____ haptoglobin;
____ LDH
high, low, high;
also increased bilirubin and hemosiderin
warm antibodies are typically Ig___;
cold agglutinins are usually ____
IgG;
IgM
2 diseases that can cause cold IgM Abs
infectious mononucleosis, mycoplasma
_____ is due to a defect in ankyrin or band 3.1
hereditary spherocytosis
_____ is due to a defect in GPI proteins, causing loss of DAF
Paroxysmal Nocturnal Hemoglobinuria
where would you see “spur cell” anemia?
liver failure
shistocytes are seen with _____.
another name for these cells?>
microangiopathic hemolytic anemia;
helmet cells
