Lecture 2 - Approach to anemias

Question 1

what kind of anemia does iron deficiency cause?

what is the classic symptom?

Answer 1

microcytic (and hypochromic);

PICA (and koilonychia-spoon nails)

Question 2

where are these three things absorbed in the GI tract?

Fe =
B12 =
Folate =

Answer 2

duodenum;
terminal illeum;
jejunum

Question 3

of folate and B12 deficiency, which has neurological symptoms?

Answer 3

B12

Question 4

what lab differentiates between decreased production and shortened red cell survival?

Answer 4

reticulocyte count

ie production probs = decreased RC;
shortened survival=increased RC

Question 5

equation for absolute reticulocyte count

Answer 5

ABR= %RC * RBC count

Question 6

equation for MCV:

low MCV indicates problem with ____
high MCV indicates problem with _____

Answer 6

MCV = HCT/RBC;

Hb amount;
DNA synthesis

Question 7

anemia of chronic disease is due to increased ____

Answer 7

hepcidin (traps iron in MQ, decreases absorption)

Question 8

sideroblastic anemia is due to a defect in ____ synthesis. Iron gets trapped in the _____

Answer 8

protoporphyrin;

mitochondria

Question 9

lead denatures _____ and ALA dehydratase. what kind of anemia does it cause?

characteristic finding on blood smear?

Answer 9

ferrochelatase;
microcytic;

basophilic stippling

Question 10

thalassemias show what on blood smears?

Answer 10

target cells

Question 11

low serum iron, high TIBC, low ferritin.

diagnosis?

Answer 11

iron deficiency

Question 12

low serum iron, low TIBC, high ferritin.

diagnosis?

Answer 12

Anemia of chronic disease

Question 13

2 main causes of non-megaloblastic macrocytic anemia:

Answer 13

liver disease, alcohol

Question 14

characteristic finding on blood smear in megaloblastic anemia?

Answer 14

hypersegmented PMNs;

also pancytopenia

Question 15

characteristic finding on blood smear in myelodysplastic syndrome?

what kind of anemia?

Answer 15

pelger-huet anomaly (bilobed PMN);

megaloblastic (also weird shaped RBCs)

Question 16

pernicious anemia typically causes megaloblastic anemia due to ____ deficiency.

alcoholics may have megaloblastic anemia due to _____ deficiency

Answer 16

B12, folate

Question 17

in aplastic anemia, RC is ____ and MCV is ____

Answer 17

low, normal

Question 18

2 viruses that can case bone marrow failure

Answer 18

parvovirus B19;

HIV

Question 19

an anemia with high reticulocyte count is due to one of 2 general reasons:

Answer 19

blood loss, hemolysis

Question 20

in hemolysis:
____ RC;
____ haptoglobin;
____ LDH

Answer 20

high, low, high;

also increased bilirubin and hemosiderin

Question 21

warm antibodies are typically Ig___;

cold agglutinins are usually ____

Answer 21

IgG;

IgM

Question 22

2 diseases that can cause cold IgM Abs

Answer 22

infectious mononucleosis, mycoplasma

Question 23

_____ is due to a defect in ankyrin or band 3.1

Answer 23

hereditary spherocytosis

Question 24

_____ is due to a defect in GPI proteins, causing loss of DAF

Answer 24

Paroxysmal Nocturnal Hemoglobinuria

Question 25

where would you see “spur cell” anemia?

Answer 25

liver failure

Question 26

shistocytes are seen with _____.

another name for these cells?>

Answer 26

microangiopathic hemolytic anemia;

helmet cells