macrocytic anemia Flashcards
what does a chronic anemia look like in a lab test
MCV normal or slightly decreased decreased reticulocytes and serum iron,
what is the mechanism of anemia in chronic inflamation
RBC survival down due to macrophage activation, hepcidin mediated impared iron absorption, TNF released from macrophagesm and Il1 released gamma inteferon and suppresses erythropoietin and red blood cell production
what is the treatement fo anemia of chronic disease
treat the cause, EPO injection, make sure fe is good, RBC transfuscion if needed, antihepcidin and antiTNF
what is sideroblastic anemia
ringed sideroblasts in the marrow, casese impated heme synth, ineffective erythropeoiesis, increased serum ferritin and cirocytossi.
what is sideroblastic anemia caused by
x linked or autosomal pyridoxin responsive and refractory, acquired from lead zinc ethanol abuse myelo dysplastic syndrome, deficiency of copper.
what are the lab feature of siderblastic anemia
dimorphic low retic response, and hyposegmemted PMN
how do you treat sideroblastic anemia
pyridoxin in the genetic, drug and toxin can be removed in lead or ethanol, or if it comes to it transfuscion or stelm cell transplantiation
what is on slide 55 on how to differentiate
look at slide 55
when do you usualy see round macrocytes
liver disease
when do you see a mitroovalocytes
b12 deficiency
what are som causes pf macrocytosis
vitamin b12 or folate deficiency, liver disease and post splenectomy, hemolysis EPO treatment, hypothyroidism hyperlipidemia cold agglutinins hyperglycemia
what are the three mechanisms of macrocytosis
reticulocytosis, membrane changes of RBC, and interference with DNA ynthesis
what is megaloblasic anemia
impared DNA synt
what would cause megaloblastic anemia
folic acid or b12 deficiecny, erytholeukemia drugs that intefere with DNA synthesis.
where is folic acid absorbed and where is b12 absorption
folic acid in the jejunum and b12 in terminal ilem
what are the causes of folate deficiency
decreased intake, impaired absorption, increased requirement, and drugs/toxins
what are some causes of B12 deficeincy
vegans, gastrectomy zollingers ellision to much h+ blind loop fish tape worm metformin
what are some neurological manifestation of b12 deficiency
cognitive defects like depression madness, optic atropy anosmia loss of taste and glossitis
when you see a blood smear with macrosytic anemia snad hypersegmented Pmn what do you expect
b12 or folate deficiency
what is pernicious anemia
autoimmune caused by destruction of acid secretion and pepsin secretion of parietal cells leads to b12 deficiency.
what are the treatments of folate and b12
Folate 1 mg po daily can use iv and prenatal in pregnant ladies, B12 parental are better absorbed oral can be given but only if its not malabsorptive anemia.
what causes acute megaloblastic anemia
nitrous oxide toxicity, severe illness complicated by dialysis.
