macrocytic anemia

Question 1

what does a chronic anemia look like in a lab test

Answer 1

MCV normal or slightly decreased decreased reticulocytes and serum iron,

Question 2

what is the mechanism of anemia in chronic inflamation

Answer 2

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

Question 3

what is the treatement fo anemia of chronic disease

Answer 3

treat the cause, EPO injection, make sure fe is good, RBC transfuscion if needed, antihepcidin and antiTNF

Question 4

what is sideroblastic anemia

Answer 4

ringed sideroblasts in the marrow, casese impated heme synth, ineffective erythropeoiesis, increased serum ferritin and cirocytossi.

Question 5

what is sideroblastic anemia caused by

Answer 5

x linked or autosomal pyridoxin responsive and refractory, acquired from lead zinc ethanol abuse myelo dysplastic syndrome, deficiency of copper.

Question 6

what are the lab feature of siderblastic anemia

Answer 6

dimorphic low retic response, and hyposegmemted PMN

Question 7

how do you treat sideroblastic anemia

Answer 7

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

Question 8

what is on slide 55 on how to differentiate

Answer 8

look at slide 55

Question 9

when do you usualy see round macrocytes

Answer 9

liver disease

Question 10

when do you see a mitroovalocytes

Answer 10

b12 deficiency

Question 11

what are som causes pf macrocytosis

Answer 11

vitamin b12 or folate deficiency, liver disease and post splenectomy, hemolysis EPO treatment, hypothyroidism hyperlipidemia cold agglutinins hyperglycemia

Question 12

what are the three mechanisms of macrocytosis

Answer 12

reticulocytosis, membrane changes of RBC, and interference with DNA ynthesis

Question 13

what is megaloblasic anemia

Answer 13

impared DNA synt

Question 14

what would cause megaloblastic anemia

Answer 14

folic acid or b12 deficiecny, erytholeukemia drugs that intefere with DNA synthesis.

Question 15

where is folic acid absorbed and where is b12 absorption

Answer 15

folic acid in the jejunum and b12 in terminal ilem

Question 16

what are the causes of folate deficiency

Answer 16

decreased intake, impaired absorption, increased requirement, and drugs/toxins

Question 17

what are some causes of B12 deficeincy

Answer 17

vegans, gastrectomy zollingers ellision to much h+ blind loop fish tape worm metformin

Question 18

what are some neurological manifestation of b12 deficiency

Answer 18

cognitive defects like depression madness, optic atropy anosmia loss of taste and glossitis

Question 19

when you see a blood smear with macrosytic anemia snad hypersegmented Pmn what do you expect

Answer 19

b12 or folate deficiency

Question 20

what is pernicious anemia

Answer 20

autoimmune caused by destruction of acid secretion and pepsin secretion of parietal cells leads to b12 deficiency.

Question 21

what are the treatments of folate and b12

Answer 21

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.

Question 22

what causes acute megaloblastic anemia

Answer 22

nitrous oxide toxicity, severe illness complicated by dialysis.