MedComplex-Exam 3 Part 1 (SickleCell,PA,FolateAnemias) Flashcards
What is the most common type of MEGALOBLASTIC anemia?
Pernicious Anemia
What type of anemia is Pernicious anemia?
Megaloblastic anemia
Pernicious anemia is a CHRONIC condition caused by malabsorption of _______, usually due to a lack of gastric _________, needed for absorption.
Vitamin B12 (in the small intestine), intrinsic factor
Pernicious Anemia is Most common in _____ adult life and is rare under the age of ____.
LATE….30
Where are the three most common areas to see Pernicious Anemia?
England, Ireland, Scandinavia
How do you test for Pernicious Anemia?
The (Curt) Schilling Test (The bloody sock test)
What is the substance tested for in a (curt) Schilling test for pernicious anemia? Which bodily fluid is looked at in this test?
Cobal-Amine (uh aka Vit B-12)…Urine (pt given cobalamine-it cannot be absorbed ORALLY by the PA patient-and then its peed out)
What is a prussian blue test looking for?
Iron deficiency anemia
What is another name for an IRON stain? What color does it stain the iron?
Prussian Blue
Which condition will the histo show HYPERSEGMENTATION of Neutrophils and Basophilic Stippling of the RBCs?
Pernicious Anemia
In hyper segmentation of neutrophils, how many nuclear segments are shown? How many are normal?
5-6 are shown whereas only 3-4 are normal
In a megaloblastic anemia which cells will be hyperhsegmented and which cells will show basophilic stippling?
hyperhsegmented NEUTROPHILS and basophilic stippling of RBCs
What amount of people with Pernicious Anemia have CNS lesions? What degeneration can this lead to?
3/4 have CNS lesions..can lead to SUBactue Combined degeneration (loss of vibratory sense)
What is the tongue manifestation of pernicious anemia?
red-beefy tongue w loss of papillae
What is the only difference in the presentation of Pernicious Anemia and Folic Acid deficiency?
FA does not have the CNS effects
What are the two most common cause of anemia? What is second?
Iron deficiency….thalassimia
Sickle cell anemia is caused by a genetic defect in the synthesis of the _____ chain of hemoglobin.
BETA
Sickle cell anemia: Substitution of ________ by _____ at the ___th position of the _____ chain.
Glutamic Acid by Valine…6th position…beta chain
In Sickle Cell Anemia: The abnormal beta chain still combines with alpha chains, but instead of normal Hgb A, an abnormal _____ is formed.
Hgb S
What type of electrophoresis is used in the diagnosis of Sickle cell anemia?
Hemoglobin Electrophoresis (not a protein electrophoresis) (NOT a plasma electrophoresis) (Hgb S migrates differently than Hgb A)
What group of people is most affected by Sickle Cell Anemia? What group of people is NOT as affected?
African Americans and Africans affected.. Meditarrainian’s not affected (thalassemia)
Like 3 questions for Sickle Crisis: What aggravates it (3)? Can they occur spontaneously?
aggravated by Fever, Respiratory Disease or Hypoxia…YES they can occur spontaneously
Like 3 questions for Sickle Crisis: all situations characterized by ___________ can induce a sickling crisis
reduced oxygen tension
Like 3 questions for Sickle Crisis: What 3 activities/life events can cause a crisis?
Mountain climbing, strenuous exercise…pregnancy
Like 3 questions for Sickle Crisis: What is a characteristic feature in children?
DACT-YL-ITIS (swelling of dorsum of hands and feet)
Complications of Sickle Cell Anemia: _______ of the skull due to bone marrow hyperplasia with “_______” appearance on skull X-ray.
BOSSING…“hair on end”
Complications of Sickle Cell Anemia: _________ are common and cause visual problems.
Retinal infarcts
Complications of Sickle Cell Anemia: What is the root cause of “Hair on End” appearance on the skull X-ray?
due to Bone Marrow Hyperplasia
Complications of Sickle Cell Anemia: Which organ becomes fibrotic and shrinks? What is the clinical term for this?
the spleen…autosplenectomy
Complications of Sickle Cell Anemia: Hemolysis results in WHAT 2 events in the liver? The increased excretion of WHAT?? in bile leads to the formation of _______.
hyperbilirubinemia and jaundice..Bilirubin…..bile stones
Complications of Sickle Cell Anemia: Foci of _______ necrosis, which heals by fibrous scarring can be detected in ALL organs.
ischemic
Complications of Sickle Cell Anemia: Retarded intellectual development, a consequence of brain ischemia and infarcts, the larger infarcts may cause a ______ syndrome.
stroke
Complications of Sickle Cell Anemia: The attempts of the heart to compensate for inadequate oxygen transport results in cardiac ________ and ultimately, heart failure.
hypertrophy
Complications of Sickle Cell Anemia: The occlusion of small peripheral blood vessels with sickled cells and thrombi aggravates the circulatory situation even more by increasing the __________.
peripheral resistance (blood pressure)
Complications of Sickle Cell Anemia: Pulmonary _____ is common due to the heart failure, and it tends to predispose to patients to PNEUMONIA.
edema
Complications of Sickle Cell Anemia: Infections are facilitated by changes in the ______ and _____.
SPLEEN and LIVER
Complications of Sickle Cell Anemia: Other infections are common and recurrent, and usually involve foci of aseptic _____ necrosis, infarcts of internal organs, and ischemic skin ulcers.
BONE
Complications of Sickle Cell Anemia: Both the spleen and liver are overloaded with _________ derived from hemolyzed red cells.
hemosiderin
What is the most common cause of a FOLATE deficiency?
pregnancy
Pregnancy is the most common cause of a ______ deficiency, but its only a minor cause in a ______ deficiency.
folate….Vit B12
