Microcytic Anemia Flashcards
Iron deficiency (hypochromic)- description
Iron- essential mineral for functioning Hgb
Most absorbed in duodenum
Absorbed —> transferred —> stored as ferritin in liver, spleen, BM, muscle
Iron deficiency (hypochromic)- cause
1 main cause of anemia
Insufficient diet of iron
Poor absorption
Chronic blood loss
W>M- pregnancy/menses
Iron deficiency (hypochromic)- s/s
Look for blood loss: GI tract, urinary tract, menses/menorrhagia, blood donations
Tachycardia DOE Fatigue Pale skin and mucosa Brittle nails Angular cheilitis- dry corners of mouth Pruritus Pica- crave non foods (ice chips) Anxiety
Iron deficiency (hypochromic)- labs and imaging
Rectal Exam - is it bleeding??
Ferritin - stored iron
- <30 + dec H/H -> IDA
- first lab to become low
Serum Iron
- can fluctuate daily
- low or nl
Tranferrin Saturation % - how much serum irion is bound
- low = IDA
Total Iron Binding Capacity (TIBC) - capacity to bind iron
- inc = IDA -> it can bind, but no iron to bind!
- Nl = 240-450
Iron deficiency (hypochromic)- treatment
Diet - red meat, spinach, beans, lentils
Ferrous Sulfate - 325mg TID
- start extremely low, and up it slowly - can be poorly tolerated
- Hct half nl in 3w and full nl in 2m, if not -> wrong dx, blood loss, or pt non-compliant
- “can” d/c 3-6m after Hct is Nl
Parental - IV
- if fail Ferrous sulfate/diet, GI inhibit absorption, cont blood loss
Thalassememia (hypochromic)- description
Hereditary disease of impaired Hgb synthesis- genetic
Thalassememia (hypochromic)- cause
Defect in either Hgb is comprised of 2 alpha and 2 beta chains
Thalassememia (hypochromic)- s/s
Pallor Splenomegaly Growth failure Bone deformities Jaundice
Thalassememia (hypochromic)- labs & imaging
Retic- nl to inc —> BM trying to compensate
Iron studies- nl
Blood smears- target cells
Hgb electrophoresis- diagnosis
Thalassememia (hypochromic)- treatment
Mild:
No spec treatment - monitor
Folate supplements
AVOID - Fe supplement snad Sulfonamides
Major: Blood transufions Splenectomy - dec risk of bleeding out, but inc risk of infection BMT AVOID- Fe supplements and Sulfonamides Curre - Allo
Thalassememia (hypochromic)- risks
Iron overload —> organ damage
Chelation therapy- poop out iron
Inc infection risk- esp w splenectomy
Bone deformities- BM expansion
Sideroblastic- description
Hgb synthesis reduced —> can’t incorporate iron
Sideroblastic- cause
Acquired- alcoholism lead/copper/zinc poisoning dietary B6 or copper deficiency OCP
Sideroblastic- s/s
Consistent w anemia
Sideroblastic- labs & imaging
BMB- ringed sideroblasts
Labs show- microcytic anemia w nl Fe studies
