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Hematology > Microcytic anemia > Flashcards

Microcytic anemia Flashcards

1
Q

Is anemia ever a concludin diganosis?

A

No–always requires further investigation

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2
Q

What are the severe symptoms of anemia?

A

Confusion
Tachycardia
Hypotenion
Syncope

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3
Q

What are the four charateristics to look for to categorize anemia?

A

Size
Color
Chronicity
Etiology

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4
Q

What is the lab that determines between microcytic or macrocytic anemia?

A

MCV

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5
Q

Why are lymphocytes captured in a PBS?

A

Used as a measuring tool, since they should be about the same size

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6
Q

What is the normal Hb levels for males? Females?

A 
Males = 14-18
Females = 12-15
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7
Q

What is the hemotocrit?

A

Percentage of solid RBCs in a spun down test tube

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8
Q

What is the normal Hct levels for males? Females?

A 
males = 42-50%
Females = 36-44
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9
Q

What is the normal MCHC (hb/hct)?

A

30-36%

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10
Q

What is the RDW?

A

average width of RBCs

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11
Q

What are the three etiologies of Fe deficiency?

A

Inadequte absorption
Inadequate utilization
Excessive loss

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12
Q

How many mg of Fe are absorbed per day?

A

1-3 mg/day

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13
Q

Fe is best absorbed in an acidic or basic environment?

A

Acidic

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14
Q

Why is plant Fe not good?

A

Fe3+ state

Non-heme

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15
Q

What is the enzyme on the brush border of enterocytes that converts Fe3+ to 2+ to allow for absorption?

A

Duodenal cytochrome B

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16
Q

What is the protective protein for Fe in enterocytes?

A

Ferritin

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17
Q

What is the passage that allows for ferritin to enter the blood

A

Ferroporitin 1

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18
Q

What is the protein in the circulation that converts Fe2+ to 3+ in the blood?

A

Hephasestin

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19
Q

What is the role of hepcidin?

A

Blocks ferroporitin

Reduces Fe release from spleen

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20
Q

What is the cytokine that upregulates hepcidin?

A

IL-6

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21
Q

What down regulates hepcidin?

A

Low ferritin, hypoxia

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22
Q

What cells produce EPO?

A

Renal fibroblasts

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23
Q

What anemias is EPO not useful for?

A

EPO abundant ones (Fe deficiency)

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24
Q

What amount of Fe is stored in RBCs?

A

2500 mg

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25
Q

What amount of Fe is stored in Fe containing proteins?

A

400 mg

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26
Q

What amount of Fe is stored in transferrin?

A

3-7 mg

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27
Q

What amount of Fe is stored in storage?

A

1000 mg

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28
Q

True or false: there is no dedicated system to get rid of Fe in the body

A

True

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29
Q

True or false: there is an insensible loss of Fe through sweat

A

True

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30
Q

What bone is particularly vascular?

A

Hip

31
Q

What happens to TIBC in Fe deficiency anemia?

A

High

32
Q

What is the most accurate measurement of total body Fe stores?

A

Ferritin

33
Q

What happens to treansferring in anemia?

A

High amounts, but low saturation d/t low Fe amounts

34
Q

What is reticulocytosis?

A

Incrased amounts of reticulocytes in circulation

35
Q

What is the normal range for Serum Fe?

A

60-150 mcg/dL

36
Q

What is the normal TIBC?

A

300-360 mcg/dL

37
Q

What is the normal saturation for Fe?

A

20-50%

38
Q

What is the normal ferritin range?

A

40-200 mcg/L

39
Q

What malignancies in particular lead to Fe deficiency anemia?

A

GI malignancies

40
Q

True or false: restless leg syndrome is a symptom of Fe deficiency

A

True

41
Q

What are the symptoms of Fe deficiency anemia?

A

Glossitis
Nail changes
Palm creases pale

42
Q

What are the three common Fe supplements?

A

Fe sulfate
fumarate
Gluconate

43
Q

Why is IM injction of Fe bad?

A

Causes myolysis

44
Q

Why is hepcidin increase in sepsis?

A

Decreases Fe circulation, which decreases bacterial growth

45
Q

Anemia of renal disease is usually normo, hyper, or hypochromic?

A

Normochromic

46
Q

What are EPo levels like in renal disease?

A

Low

47
Q

What is the composition of Hgb A?

A

alpha2 beta2

48
Q

What is the composition of Hgb A2?

A

alpha2 delta2

49
Q

What is the composition of Hgb F?

A

alpha2 gamma2

50
Q

What is the composition of Hgb H?

A

beta4

51
Q

What is the composition of Hgb barts?

A

gamma4

52
Q

What is the composition of Hgb S?

A

alpha2 B (6glu to val)2

53
Q

What causes Hb H synthesis?

A

having only one alpha gene

54
Q

What are the histological features of Hb H disease?

A

Odd shaped RBCs

55
Q

What happen in beta (naught) thalaessemia?

A

No Hb A

56
Q

What happens to RBC destruction in beta-thalassemia?

A

Increased

57
Q

What is the treatment for beta thalaessemia?

A

phlebotomy

58
Q

What is sideroblastic anemia?

A

Problem with protoporphyrin synthesis

59
Q

What are Fe stores like in siderblastic anemia?

A

High

60
Q

What are the histological features of sideroblastic anemias?

A

Ringed siderblasts (concentrated mitochondria around the nucleus)

61
Q

How are the congenital siderblastic anemias pass on, usually? What is the basis for this?

A

xLR defect in ALA synthase

62
Q

What is the primary cause of siderblastic anemia?

A

Myelodysplasitc syndrome

63
Q

What are the secondary causes of siderblastic anemia?

A

Drug induced
EtOH abuse
Pb poisoning

64
Q

Are sideroblastic anemias hyper, hypo, or normocytic?

A

normocytic

65
Q

What are pappenheimer bodies?

A

Precipitated Fe granules in RBCs found in siderblastic anemias

66
Q

What is the treatment of sideroblastic anemia?

A

Pyridoxine

67
Q

What are the following labs like in anemia of thalassemia?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin
A 
Hbg = low
MCV =low
Smear = micro/hypo
Fe = normal
TIBC = Normal
Sat% = 30-80
Ferritin = 50-300
68
Q

What are the following labs like in siderblastic anemia?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin
A 
Hbg = low
MCV = variable
Smear = variable
Fe = normal
TIBC = Normal
Sat% = 30-80
Ferritin = 50-300
69
Q

target/cigar cells on a PBS indicates what?

A

Siderblastic anemia

70
Q

What is the MOA behind renal failure and anemia?

A

Fibroblasts in kidneys are damaged, and thus do not produce EPO

71
Q

What are the following labs like in anemia of chronic disease?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin
A 
Hbg = low
MCV =low
Smear = normal/ micro+hypo
Fe = normal/high
TIBC = 10-20
Ferritin = 30-200
72
Q

What are the following labs like in IDA?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin
A 
Hbg = low
MCV = low
Smear = microcytic, hypochromic
Fe = 360
Sat% =
73
Q

What are the following labs like in anemia of renal disease?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin
A

Hbg = low
MCV =low
Smear = normal
Fe =

Hematology (32 decks)

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