Microcytic Anemias

Question 1

Microcytic Anemias

Answer 1

MCV <80

Question 2

Iron Deficiency Anemia (IDA)

Answer 2

Microcytic and hypochromic

Caused by dietary deficiency, chronic blood loss, malabsorption in the duodenum, increased iron utilization

Question 3

IDA Iron Studies

Answer 3

Decreased serum iron, % saturation, ferritin

Increased TIBC/transferrin, sTfR, ZPP

Question 4

IDA Labs

Answer 4

Decreased Hgb, Hct, RBC, MCV, MCHC
Increased RDW, Plt
Normal Retic

Question 5

IDA Microscopics

Answer 5

Anisocytosis, poikilocytosis, microcytosis, hypochromia, pencil cells
Possible codocytes

Question 6

Anemia of Chronic Disease

Answer 6

Chronic disease causes increased inflammatory cytokines and increased hepcidin levels and decreased erythropoietin

Question 7

ACD Iron Studies

Answer 7

Decreased serum iron, TIBC/transferrin, % saturation
Increased ferritin, ZPP
Normal sTfR

Question 8

ACD Labs

Answer 8

Decreased Hgb, Hct, RBC, MCV, MCHC

Normal RDW, Retic

Question 9

ACD Microscopics

Answer 9

Microcytosis, hypochromia

Iron retention in macrophages in the bone marrow

Question 10

Sideroblastic Anemia

Answer 10

Inherited forms are from a defect in ALA synthase
Acquired forms are from RARS or drugs/toxins
Ineffective erythropoiesis leads to erythroid hyperplasia which causes increased iron absorption and ringed sideroblasts

Question 11

SA Iron Studies

Answer 11

Decreased TIBC/transferrin, sTfR

Increased serum iron, % saturation, ferritin

Question 12

SA Labs

Answer 12

Decreased Hgb, Hct, RBC, MCV, MCHC, Retic

Increased RDW, Plt

Question 13

SA Microscopics

Answer 13

Anisocytosis, poikilocytosis, microcytosis, hypochromia
DImorphic RBC population
Pappenheimer bodies, basophilic stippling
Ringed sideroblasts in the bone marrow

Question 14

Lead Poisoning

Answer 14

Lead inhibits delta-ALA dehydratase and ferrochelatase
Type of sideroblastic anemia
Diagnosed by measuring lead levels and pronounced basophilic stippling