Microcytic Anemias

Question 1

MCC of Iron Deficiency Anemia?

Answer 1

Blood Loss (>5mL/day)

2. Malabsorption

Question 2

Heavy periods, Glossitis, and Cheilosis are ss of ____ anemia

Answer 2

Iron Deficiency

Question 3

Is ferritin high or low in iron deficiency anemia?

Answer 3

LOW

use up iron stores

Question 4

Is transferrin high or low in iron deficiency anemia?

Answer 4

HIGH

Question 5

1 Tx for confirmed iron deficiency anemia

Answer 5

Ferrous Sulfate PO

325mg/day for 3-6mo
SE: N/C/D

Question 6

Thalassemia definition

Answer 6

Grp of hereditary HgB DOs in which alpha or beta globin chains are mutated -> imbalance b/w A to B chain ratio -> excess globins damage RBC membranes -> Anemia

Question 7

____ Thalassemia = Chromo 16 Deletions

____ Thalassemia = Chromo 11 Point Mutations

Answer 7

Alpha Thalassemia = Chromo 16 Deletions

Beta Thalassemia = Chromo 11 Point Mutations

Question 8

4 severity levels of Alpha Thalassemia
1/4 foci =
2/4 foci =
3/4 foci =
4/4 foci =

Answer 8

• 1/4 foci = Silent thalassemia -> Asymp
• 2/4 foci =Thalassemia Treat -> Mild anemia
• 3/4 foci = Hemoglobin H disease ->
• Splenomegaly
• 4/4 foci = Hemoglobin Bart’s (incompatible with life) ->
• Hydrops fetalis

Question 9

3 severity levels of Beta Thalassemia

Answer 9

Question 10

• ____ Thalassemia has HIGH HbA2 /HbF and Absent HbH
• ____ Thalassemia has Norm/Low HbA2 / HbF and PRESENT HbH

Answer 10

• Beta = High HbA2 and HbF, Absent HbH
• Alpha = Norm/Low HbA2 and HbF, Present HbH

Question 11

Those with Thalassemia should avoid which ABX type?

Answer 11

Sulfas -> oxidative stress/hemolysis

Question 12

Why do those with Thalassemia need to avoid unnecessary Iron supplementation?

Answer 12

They already have an incr iron absorption. Extra iron would make their ss worse!

Question 13

HgB < ____ requires transfusions

Answer 13

7

Question 14

Thalassemia pt with frequent transfusions are at high risk for ____ syndrome

Answer 14

Iatrogenic iron overload syndrome -> decr future bone marrow transplant success

Question 15

Those with severe Thalassemia should take ____ supplements

Iron? Vit B12? Folate?

Answer 15

Folate

Question 16

“Target cells” =

Pathognomonic

Answer 16

Thalassemia

Question 17

Sideroblastic Anemia definition

Answer 17

defective heme metab -> iron trapped in mitochondria & is unusable to the RBC

Question 18

Causes of Sideroblastic Anemia

Answer 18

• Inherited -> X-linked, AR, or Mitochondrial
• Drugs -> Isoniazid, Pyrazinamide, Linezolid (TB)
• Toxins -> ETOH, Lead
• Deficiency -> Vit B6 (pyridoxine), Copper

Question 19

Microcytic Anemia + Neuro SS =

#1 DDx

Answer 19

Sideroblastic Anemia

Question 20

Microcytic Anemia + Bone Marrow Bx - “Ringed Sideroblasts” =

#1 DDx

Answer 20

Sideroblastic Anemia

Question 21

Tx for Inherited Sideroblastic Anemia?

Answer 21

Pyridoxine (B6) supplementation

Question 22

Deficiencies in ____ -> incr lead absorption

5 things

Answer 22

1. Iron
2. Calcium
3. Zinc
4. Copper
5. Protein

Question 23

Microcytic Anemia + “Burton Lines” & Basophilic stippling =

Burton Lines: purple-blue line on the gums

Answer 23

Lead poisoning

Question 24

Tx for Lead Poisoning

Answer 24

+/- Chelation Therapy