Microcytic Anemias

Question 1

What is the definition of anemia?

Answer 1

Decreased oxygen transport due to red blood cells not supplying enough oxygen

Question 2

What values do we see when Microcytic/Hypochromic anemia occurs?

Answer 2

MCV < 80
MCHC < 32%

Question 3

What are factors affecting Iron levels?

Answer 3

Ingestion
Absorption
Recycled Hemoglobin
Stores
Loss

Question 4

What are factors affecting iron Absorption?

Answer 4

Health of the Gastric Mucosa
Gastroesophageal Reflux Disease (GERD)
Current Iron Stores
Erythropoietic Need
Amount of Iron Ingested

Question 5

How much iron is recycled for adults?

Answer 5

95%
1.0 mg for men and infants
2.0 mg for women

Question 6

How much iron is recycled for infants?

Answer 6

70%
1.0 mg for infants

Question 7

What are the causes related to Iron Deficiency Anemia (IDA)?

Answer 7

Increased Demands
Lack of Iron Intake
Nutritional Deficiency
Blood Loss

Question 8

Pica, Cheilitis, and Koilonychia are representative of what?

Answer 8

Unique Symptoms of Iron Deficiency Anemia (IDA)

Question 9

How do we test for IDA in a lab?

Answer 9

RBC status by CBC
Iron Status (Serum Iron, Total Iron Binding Capacity (TIBC))

Question 10

Accumulation of iron in the mitochondria, resulting in Mitochondrial Overload is a cause of what?

Answer 10

Sideroblastic Anemia

Question 11

Is Sideroblastic Anemia Acquired or Hereditary?

Answer 11

Both
Acquired: High Transfusion, Alcoholism, Lead Poisoning, Chloramphenicol
Hereditary: Enzyme Deficiency

Question 12

How do we diagnose Sideroblastic Anemia?

Answer 12

Ringed Siderblasts

Question 13

What does the abnormal gene HFE cause at a young age?

Answer 13

Hereditary Hemochromatosis (HH)
Autosomal Recessive Disorder

Question 14

Cirrhosis of the liver, Diabetes, Swollen Joints, and Hair Loss are characteristic of what?

Answer 14

Hereditary Hemochromatosis (HH)

Question 15

What are the specific diagnostic guidelines set by the CDC in relation to Hereditary Hemochromatosis (HH)?

Answer 15

Serum Ferritin Levels > 300 ug/L
Transferrin Saturation Levels >60% (45-60% = borderline)

Question 16

What is the cause of Thalassemia?

Answer 16

Defect in Hemoglobin Synthesis
Lack of Alpha or Beta globin chain production

Question 17

What is the cause of Alpha Thalassemia?

Answer 17

Deletion of one or more alpha genes
A-chain is critical in adult Hb formation

Question 18

What is known as the complete absence of alpha globin chain synthesis?

Answer 18

Bart’s Hydrops Fetalis

Question 19

How is Hgb Bart’s created?

Answer 19

4 gamma globin chains
Spontaneous abortion and stillbirth

Question 20

How is Hemoglobin H Disease acquired?

Answer 20

3 gene deletion, 1 functional A chain
RBC resembles a pitted golf ball

Question 21

What is known as having two functional alpha genes that is usually seen with mild anemia?

Answer 21

Alpha Thalassemia Trait

Question 22

What is known as having three functional alpha genes and is hematologically normal?

Answer 22

Silent Carrier

Question 23

Beta Thalassemia Major aka Cooley’s/Mediterranean Anemia is caused by?

Answer 23

Little or no Beta globin chain synthesis

Question 24

What is known as One abnormal beta gene that is inherited heterozygously?

Answer 24

Beta Thalassemia Trait (Minor)
Mimics IDA
Basophilic Stippling
Target cells