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2nd U2 Path > Microcytic Anemias > Flashcards

Microcytic Anemias Flashcards

1
Q

What is the cause of microcytic anemias?

A

Decreased production of hemoglobin

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2
Q

Why is microcytosis seen in the presence of decreased hemoglobin?

A

RBCs must divide an extra time in order to try and maintain hemoglobin concentration, causing microcytic anemia

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3
Q

What is the composition of heme?

A

Iron and protoporphyrin

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4
Q

What are the 4 microcytic anemias?

A

1) iron deficiency anemia
2) anemia of chronic disease
3) sideroblastic anemia
4) thalassemia

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5
Q

Anemia due to decreased levels of iron…

A

Iron deficiency anemia

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6
Q

Where does the absorption of iron occur?

A

Duodenum

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7
Q

How is iron transported across the cell membrane into the blood?

A

Enterocytes transport iron using ferroportin

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8
Q

What substance is responsible for the transport of iron in the blood?

A

Transferrin

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9
Q

Where does transferrin transport iron for storage?

A

To the liver and bone marrow macrophages

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10
Q

What is stored intracellular iron bound to?

A

Ferritin

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11
Q

What does the storage of iron bound ferritin prevent?

A

Free radical formation via the Fenton reaction

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12
Q

What are the 4 laboratory measurements used to evaluate iron status in patients?

A

1) serum iron
2) Total iron-binding capacity (TIBC)
3) % saturation
4) Serum Ferritin

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13
Q

What serum iron measuring?

A

Measure of iron in the blood

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14
Q

What is total iron-binding capacity (TIBC) measuring?

A

Measure of transferrin molecules in the blood

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15
Q

What is % saturation of iron measuring?

A

% of transferrin molecules that are bound by iron (normal is 33%)

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16
Q

What is serum ferritin measuring?

A

Iron stores in macrophages and the liver

17
Q

What is the most common cause of microcytic anemia seen in infants?

A

Breast-feeding—human milk is low in iron

18
Q

What is the most common cause of microcytic anemia in children?

A

Poor diet

19
Q

What is the most common cause of microcytic anemia in male adults ages 20-50?

A

Peptic ulcer disease

20
Q

What is the most common cause(s) of microcytic anemia in female adults ages 20-50?

A

Menorrhagia

Pregnancy

21
Q

What is the most common cause(s) of microcytic anemia in the elderly?

A

Colon polyps/carcinoma in Western world

Hookworm in developing world

22
Q

Malnutrition, malabsorption and gastrectomy are all causes of why type of anemia?

A

Microcytic anemia

23
Q

What is the first stage of iron deficiency?

A

Storage iron is depleted

24
Q

What are the laboratory values, with respect to ferritin and TIBC, in the first stage of iron deficiency?

A

Ferritin: decreased
TIBC: increased

NOTE: If ferritin is decreased then TIBC will be increased, ALWAYS

25
Q

What is the second stage of iron deficiency?

A

Serum iron is depleted

26
Q

What are the laboratory values, with respect to serum iron and % saturation of iron, in the second stage of iron deficiency?

A

Serum iron: decreased

% Saturation: decreased

27
Q

What is the third stage of iron deficiency?

A

Normocytic anemia

28
Q

Why is normocytic anemia seen in the third stage of iron deficiency?

A

The bone marrow is making fewer, but normal sized RBCs

29
Q

What is the fourth stage of iron deficiency?

A

Microcytic, hypochromic anemia—bone marrow is making smaller and fewer RBCs

30
Q

What are the clinical features of iron deficiency?

A

Anemia
Koilonychia
Pica

31
Q

What are the laboratory findings seen with iron deficiency anemia with respect to the following: RBCs, Ferritin, TIBC, serum iron, % saturation, and free erythrocyte protoporphyrin (FEP)?

A 
RBCs: microcytic and hypochromic with increased red cell distribution width
Ferritin: decreased
TIBC: increased
Serum iron: decreased
% Saturation: decreased
FEP: increased
32
Q

What is the treatment for iron deficiency microcytic anemia?

A

Supplemental iron—ferrous sulfate

33
Q

Iron deficiency anemia with esophageal web and atrophic glossitis that presents as anemia, dysphagia, and beefy-red tongue…

A

Plummer-Vinson syndrome

2nd U2 Path (31 decks)

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