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Clinical Medicine 1 > Microcytic Anemias > Flashcards

Microcytic Anemias Flashcards

1
Q

What is heme composed of?

A

4 porphyrin rings

4 iron molecules

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2
Q

What is Globin composed of?

A

2 alpha chains, 2 beta chains

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3
Q

Where is iron absorbed?

A

Intestines

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4
Q

What is job of Transferrin?

A

Transports iron

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5
Q

What is Ferritin?

A

Simple storage form of iron

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6
Q

What and where is Hemosiderin?

A

Complex iron stored in macrophages

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7
Q

What is most common type of stored iron?

A

Ferritin

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8
Q

Daily Iron requirements for men and non-mensturating women?

A

1mg/day

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9
Q

Daily Iron requirements for mensturating women?

A

3-4mg/day

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10
Q

Daily Iron requirements for pregger women?

A

2-5mg/day

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11
Q

How often to screen men and non-mensturating women for anemia?

A

5-10 years

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12
Q

How often to screen mensturating women for anemia?

A

Annually

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13
Q

Cytic of Iron Deficiency, Thalassemias, Lead Poisoning, Sideroblastic anemia, and Anemia of Chronic Dz? (micro, normo, macro)

A

All microcytic. MCV <80

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14
Q

Cytic of B12 deficiency, Folate deficiency, Liver dz, and Thyroid dysfunction?

A

Macrocytic

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15
Q

Etiology of Iron Deficiency Anemia?

A

1 blood loss

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16
Q

Decreased iron causes what to RBC production?

A

Decreased RBC production

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17
Q

Define Pica? Which anemia?

A

Eating non-food things. Iron Deficiency anemia.

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18
Q

Define Pagophagia. Which anemia?

A

Eating ice. Iron Deficiency anemia.

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19
Q

Eye and palm color in Iron Deficiency Anemia?

A

Conjunctival pallor, palm pallor

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20
Q

Cell size and color in Iron Deficiency Anemia?

A

Microcytic Hypochromic. MCV <80, MCHC <33.

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21
Q

TIBC increased or decreased in Iron Deficiency Anemia?

A

Increased. All others decreased (SE, SI, % Sat).

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22
Q

Tx for Iron Deficiency Anemia?

A

Ferrous Sulfate 325mg BID PO x1-2mo, then qd x3-6 mo

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23
Q

What can decrease iron absorption?

A

Fiber, dairy, phospates, tea/tannins

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24
Q

When to refer iron deficiency anemia?

A

H & H < 9 and 27%

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25
Q

Etiology of Alpha-Thalassemia?

A

Gene deletion

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26
Q

Who gets Alpha-Thalassemia most often?

A

SE Asian and Chinese

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27
Q

Silent Alpha-Thalassemia genotype?

A

__ alpha/alpha alpha

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28
Q

Alpha-Thalassemia Trait 1/Minor genotype?

A

___alpha/___alpha

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29
Q

Who gets Alpha-Thalassemia Trait 1/Minor?

A

Asian population

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30
Q

Alpha-Thalassemia Trait 2/Minor genotype?

A

alpha alpha / ____ ____

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31
Q

Who gets Alpha-Thalassemia Trait 2/Minor?

A

Black population

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32
Q

Alpha-Thalassemia Intermedia/Hgb H Disease genotype?

A

___ ___ / ___ alpha

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33
Q

Alpha-Thalassemia results in what?

A

Decreased alpha globin chain synthesis

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34
Q

Hydrops Fetalis genotype?

A

___ ___ / ___ ___

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35
Q

Alpha-Thalassemia Trait/Minor RBC and MCV?

A

Elevated RBC, decreased MCV

36
Q

Heinz Bodies in which anemia?

A

Alpha Thalassemia intermedia

37
Q

PE in Alpha Thalassemia Intermedia?

A

Pallow, hepatosplnemomegaly, skull and maxilla deformed

38
Q

Skull deformations in which anemia?

A

Alpha Thalassemia Intermedia

39
Q

Cytic in Alpha Thalassemia Intermedia?

A

Microcytic 60-70

40
Q

Tx for Silent and Trait/Minor Thalassemia?

A

None needed

41
Q

Tx Alpha Thalassemia Intermedia?

A

Folic Acid supp 1mg PO/da. Avoid oxidative medications (Sulfa drugs)

42
Q

What drugs should Alpha Thalassemia Intermedia avoid?

A

Oxidative drugs (Sulfa)

43
Q

Who gets Beta-Thalassemia?

A

Mediterranian

44
Q

What type of gene defect in Beta-Thalassemia?

A

Gene point mutations (NOT deletions)

45
Q

Beta-Thalassemia results in decreased production of what?

A

Decreased production of Beta globin chains

46
Q

Most common type of Beta-Thalassemia?

A

Beta-Thalassemia Minor

47
Q

Beta-Thalassemia Minor genotype?

A

B/B+ or B/Bº

48
Q

Genotype of Beta-Thalassemia Intermedia?

A

B+/B+

49
Q

Beta-Thalassemia Intermedia and Hgb B synthesis rate?

A

Homozygous but increased rate of Hgb B synthesis. Mild form.

50
Q

When does anemia appear in Beta-Thalassemia Intermedia?

A

Normal at birth, anemia at 6 mo

51
Q

Percent Hgb A and A2 in Beta-Thalassemia Intermedia?

A

HgbA=30%

HgbA2=10%

52
Q

What deformed and what enlarged in Beta-Thalassemia Intermedia?

A

Bone deformities. Hepatosplenomegaly.

53
Q

Beta-Thalassemia Major/Cooley Anemia genotypes? (Hint: 2)

A

Bº/Bº or B+/B+

54
Q

Why Beta-Thalassemia PT normal until 6 months?

A

Due to presence of HgbF

55
Q

Beta-Thalassemia Major/Cooley Anemia PE?

A

Extramedullary erythropoiesis (Frontal bossing).

56
Q

How severe hemolytic anemia in Beta-Thalassemia Major/Cooley?

A

Very severe hemolytic anemia

57
Q

What type of cell will Peripheral Smear show in Beta-Thalassemia?

A

Target cell (also in alpha thalassemia)

58
Q

If microcytic but normal serum Fe what to consider?

A

Thalassemia

59
Q

Dx for Beta-Thalassemia?

A

Electrophoresis

60
Q

What will Electrophoresis show for Beta-Thalassemia Major/Cooley?

A

HgbF (90%), HgbA2, little to no HgbA

61
Q

What will Electrophoresis show for Beta-Thalassemia Trait/Minor?

A

Decreased HgbA, increased HgbA2

62
Q

Tx of Beta-Thalassemia Major/Cooley?

A

Transfusions if Hgb 9-10, Folic Acid, iron chelation to prevent iron overload. Allogenic stem cell bone marrow transplant.

63
Q

TOC of Beta-Thalassemia Major/Cooley?

A

Allogenic stem cell t/p

64
Q

What is “Vampire Disease”?

A

Porphyria

65
Q

Etiology of Porphyria

A

Porphyrin ring not formed due to altered enzyme activities in heme biosynthetic pathway

66
Q

Skin in Porphyria?

A

Very pale, blisters in sun

67
Q

Etiology of Sideroblastic Anemia?

A

Defect in heme synthesis causing ringed sideroblast.

68
Q

Where does iron ring form in Sideroblastic Anemia?

A

Forms in bone marrow

69
Q

Neutropenia in Sideroblastic Anemia due to what?

A

Copper deficiency

70
Q

Which iron study low in Sideroblastic Anemia?

A

TIBC. Rest high.

71
Q

Which dz are Pappenheimer Bodies found in?

A

Sideroblastic Anemia

72
Q

Sideroblastic Anemia can be induced by what? Treatment?

A

INH. Vit B6.

73
Q

Splenectomy in Sideroblastic Anemia?

A

NO!

74
Q

Sideroblastic Anemia tx?

A

Transfuse and chelate as needed

75
Q

Basophillic Stipling found in what dz?

A

Lead Toxicity

76
Q

Lead Toxicity does what to heme synthesis?

A

Decreases heme synthesis

77
Q

Test for Lead Toxicity?

A

Peripheral smear. Microcytic hypochromic anemia w/basophillic stippling.

78
Q

Tx for Lead Toxicity?

A

Remove lead. Chelation if severe.

79
Q

What is Hepicidin and which dz?

A

Inflammatory marker. Anemia of Chronic Dz-Inflammation

80
Q

Resistance to Erythropoietin in which Anemia of Chronic Dz?

A

Elderly

81
Q

Reduced Erythropoietin in which Anemia of Chronic Dz?

A

Organ Failure

82
Q

Anemia of Chronic Dz is what type of dx?

A

Dx of exclusion

83
Q

SI in Inflammatory and Organ Failure/Eldery Anemia of Chronic Dz?

A

Inflammatory=low

Org fail/elderly=normal

84
Q

ESR and CRP are what type of markers?

A

Non-specific inflammatory markers

85
Q

Tx for Anemia of Chronic Dz?

A

Tx underlying dz. EPO is Hgb <10. Folic Acid is concomitant anemia.

Clinical Medicine 1 (8 decks)

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