Midterm

Question 1

hemoglobin

Answer 1

Male 14-18
Female 12-16
the oxygen-carrying molecule in the red blood cell, (the concentration of iron containing protein in RBCs, which is a reflection of the oxygen carrying capacity of the blood). More sensitive than Hct because not affected by hemodilution

Question 2

Hematocrit

Answer 2

the % of the volume of blood that is red blood cells
Male 42-53%
Female 36-47%

Question 3

MCV Mean corpuscular volume

Answer 3

the mean cell volume or average size of the red blood cell (Hct/RBC calculation)
Microcytic 100

Question 4

reticulocytes

Answer 4

immature RBCs (normal 1% of total RBCs) indicates how the body is responding to anemia

Question 5

Microcytic Anemia Differential

Answer 5

Iron deficiency
chronic disease
thalassemia
lead poisoning

Question 6

Iron deficiency anemia lab findings

Answer 6

microcytic, low serum ferritin, and low Fe

Increased TIBC and RDW

Question 7

Anemia of chronic disease lab findings

Answer 7

microcytic, low serum Fe and TIBC, normal or increased ferritin

Question 8

Normocytic anemia differential diagnosis

Answer 8

sudden massive blood loss
hemolysis
bone marrow failure

Question 9

Macrocytic anemia differential diagnosis

Answer 9

megaloblastic anemia (B12 or folate deficiency - ETOH, diet, intrinsic factor deficiency can lead to pernicious anemia, malabsorption or medications) 
liver/thyroid dz
pregnancy
drugs like cancer meds
hematologic dz

Question 10

Iron deficiency risk factors

Answer 10

pregnancy, menstruation, infancy, decreased intake (vegetarians or poor diet), decreased absorption conditions such as gastrectomy, diarrhea, celiac
GI blood loss

Question 11

stages of iron deficiency

Answer 11

iron depletion - Fe stores are depleted, low serum ferritin first indicator
iron deficiency no anemia - low serum Fe increased TIBC, low normal MCV/MCH and Hgb
Iron deficiency with anemia - low Hgb, microcytic and hypo chromic RBCs

Question 12

Iron deficiency anemia treatment

Answer 12

ferrous sulfate 325mg TID is best but hard to tolerate, give lower dose of a ferrous compound for slower rebound
better absorbed on empty stomach but that causes upset, avoid dairy or calcium, citrus increases absorption

Question 13

anemia of chronic disease

Answer 13

seen with chronic infections, inflammation, malignancy, renal dz, hospitlation, etx.
the mean cell volume or average size of the red blood cell (Hct/RBC calculation)
mild, can be micro or normocytic, low serum FE, normal or low TIBC and retics, normal ferritin
treat underlying dz, help utilize the iron on board, Rx epo

Question 14

thalassemia Dz

Answer 14

hereditary defect in glob in production (either the alpha or beta chain) most common in African, Asian, mediterreanea and middle eastern
Beta type, major, intermedia and minor or Alpha type

Question 15

Beta thalassemias

Answer 15

More common variation
majore (cooley’s) a homozygous thalasemia, life threatening
Intermedia - homozygous but not as severe
Minor- most common, heterozygous, mild anemia often misdiagnosed as IDA, sometimes no clinical manifestations, genetic counseling is important, no treatment
Diagnosed by Hgb electrophoresis