Normochromic/Normocytic Anemia

Question 1

Anemia of Renal Disease

Answer 1

• Severity of anemia roughly parallels extent of renal dysfunction
• Chronic renal lesions in glomerular region-> excretory failure (EPO)

Question 2

Anemia of Renal Disease: Clinical Findings

Answer 2

-Usually incidental finding-Edema, hypertension, fatigue, decreased urine output, increased urine frequency, muscle cramping

Question 3

Anemia of Renal Disease: Lab Findings

Answer 3

-CBC: Anemia, Normo/Normo
-PBS: Echinocytes
-UA: Proteinuria, glucosuria
-Additional Tests: Kidney Function Tests, Renal Imaging Studies (Nephrologist)

Question 4

Anemia d/t hypothyroidism: Normo vs. Hypo/Micro vs. Macro

Answer 4

-Normo: Decreased EPO->Decreased RBC->Decreased O2 requirement
-Hypo/Micro: Heavy menses->chronic blood loss->IDA
-Macro: Decreased metabolism->less parietal cells->decreased IF and stomach acid->decreased absorption of B12

Question 5

Anemia d/t Hypothyroidism: Clinical Findings

Answer 5

-Fatigue, Brain Fog, Increased sensitivity to cold, constipation, weight gain, weakness, thinning of outer 1/3 of eyebrow

Question 6

Anemia d/t hypothyroidism: Lab Findings

Answer 6

-CBC: Anemia, micro/normo/macro
-Additional tests: Thyroid panel, Iron panel, Serum B12/RBC folate
-Management: Hormone therapy (Endo)

Question 7

Aplastic Anemia

Answer 7

-Panhypoplasia
-Pancytopenia (decreased RBC, WBC, platelets) and hypocellar bone marrow (absence of abnormal cell infiltrate)
-Very Severe

Question 8

Aplastic Anemia is caused by:

Answer 8

-Idiopathic, drugs, viral, toxic exposures, immune disorders, congenital, radiation treatment

Question 9

Aplastic Anemia: Clinical Findings

Answer 9

-Increased susceptibility to infections, hemorrhagic difficulties (low plts),
Pallor, Fever, Dyspnea, Palpitations

Question 10

Aplastic Anemia: Lab Findings

Answer 10

-CBC: Anemia (normo), Leukopenia, Neutropenia, Thrombocytopenia
-Additional Tests: Low reticulocyte count, bone marrow biopsy (hypercellularity)

Question 11

Aplastic Anemia: Management

Answer 11

-Bone marrow transplantation
-Often refractory

Question 12

Myelophthisic Anemia is connected to what conditions

Answer 12

-Carcinoma metastasizing to bone marrow from primary tumors (breast, prostate, kidney, lung, adrenal, thyroid)
-Myelofibrosis-PCV
-Myeloproliferative conditions: mulitple myeloma, leukemias, lymphoma, Hodgkins
-Osteopetrosis

Question 13

Myelophtisic Anemia: Clinical Findings

Answer 13

-Symptoms of: Anemia, Underlying disease
-Hepatomegaly & splenomegaly

Question 14

Myelophthisic Anemia: Lab Findings/Management

Answer 14

-Normo anemia, nucleated RBCs, immature WBCs, Teardrop RBCs, Reticulocytosis, polychromatophilia
-Management: Tx underlying disease

Question 15

Which disorder can fall into different categories of anemia

Answer 15

Hypothyroidism (Hypo/Micro, Normo, Macro)

Question 16

Causes of chronic kidney disease

Answer 16

Diabetes mellitus, hypertension, glomerulonephritis, polycystic kidney disease, recurrent kidney infection