Normocytic Anemias

Question 1

Normocytic Anemias

Answer 1

MCV 80 to 100

Question 2

Aplastic Anemia

Answer 2

Hypocellularity of the bone marrow (<25%)

Pancytopenia, fatigue, bleeding, pallor, and infections

Question 3

Aplastic Anemia Labs

Answer 3

Decreased WBC, RBC, PLT

Normal MCV, MCHC

Question 4

Aplastic Anemia Micrscopics

Answer 4

Pancytopenia, normocytic, normochromic, no abnormal RBC morphologies

Question 5

Fanconi’s Anemia (FA)

Answer 5

Form of aplastic
Same labs as aplastic
Autosomal recessive disorder
Features include dwarfism, mental retardation, and microcephaly

Question 6

Pure Red Cell Aplasia

Answer 6

Suppression of only erythropoiesis

Can be congenital or acquired

Question 7

PRCA Labs

Answer 7

Decreased RBC, Hgb, Hct, Retic

Question 8

PRCA Microscopics

Answer 8

Normocytic, normochromic

Question 9

Diamond-Blackfan Anemia

Answer 9

Congenital PRCA
RBC precursors are not responsive to EPO
Increased serum iron and ferritin, 100% saturation (really high iron)

Question 10

Acquired PRCA

Answer 10

Acute: caused by infection
Chronic: associated with autoimmune disorders, caused by T cells

Question 11

Chronic Renal Disease

Answer 11

Elevated BUN levels (>30)

Decreased EPO from the kidneys

Question 12

CRD Labs

Answer 12

Decreased RBC, Hgb, Hct
Increased RDW
Normal Retic

Question 13

CRD Microscopics

Answer 13

Anisocytosis, poikilocytosis, echinocyte, possible schistocytes

Question 14

Endocrine Disorders

Answer 14

Hypothyroidism
Hyperthyroidism
Hypopituitarism
Inability to proliferate RBCs
Decreased RBC, Hgb, Hct, Retic 
Normal or increased MCV (increased in hypothyroidism)

Question 15

Congenital Dyserythropoietic Anemia (CDA)

Answer 15

Group of rare congenital anemias
Characterized by abnormal and ineffective erythropoiesis
Peripheral smear show pancytopenia
3 types

Question 16

CDA I

Answer 16

Autosomal recessive
Megaloblastic binucleate erythroid precursors
Incomplete division of nuclear segments is common, results in internuclear bridging
Macrocytic anemia with pancytopenia

Question 17

CDA II

Answer 17

Most common CDA, autosomal recessive, aka HEMPAS
Test positive for Ham’s test, acidified serum will lyse the RBCs, the sucrose lysis test does not lyse cells
Normocytic anemia with multinucleated RBC precursors (up to 7)

Question 18

CDA III

Answer 18

Autosomal dominant
Giant erythroblasts containing up to 16 nuclei
Megaloblastic anemia