OME - Day 9 Flashcards
Macrocytic anemia, what is the next step?
Blood smear (not B12 and Folate)
Megaloblastic anemia, differential?
B12 deficiency and Folate deficiency.
Normocytic anemia, decreased reticulocyte count, differential?
Cancer and CKD
Normocytic anemia, elevated reticulocyte count, differential?
Hemorrhage and Hemolysis
Pallor, tachycardia, dyspnea on exertion, diagnosis?
Anemia
Two tests you should look at with every anemia
MCV and Retic Count
What are 4 causes of Microcytic anemia?
Iron Deficiency, Anemia of Chronic Inflammatory Disease, Thalassemia, and Sideroblastic
Diagnose Pernicious anemia, what’s the best test?
EGD with biopsy showing atrophy of gastric mucosa
Diagnose Pernicious anemia, what’s the first step?
Anti-IF and Anti-parietal cell antibodies
Tea and toast diet, diagnosis?
Folate deficiency
What leads to a non-megaloblastic anemia?
Lead, Toxins, Cirrhosis
What separates B12 from folate deficiency?
Neurologic symptoms (irreversible)
What test can you get if the B12 and Folate are equivocal?
Methylmalonic Acid (B12 def elevated, Folate def not elevated)
A picture of a red blood cell with a circle of darkly pigmented iron, what’s the diagnosis?
Sideroblastic anemia (ringed sideroblasts)
Decreased Ferritin, increased TIBC, decreased iron, diagnosis?
Iron deficiency anemia
Elevated ferritin, decreased TIBC, decreased iron, diagnosis?
Anemia of chronic inflammatory disease
How do you diagnose thalassemia?
Hemoglobin electrophoresis
How do you treat iron overload from blood transfusions?
Deferoxamine, Deferasirox (not phlebotomy)
Hydrops Fetalis, diagnosis?
4 alpha genes deleted, incompatible with life
Iron deficiency anemia in an old man, what’s the diagnosis and next step?
Colon cancer, get a c-scope
Normal iron studies in an Asian, diagnosis?
Thalassemia
Thalassemia Major, diagnosis and next step?
Monthly transfusions to support life, iron overload
Thalassemia Minor, diagnosis and next step?
Has mild anemia, does not need treatment
What one test do you get to separate microcytic anemias?
Ferritin
African American man, anemia, jaundice, joint pain, bone pain, how would you treat?
O2, IVF, Pain Control
African American man, anemia, jaundice, joint pain, bone pain, priapism, how would you treat?
Exchange transfusion (priapism)
Aplastic anemia in a sickle cell patient - causative organism?
Parvovirus B19
Bite Cells shows what?
G6PD Deficiency
CD55 Negative?
Paroxysmal Nocturnal Hemoglobinuria
Heinz Bodies shows what?
G6PD Deficiency
How do you diagnose hereditary spherocytosis?
Osmotic Fragility test (spherocytes on smear is wrong)
How do you diagnose Sickle cell Disease?
Hgb Electrophoresis (first time), Sickled Cells on smear (for crisis)
How do you test for Paroxysmal Nocturn Hemoglobinuria?
Flow Cytometry (Decreased CD55 and CD59)
How do you test for warm autoimmune hemolytic anemia?
Coomb’s test
Mediterranean man, salads, and HIV drugs, diagnosis?
G6PD Deficiency
Sickle Cell patient with chest pain and fluffy infiltrates on chest-x-ray, diagnosis and next step?
Acute chest, exchange transfusion
Smear for sickle cell anemia shows what?
Sickled Cells
What is the best test for Hereditary Spherocytosis?
Osmotic Fragility
What test for Autoimmune Hemolytic Anemia?
Coomb’s test
What’s the best test for sickle cell anemia?
Hgb Electrophoresis
What’s the treatment for a pain crisis in sickle cell?
IVF, O2, Pain Control
What’s the treatment for hereditary spherocytosis?
Splenectomy (fixes anemia, not spherocytes)
What’s the treatment for Sickle Cell chronically, reduce attacks?
Hydroxyurea
