OnlineMedEd: Hematology Oncology - "Microcytic Anemia"

Question 1

The microcytic anemias are _____________ anemias.

Answer 1

production

Question 2

When you see a low MCV, the next test you should order is ______________.

Answer 2

the iron panel: ferritin, serum Fe, TIBC, and iron saturation

Question 3

What are the four microcytic anemias?

Answer 3

• Iron-deficiency
• Anemia of chronic disease
• Thalassemia
• Sideroblastic

Question 4

The body needs to absorb about ______ mg of iron per day to replace the daily needs. The max that can be absorbed is ________.

Answer 4

1-2; 3-4

Question 5

Ferritin represents the ______________.

Answer 5

store of iron in the body (generally in the marrow)

Question 6

Review the labs that suggest iron deficiency.

Answer 6

• Low serum Fe
• Low ferritin
• High total iron-binding capacity

Technically, the best test for diagnosing iron-deficiency anemia is bone marrow biopsy, but this is rarely done.

Question 7

The usual replacement recommendation for iron-deficiency anemia is _____________.

Answer 7

324 mg oral iron TID

Also, use stool softeners to prevent constipation.

Question 8

Describe the three iron labs that will be seen in anemia of chronic disease.

Answer 8

• Low serum Fe (the body is trying to hide the iron from the bacteria)
• High ferritin (the body is hiding iron in the form of ferritin in the bone marrow)
• Low TIBC (the ferritin is increased)

Question 9

ACID is usually treated with _____________.

Answer 9

EPO and managing the inflammatory process

Question 10

Generally, those with ___________ anemia are asymptomatic.

Answer 10

chronic-disease

Question 11

Thalassemia will present with what iron labs?

Answer 11

• Normal serum Fe
• Normal ferritin
• Normal TIBC

Question 12

Go through the types of alpha and beta thalassemias.

Answer 12

• Alpha:

• missing 1: asymptomatic
• missing 2: mild anemia
• missing 3: severe anemia; transfusion dependent
• missing 4: hydrops fetalis

• Beta:

• missing 1: mild anemia
• missing 2: severe anemia; transfusion dependent

Question 13

On hemoglobin electrophoresis, beta thalassemia presents with _______________.

Answer 13

alternate alpha binding complexes: alpha2-gamma2 (HgbF), alpha2-delta2 (HgbA2)

Question 14

A single unit of RBCs contains _______________ iron.

Answer 14

325 mg –enough for a year! –

Question 15

True or false: repeated transfusions can cause hemochromatosis.

Answer 15

False

It causes hemosiderosis!

Question 16

_____________ deficiency can cause sideroblastic anemia.

Answer 16

B6 (because it is a co-factor for ALA-synthase)

Question 17

Sideroblastic anemia presents with elevated ____________.

Answer 17

serum Fe

Question 18

You need to differentiate the two kinds of sideroblastic anemia: ___________________.

Answer 18

reversible (lead poisoning, alcohol abuse, and drugs) and irreversible (B6 deficiency, myelodysplastic syndrome)

Question 19

Why do thalassemias present with normal iron studies?

Answer 19

Thalassemia is a problem in making globin –not heme!