OnlineMedEd: Hematology Oncology - "Microcytic Anemia" Flashcards

1
Q

The microcytic anemias are _____________ anemias.

A

production

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2
Q

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

A

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

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3
Q

What are the four microcytic anemias?

A
  • Iron-deficiency
  • Anemia of chronic disease
  • Thalassemia
  • Sideroblastic
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4
Q

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

A

1-2; 3-4

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5
Q

Ferritin represents the ______________.

A

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

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6
Q

Review the labs that suggest iron deficiency.

A
  • 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.

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7
Q

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

A

324 mg oral iron TID

Also, use stool softeners to prevent constipation.

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8
Q

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

A
  • 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)
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9
Q

ACID is usually treated with _____________.

A

EPO and managing the inflammatory process

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10
Q

Generally, those with ___________ anemia are asymptomatic.

A

chronic-disease

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11
Q

Thalassemia will present with what iron labs?

A
  • Normal serum Fe
  • Normal ferritin
  • Normal TIBC
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12
Q

Go through the types of alpha and beta thalassemias.

A

• 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
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13
Q

On hemoglobin electrophoresis, beta thalassemia presents with _______________.

A

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

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14
Q

A single unit of RBCs contains _______________ iron.

A

325 mg –enough for a year! –

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15
Q

True or false: repeated transfusions can cause hemochromatosis.

A

False

It causes hemosiderosis!

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16
Q

_____________ deficiency can cause sideroblastic anemia.

A

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

17
Q

Sideroblastic anemia presents with elevated ____________.

A

serum Fe

18
Q

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

A

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

19
Q

Why do thalassemias present with normal iron studies?

A

Thalassemia is a problem in making globin –not heme!