Patho anemia (consol slides) Flashcards
Classify the pathopgysiology of anemia based on the size classification
Microcytic
- iron deficiency anemia
- thalassaemia
Normocytic
- anemia of chronic disease (kidney failure, crohn’s disease or other inflammatory disease)
- aplastic anaemia (decrease in the bone marrow’s ability to produce RBC, bone marrow turn into fatty tissue)
- hemolytic anemia (RBC destroyed)
- sickle cell anemia (defective Hb)
Macrocytic
- VitB and folate deficiency (megoblastic anemia)
- alcohol/ liver disease
Lab test for iron deficient anemia
Low RBC, Hb, serum iron & ferritin
HIGH TIBC, transferrin (high capacity to bind iron)
HIGH RDW (diff size of cells)
LOW MCV (microcytic)
LOW MCHC, MCH (hypochromic)
Signs and symptons of iron deficient anemia
symptoms
- tiredness
- dyspnea
- headache
- palpitations
- dizziness
Signs
- pallor*** (drying of mucosal membrane)
- koilonychia (spooning of nails)
- tachycardia
- cardiomegaly
- HF (from high o/p)
- capillary refill >3 seconds
Lab Test for Vit B12/ folate deficiency
LOW RBC, WBC & platelet counts
HIGH MCV (macrocytic)
What is the difference between minor and major beta- thalassemia?
Minor:
What are the serious repercussions of not having alpha genotype?
3 alpha missing: HbH disease
4 alpha missing: hydrops fetalis
Lab Test for alpha thalassemia
- LOW Hgb, Hct, MCV
- HIGH RBC count, RDW
- HbH on electropeoisis
- Normal Iron studies, because we’re not touching heme. the missing alleles are on globin
Signs and Symptoms of HbH disease
jaundice, black pigment stones, Possible extramedullary hematopoeisis with frontal bossing and hepatospenomegaly
Treatment for beta thalassemia
Blood transfusions every 2-3 weeks, but there can be overdose of iron
what is thrombocythaemia? how is it different from thrombocytosis?
when there is an abnormally high platelet count.
thrombocytosis also has high platelet count, but it is caused by another disease
what is primary and seocondary and thrombocythemia?
how to classify more acute one?
primary: polycethemia cera or chronic granulocytic leukemia
secondary: response to hemorrhage, splenectomy
more acute: will be secondary
what are the inherited and acquired clotting disorders?
INHERITED
- hemophilia A&B
- von Willebrand disease
ACQUIRED
- vit k deficiency
- disseminated intravasclar coagulation
- hepatic disease
difference between hemophilia a&b?
hemophilia A (classic- our dear B22)
- due to low Factor VIII
- bleeds into joints and muscles
hemophilia B (christmas disease)
- due to low Factor IX
- AVOID aspirin
which gender is most likely to inherit hemophilia and why?
males.
the male gender is determined by XY gene -> so then one get hemophilia when there is only a single copy of Xh gene.
however, girls can be carriers (50% if dad has hemophilia, 20% if mum has)
how does one acquire disseminated intravascular coagulation (DIC)? what are the repercussions?
complication of diseases and conditions that accelerate clotting
basically, the body uses all the clotting factors, so when there is a bleed, there is reduced fibrinogen and platelets for clotting.
excessive bleeding and hemorrhagic shock
