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Get prepared for Comps! > Primary Care: Hematologic Conditions > Flashcards

Primary Care: Hematologic Conditions Flashcards

1
Q

What is Anemia (non pregnant)?

A

Decrease in red blood cell mass or decrease in hemoglobin. Hemoglobin level less than 12

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2
Q

Signs of Anemia

A

pallor, jaundice, Orthostatic hypotension, peripheral edema, pale mucous membranes and nail beds, smooth, sore tongue, splenomegaly, tachypnea, dyspnea on exertion, tachycardia or flow murmur

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3
Q

Symptoms of Anemia

A

Fatigue, drowsiness, weakness, dizziness, headaches, malaise, pica, poor appetite, changes in food preferences, changes in sleep habits, changes in mood

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4
Q

Microcytic anemias

A

iron deficiency, thalassemias, and anemia of inflammation

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5
Q

Macrocytic anemias

A

folate and vit b12 deficiency, anemia associated with liver disease, increased reticulocyte production, and some medication effects

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6
Q

Normocytic anemias

A

acute blood loss or conditions such as sickle cell disease, hemoglobin C disease, or glucose-6-phosphate dehydrogenase (G6PD) deficiency.

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7
Q

Aplastic anemia

A

normocytic but characterized by pancytopenia, reduction in the number of red blood cells (RBCs), white blood cells (WBCs), and platelets.

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8
Q

Which Anemia:
RBC: low
Hgb: Low
MCV: Low
MCH: Low
Reticulocytes: Low
ferritin: Low
Iron: Low
TIBC: High

A

Iron Deficiency

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9
Q

Which Anemia:
RBC: Low
Hgb: Low
MCV: High
MCH: High
Reticulocytes: Low
Ferritin: High
Iron: High
TIBC: Normal

A

Vit B12 Deficiency

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10
Q

Which Anemia:
RBC: Low
Hgb: Low
MCV: High
MCH: High
Reticulocytes: Low
Ferritin: High
Iron: High
TIBC: Normal

A

Folate Deficiency

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11
Q

Which Anemia:
RBC: Normal
Hgb: Low
MCV: Low
MCH: Low
Reticulocytes: High
Ferritin: Normal- High
Iron: Normal- Decreased
TIBC: Variable

A

Thalassemia

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12
Q

Which Anemia:
RBC: Low
Hgb: Low
MCV: Normal- Low
MCH: Low
Reticulocytes: Low
Ferritin: Normal- High
Iron: Low
TIBC: Low

A

Chronic Disease

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13
Q

First level of assessment to help differentiate many underlying causes of anemia

A

CBC

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14
Q

Most sensitive and specific predictor of iron stores; true iron defiency

A

ferritin level

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15
Q

Recommended intake of iron for 14 to 18 years

A

15 mg

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16
Q

Recommended iron from 19 to 50

A

18 mg

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17
Q

Most common causes of iron deficiency anemia in adults

A

occult blood loss, excessive menstrual loss, and inadequate nutritional intake

18
Q

Ferritin level that confirms diagnosis of iron deficiency

A

less than 100-150

19
Q

Severe anemia

A

< 9.0

20
Q

First line tx of iron def anemia

A

dietary intake of iron risk foods, consumption of vit C- enriched products to enhance absorption of the heme iron

21
Q

Iron rich foods

A

green leafy veggies, collard greens, egg yolks, raisins, prunes, liver, oysters, some fortified cereals

22
Q

Taking iron preparations will..

A

decrease absorption but will improve GI effects

23
Q

Antacids will do what to iron supplement absorption

A

decrease it, should not be taken at the same time

24
Q

Sickle cell disease

A

Hb SS, severe illness, sickle cell crisis

25
Q

Sickle cell trait

A

Hb SA; mild anemia, increased risk of UTI, may have sickle cell crisis at high altitudes, if dehydrated, or during extreme physical activity

26
Q

Sickle cell hemoglobin C Disease

A

Hb SC; mild to moderate anemia and sickle cell crisis; risk for infection, retinopathy, and blindness

27
Q

Hemoglobin C disease

A

Hb CC; usually asymptomatic, symptoms may be with splenomegaly

28
Q

Hemoglobin C trait

A

HB CA; usually asymptomatic

29
Q

Beta- thalassemia

A

Cooley’s anemia, severe anemia- frequent blood transfusions, classic facial features

30
Q

Thalassemia intermedia

A

significant anemia but does not need blood transfusions

31
Q

Thalassemia minor

A

mild microcytic anemia, individual asymptomatic

32
Q

Alpha- thalassemia trait

A

mild microcytic anemia, individual is aymptomatic

33
Q

Hemoglobin H disease

A

(alpha- thal) enlarged spleen, bone abnormalities, severe illness

34
Q

Hemoglobin Bart’s hydrops fetalis

A

incompatible with life; causes hydrops fetalis

35
Q

Thalassemias more prevalent in..

A

Southeast Asia, the Mediterranean, Africa, Middle East, and the Indian sub continent

36
Q

Alpha- thalassemia most common among..

A

Chinese and Southeast Asian descent

37
Q

Beta thalassemia most common among…

A

Mediterranean, Chinese, Asian, and African women

38
Q

Diagnosis of Thalassemia, what should be given and not given

A

YES: Folic acid supplementation may be used
NO IRON PLEASE, INAPPROPRIATE

39
Q

Common complication for nonpregnant women with sickle cell trait

A

increase in UTI, lessen the accuracy of hemoglobin A 1c testing ( makes testing for diabetes more difficult)

40
Q

Glucose 6 Phosphate Dehydrogenase Deficiency

A

-X linked
-Found in Mediterranean descent and African Americans
-Rarely symptomatic in women
-Can go from being symptomatic to presenting with severe acute or chronic hemolytic anemia
-Hemolysis occurs when the individual has an infection or receives oxidative drugs
-Cannot get sulfa drugs or sulfa derivatives, Macrobid, NSAIDS, toluidine blue, and methylene blue
- No fava beans and some other legumes
-Prompt dx and tx important

41
Q

Von Willebrand’s Disease

A
  • Autosomal dominant
  • Causes defects in protein necessary for plate;et adhesion and affects clotting factor VII
    -Heavy menses, prolonged bleeding, and fam hx of bleeding problems
  • Assess: plaetelet count, ferritin level, bleeding time, and coagulation studies
    -Labs: platelets normal; ferritin low; bleeding time prolonged
    -Avoid : meds that can make you bleed more, like NSAIDS

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