Quiz 10 Flashcards
Howell Jolly bodies and hypersegmented PMNs
Macrocytic anemia
Low Iron, low ferritin, high TIBC
Iron deficiency anemia
Sx of iron deficiency anemia
Sx: HA, irritability, loss of stamina, increased pallor, difficult concentration
Severe deficiencies – pica, glossitis, cheilosis, concave nails, increased heart rate, dyspnea, restless leg syndrome, glossal pain, reduced salivary flow leading to dry mouth,
Labs for Iron Deficiency Anemia
CBC/smear
Stool blood
Iron Absorption
Iron, TIBC, ferritin
Labs for Sideroblastic Anemia
CBC/smear
Iron Ferritin
BM biopsy
Lead screen
Labs for Anemia of Chronic Dz
CBC/smear
Iron, Ferritin, Transferrin
ESR, CRP
EPO Epogen
Target cells, stippling, polychromatophilic, erythroid hyperplasia in BM.
High iron, ferritin, transferrin
Sideroblastic anemia
Microcytic, hypochromic
Bone marrow responsiveness to erythropoietin is mediated by inflammatory cytokines
Anemia of chronic dz
Causes of anemia of chronic dz
• Causes: infectious, inflammatory, neoplastic disease, severe trauma, heart failure, diabetes mellitus, anemia of the elderly, and acute or chronic immune activation
Labs for Hypoproliferative Anemia
CBC/smear
Creatinine clearance
TSH
BM biopsy
Low marrow activity due to lack of EPO or inability of marrow to respond to it
Hypoproliferative Anemia
Pancytopenia of all cell lines
Aplastic/Hypoplastic anemia
Thrombocytopenia: ecchymosis, petechiae, bleeding from gums, ocular fundi
Aplastic/Hypoplastic anemia
Causes: Chemical exposure: drugs, pesticides, industrial chemicals, benzenes, anti-cancer agents (unknown mechanisms). Infections such as Parvo-B19, HIV
Aplastic/Hypoplastic anemia
Labs for Aplastic Anemia
CBC/smear
Iron
RET
BM aspiration (Acellular bone marrow)
Marrow is replaced by a tumor, granuloma, lipid storage diseases, or fibrosis
Myelophthisic anemia
Labs for Myelophthisic anemia
CBC/smear
BM biopsy
Anisocytosis, poikilocytosis, nucleated RBCs, immature myeloid cells
Myelophthisic anemia
Neurological signs, glossitis, diarrhea, muscle wasting
Macrocytic anemia
MCV > 95-100, aniso, poikilo, high RDW
Macrocytic anemia
Labs for Macrocytic anemia
CBC/smear
B12/folate
Autoimmune Hemolytic anemia: warm is assocated with RBC breakdown in ______ cold is associated with breakdown in ______
Warm - spleen
Cold - liver
Labs for Autoimmune Hemolytic anemia
Coombs test
MCV low/norm, MCHC high, aniso, high LDH and bilirubin, low haptoglobin
Hereditary Spherocytosis, Elliptocytosis
High RET, Heinz bodies and bite cells
G6PD anemia
Labs for G6PD anemia
G6PD assay
Norm MCV, Norm/High WBC, nucleated RBC, high plasma Hgb, high haptoglobin
Sickle Cell anemia
SX of Sickle Cell anemia
Abd pain/vomit, bone pain, leg ulcers, myalgia, hematuria
Labs for Sickle Cell anemia
Hgb electrophoresis
Norm MCH, 30-100% target cells and spherocytes
Hgb C Disease
Low MCV, low MCH, marked aniso and poiklilocytosis, target cells, stippling, nucleated RBC, norm/high iron
Thalassemia
Labs for Thalassemia
Hgb electrophoresis
leg ulcers, gallstones
Thalassemia
Labs for Neutropenia
CBC, bact & fung blood cultures, skin lesion biopsy, UA, CXR, Radiography of sinuses, BM biopsy
Low PMNs, granulocytes
Neutropenia
Low lymphocytes
Lymphocytopenia
Diminished tonsils/lymph nodes, LAD
Lymphocytopenia
List the categories of severity of Neutropenia and give the severity
1000-1500/mm3 mild risk infx
500-1000/mm3 mod risk infx
<200/mm3 – rapidly fatal infx
Sx of severe Neutropenia
Cellulitis, liver abscesses, furunculosis, pneumonia, and septicemia
What levels of lymphocytes define Lymphocytopenia?
< 3000/mm3 in children <2 yo
