RBC Disorders Part #2 Flashcards
Anemias due to impaired Hgb synthesis have what type of MCV?
It will a microcytic and/or hypo chromic RBCs (low MCV) <82.
What is Iron deficiency anemia (IDA) caused by?
lack of iron. Some examples include:
- chronic blood loss: GI or menstrual
- decreased intake/not enough: pregnancy, kids, females, elderly
- Progressive depletion of body iron stores: infants after 6 months.
what will iron studies show for IDA?
decreased serum iron, decreased serum ferritin, increased TIBC
How can you distinguish IDA from Anemia of Chronic Disease?
ACD will have decreased TIBC and increased ferritin
What are the physical signs for someone with IDA?
iron lack causes brittle hair and nails, pica, glossitis.
you may see ovalocytes/pencils on microscopic exam.
What is Anemia of Chronic Disease?
inability to use iron and decreased response to EPO. Usually due to persistent infection, chronic inflammation, collagen disorder (RA, SLE), malignant disease (carcinoma).
T/F: ACD can be both microcytic or normocytic?
true. and theres no distinct morphology of the RBCs. the severity of the anemia parallels the severity of the disease.
What will the iron studies show for ACD?
decreased serum iron, decreased TIBC, and normal or increased serum ferritin.
what is Thalassemia?
inherited decreased in alpha or beta glob in chain production needed for Hgb A.
“Major” conditions are severe, Hgb A is absent
“Minor conditions are mild, common.
What happens if someone has Thalassemia alpha major? thalassemia beta major?
alpha major = dies
beta major = lifelong transfusions
What will thalassemia show on microscopy? electrophoresis?
Target cells on microscopy
increased Hgb A2 level (Beta)
How can you differentiate thalassemia from iron deficiency?
you will have normal iron tests with thalassemia.
What is sideroblastic anemia (SA)?
protoporphyrin block leads to iron overload. There are two types:
1. primary: cause unknown. Could be due to malignancy, requires bone marrow exam. you’ll see increased serum iron, decreased TIBC, and increased serum ferritin.
- secondary is due to lead poisoning, alcohol, anti-TB drugs.
you will see basophilic stippling of the red cells on morphology.
What anemia is due to impaired DNA synthesis?
Megaloblastic or macrocytic anemia (MCV>98)
What is Megaloblastic anemia due to?
due to deficiency of vitamin B12 or folate.
- DNA coenzymes necessary for nuclear maturation.
- both deficiencies cause enlarged fragile cells with reduced lifespan.
How can you differentiate a megaloblastic anemia due to Vit b12 from folate defiency?
ONLY vit b12 deficiency causes neruological symptoms….b12 is required for myelin synthesis.
What are the causes vitamin b12 deficiency
malabsorption is the most common cause due to a lack of intrinsic factor or antibodies to IF/parietal cells in pernicious anemia. Dietary defiency is UNCOMMON.
What are the causes of folate deficiency?
dietary is leading cause, increased need (pregnancy), or drug induced (anti-folate chemo drugs)
An MCV > 110 is most likely due to :
low b12 or folic acid
what is aplastic anemia?
There will be normocytic RBCs, and normal MCV (82-98). It is due to decreased production of all cell lines by the bone marrow (hypo cellular). There will be a low absolute retic count. It is NOT due to red cell destruction, but rather decreased production.
what other cellt ypes will you see a decrease in for aplastic anemia?
decreased WBC and decreased platelets
What causes aplastic anemia?
it is due to an unknown agent (immune process), or damage by radiation, benzene, viruses, pesticides, etc.
Describe usual blood findings for aplastic findings?
pancytopenia describes usual blood findings
- present with symptoms of bleeding and or infection
- low WBC with neutropenia, low RBC/HGB values, low PLT count.
is a bone marrow exam required for aplastic anemia?
yes!!
