Red Cell Disorders Flashcards
1
Q
Microcytic Anemia
A
Low MCV (<80)
Iron deficiency anemia
Anemia of chronic disease
Thalassemia
Sideroblastic anemia
2
Q
Macrocytic Anemia
A
- MCV > 100
- Megaloblastic
- b12 and folate deficiency
- Non megaloblastic
3
Q
MCH
A
Mean Corpuscular Hemoglobin
hb/rbc
4
Q
MCHC
A
Mean corpuscular hemoglobin concentration
hb/hct
5
Q
Iron Deficiency Anemia
A
- fatigue, atrophic glossitis, PICA, koilonychias
- Most common in USA from blood loss
- Pregnant women need more women
- Labs
- decrease in Fe, ferritin, % Fe saturation
- decrease MCV
- increase TIBC, transferrin, and EDW
- (serum iron also dec. in ACD, but ferretin increased in ACD)
6
Q
Ferritin
A
in increased with inflammation, so be careful.
look at saturation instead
7
Q
Anemia of Chronic inflammation
A
- Iron stuck in macrophages because of chronic inflammation
- Hepcidin blocks movement of iron from machrophges
- decreased response to EPO
- Labs
- increased ferritin
- decrease TIBC, transferrin
- N transferring receptor
- often normocystic but usually microcytic
*
8
Q
Sideroblastic anemia
A
- Fe in RBC mitochondria from abnormalities in porphyrin metabolism, blocks heme sysnthessis
- iron overload, inc. ferritin, low tibc
- blood basophilic stippling
- decreased pyridoxine b6
- decreased MCV unless there is MDS
- Causes
- Alcohol, most common
- MDS, drugs, toxins (lead, zinc, copper)
9
Q
Macrocytic Anemia
A
- Megaloblastic
- b12
- folate
- mds
- others where cells are more oval
- Non megaloblastic
- more round
- alcohol, liver biases, aplastic anemia, hypothyroid.
- more common than megaloblastic
10
Q
Megaloblastic anemia
A
- macrocytic anemia resulting from disorder in DNA synthesis
- Macroovalocytes
- hypersegment neutraphils (1 with 6 lobes or >5% with 5 lobbies)
- associates with MDS
- b12
- usually from pernicious anemia or other malabsortion
- takes longer
- neurologic problems, peripheral neuropathy,
- folate
- diet problem, green leafy vegatables
- develops faster than b12 deficiency
10
Q
Megaloblastic anemia
A
- macrocytic anemia resulting from disorder in DNA synthesis
- Macroovalocytes
- hypersegment neutraphils (1 with 6 lobes or >5% with 5 lobbies)
- associates with MDS
- b12
- usually from pernicious anemia or other malabsortion
- takes longer
- neurologic problems, peripheral neuropathy,
- folate
- diet problem, green leafy vegatables
- develops faster than b12 deficiency
11
Q
Megaloblastic Anemia Labs
A
- serum b12, folate
- RBC folate better than serum
- homocysteine (increased in both folate and b12 def)
- methylmalonic acid (normal in folate def)
- these may be easiest changes (before blood changes)
12
Q
Pernicious Anemia
A
- Auto immune dz with anti-intrinsic factor and anti-parietal cell antibodies and chronic atrophic gastitis
- Anti-intrinsic factor Ab (most specific but insensitive)
- Anti-parietal cell Ab (more sensitive but less specific, positive in other autominnume dz)
- Schilling test (normalizes when give intrinsic factor)
13
Q
Normocytic anemia
A
- abnormal break down of rbcs
- inc. reticulocytes (do methylene blue , other super vital)
- Hemolytic anemia
- dec haptoglobin
- inc. LDH
- inc. bilirubin
14
Q
Hereditary Spherocytosis
A
- problem with vertical interactions with RBC membrane in hereditary (ankryn)
- normal MCV
- also see in autoimmune hemolytic anemia
- DAT positive
- dec. MCV
- Osmotic fragility test, cells lyse when put in low tonic strength fluid
- EMA test is new (eosin-5-meleimide binding)
- lower update of a dye
- flow cytometry
15
Q
Elliptocytes
A
- Abnormal horizontal interactions with cytoskeleton
- abnormal spectrum or protein 4.1
- usually only mild hemolysis
- 25% of cells
- differential: iron deficiency anemia (pencil cells)
