Rest Of Medical Disorders

Question 1

Aplastic anemia mr is about

Answer 1

30 percent

Question 2

Microangiopathic hemolytic anemia

Answer 2

ITTP , severe PE and eclampsia

Question 3

Maternal complications of anemia

Answer 3

1) weakness and fatigue up to anemic HF
2) sepsis (antepartum / puerperal sepsis )
3) PE 4) placental abruption
5) abnormal labor pattern
6) PPH , atonic utereus

Question 4

Fetal complications

Answer 4

Decreased iron stores - neonatal sepsis and anemia
Iugr
PTL abortion
Oligohydraminos ? No

Question 5

Diagnosis of Anemia
Symptoms signs

Answer 5

Pica weakness increased easy fatigue dysnpea normal in pregnancies
Pallor weak epithelium glossitis stomatitis kolionychias in more severe cases

Question 6

Inv of anemia

Answer 6

CBC
Red cell indices

Question 7

Iron def anemia indices

Answer 7

microcytic <80 fl hypochromic - mchc <30mg/dl
1)peripheral blood smear - anisocytosis
Iron profile - decreased serum ferritin <10ng/dl
Tibc increased >15%
Decreased serum fe

Question 8

Beta thalassemia microcytic anemia

Answer 8

microcytic <80 fl hypochromic - mchc <30mg/dl
Not responding to iron therapy
1) peripheral blood smears increased RDW +nucleated RBC’w + target cells + increased reticulocyte count
2) hb electrophoresis increased hb A2 >3.5% and hb f

Question 9

Normochromic normocytic mch - mchc

Answer 9

Physiological dilution anemia or hemorrhagic

Question 10

Ta2sema for anemia

Answer 10

1) physiological increased plasma volume > increase rbc volume
2) nutritional - iron
Dec intake nausea and vomiting dec absoription dec gastric acidity
Iron demand 4-6 mg /day
Megaloblastic folate def vit b12 def strict veg / pernicious anemia
3)Aplastic anemia
Incr loss
1) hge aph / git bleeding
2) acquired IgG antibodies against rbc’s antigens
3) sickle/ beta thalassemia one or two of beta globin are defective
4) hus - pe eclamp ITTP

Question 11

Iron therapy iron def

Answer 11

Oral iron therapy 150-200 mg oral/ day mid trimester or early 3 rd trim
Iron dextran parenteral for severe anemia or poor compliance

Blood transfusion for 1)non responding 2) severe anemia >36 weeks 3) aph / infection

Question 12

Beta thalassemia management

Answer 12

At reg interval target is hb 10 gm/dl
Folic acid 5mg from 3 ms to avoid open ntd
Screening for hemosiderosis hepatic cardiac hepatic endocrine (thyroid dm ) bone depo
Iron chelation desferrioxamine