The Microcytic Anemias Flashcards
Anemia
A condition in which red blood cells are no longer able to supply oxygen to body tissues resulting to decreased oxygen transport
If Microcytic/Hypochromic anemia develops, then:
MCV is less than 80 fL
MCHC is less than 32%
General symptoms of Anemia are:
Fatigue
Factors affecting iron absorption are:
Gastroesophageal reflux disease (GERD)
What % of the daily intake of iron is need to maintain RBC’s
5%
Iron needs for Infants, Children, Men, and Women are:
Men: 1mg
Women: 2mg
Infants: 1mg
Children: .5mg
What % of iron used for RBC production is recycled for infants and adults?
Infants: 70%
Adults: 95%
Iron Deficiency Anemia is related to what?
Increased demands
Lack of iron intake
Blood loss
How is IDA related to increased demands?
Growth spurts in infants and children and pregnancy and nursing
How is IDA related to lack of iron intake?
Nutritional deficiency and conditions that diminish absorption
How is IDA related to blood loss?
Gastrointestinal bleeding, excessive menses, and hemolysis
How is IDA related to blood loss?
Gastrointestinal bleeding, excessive menses, and hemolysis
The IDA clinical symptoms are:
Vertigo-dizziness and Dyspnea (air hunger)
Unique symptoms of IDA are:
Cheilitis (chapping around edges of the mouth)
Koilonychia (spooning of the nail beds)
Laboratory testing for IDA
if iron deficiency is suspected, analysis to include RBC status and iron status.
RBC is assessed by:
CBC
Iron status is assessed by:
serum iron, serum ferritin, transferrin, or total iron binding capacity (TIBC)
What will happen with the total iron binding capacity with IDA
It will be elevated
Sideroblastic Anemias (too much iron)
Accumulation of iron in the mitochondria
How does one get Sideroblastic Anemias
either acquired or hereditary
Acquired Sideroblastic Anemia occurs with:
High transfusion protocol
Alcoholism
Lead poisoning
Chloramphenicol
(HALC)
Hereditary Sideroblastic Anemia occurs with:
Enzyme deficiency
Diagnosis of Sideroblastic Anemia happens with:
Ringed sideroblasts
Hereditary Hemochromatosis (HH)
Rare disease compared to other blood disorders. It is an autosomal recessive disorder.
Hereditary Hemochromatosis is caused by:
An abnormal gene called HFE
Clinical Symptoms of Hereditary Hemochromatosis:
Hair loss
Chronic fatigue or weakness
Tender swollen joints
Diagnosis of Hereditary Hemochromatosis
Transferrin saturation, Serum iron, and Serum Ferritin are elevated.
Serum ferritin levels are >300 ug/L and transferrin saturation levels are >60%
Basic defects in Thalassemia
2 million Americans carry the gene for Thalassemia
Defects of hemoglobin synthesis which results in lack of production of alpha or beta globin chains
Alpha Thalassemias
Each of the four alpha thalassemia is a result of a deletion of one or more alpha genes.
What is critical in the formation of adult hemoglobin?
The alpha chain
Barts hydrops fetalis happens when:
There is no Hgb A or Hgb F
Barts hydrops fetalis results in:
Spontaneous abortion or stillbirth. If discovered, most pregnancies are terminated
Hemoglobin H disease happens when:
3 gene deletion, 1 function gene (a chain)
Hemoglobin H inclusions are formed when:
RBC resembles pitted golf ball when stained with supravital
Clinical results of Hemoglobin H disease are:
MCV >60fL
Alpha thalassemia trait occurs when:
Two functional alpha gene
5-10% hgb barts
Silent carrier happens when:
Three functional alpha gene.
Hematologically normal
Beta Thalassemia Trait (Minor)
One abnormal beta gene inherited.
Mimics IDA
What will you see of a smear with Beta Thalassemia Trait?
May see basophilic stippling
Target cells
