Wed - Krafts - anemia 2

Question 1

“post-splenectomy blood picture”

can be a result of autosplenectomy as a result of sickle cell

Answer 1

nucleated red blood cells
Target cells
Howell-Jolly bodies – nuclei that didn’t get extruded from the RBC
Pappenheimer bodies – iron deposits
increased platelet count

Question 2

what type of bacteria is hard to fight in people with sickle cell

Answer 2

encapsulated bugs:

s. pneumo (diplococci)
h. flu (a coccobacilus)

Question 3

genetic disease that causes hypochromic, microcytic anemia with anisocytosis

Answer 3

thalassemia

you can also get basophilic stippling

Question 4

Main mechanism of diesease in G6PD

what do you see on blood smear

where in the world is it most common

Answer 4

decrease in G6PD

can’t make the reduced form of glutathione (which normally neutralizes superoxides)

superoxides attack heme
increase in peroxidases
increase in cell lysis
globin denatures creating heinz bodies (seen on super vital stain)

get “bite cells,” RBCs that look like bites were taken out of them.

common in areas where there is malaria

Question 5

how do you diagnose microangiopathic hemolytic anemia

what is it

Answer 5

blood smear, look for:

*Schistocytes (they look small and weird)
**Triangulocytes
helmet cells

something is physically squashing or cutting RBCs like a heart valve or fibrin strands

Question 6

what do you see on a blood panel 2-3 days after a lot of blood loss

Answer 6

reticulocytes are up (big purple things)

Question 7

what is the cause of anemia of renal disease

what might you see on a smear

Answer 7

lack of erythropoiethin

echinocytes

Question 8

Anemia of liver disease:

how common in liver diesease?
blood smear findings

Answer 8

common in liver diesease (3/4) patients are anemic

may see acanthocytes (little spikey guys), targets

can see megaloblastosis from folate deficiency, microcytosis from iron deficiency.

Question 9

aplastic anemia

definition

clinical pearls

marrow looks like

Tx

Answer 9

bone marrow cannot produce cells = pancytopenia (decrease in RBC, WBC, platelets)

clinical:
Pallor, dizziness, fatigue (anemia)
Recurrent infection (leukopenia)
Bleeding, bruising (thrombocytopenia)

Empty marrow (too much fat in it)

Tx: give blood, G-csf, prednisone, ATG, last resort is bone marrow transplant