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MS1 FOM > Week 9 - anemia > Flashcards

Week 9 - anemia Flashcards

1
Q

What precursor blood cells are OK to find in peripheral blood?

A

Bands and segmented granulocytes

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2
Q

What are general symptoms of anemia

A

Fatigue, pallor, muscular weakness, shortness of breath

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3
Q

What is the Hb threshold for needing a blood transfusion?

A

Hb<70

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4
Q

What conditions have elliptocyte RBCs?

A

Iron deficiency anemia

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5
Q

What are acanthocytes?

A

RBCs that lost central pallor and have irregular cytoplasmic projections

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6
Q

What conditions have acanthocytes?

A

Liver disease, hyposplenism

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7
Q

What conditions have target cells?

A

Liver disease, alcohol, thalassemia, hyposplenism, seveer iron deficiency

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8
Q

What conditions have bite cells?

A

G6PD deficiency and oxidative stress

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9
Q

What conditions have schistocytes?

A

DIC, TTP, HUS

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10
Q

What conditions have spherocytes?

A

Hereditary spherocytosis, AIHA, general hemolytic anemia

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11
Q

What conditions have teardrop cells?

A

Myelofibrosis, thalassemia, myelophthisis,

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12
Q

What conditions have rouleaux?

A

severe inflammation/infection, myeloma

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13
Q

What conditions have RBC agglutination?

A

cold AIHA

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14
Q

What gene variants are responsible for SCD?

A

HbS (glu -> val) and HbC (glu -> lys)

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15
Q

What are some effects of sickle trait?

A

Hematuria, glaucoma, dehydration, medullary renal carcinoma

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16
Q

What causes veno occlusive crises? How to do you treat?

A

HbS agglutination. Treat with O2, NSAIDs, fluids, treat underlying cause

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17
Q

What are the causes of microcytic anemia

A

Iron deficiency, anemias of chronic inflammation, sideroblastic anemia, lead poisoning, thalassemia

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18
Q

How does Iron def anemia present?

A

pica, brittle nails, tachycardia, heart murmurs, glossitis, spoon nails

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19
Q

What are cellular features of iron def anemia?

A

Anisocytosis, poikilocytosis, hypochromia

Low ferritin, Tf saturation and RBC
High Tf, RDW, platelets

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20
Q

What are cellular features of anemias of chronic inflammation

A

Low/normal ferritin, low Tf and Tf saturation, high cytokines and hepcidin

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21
Q

What is the management for anemia of chronic inflammation?

A

infection workup, treat underlying cause.
In severe cases, need BM transplant, transfusions, EPO

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22
Q

What are some causes of sideroblastic anemia

A

B6 deficiency, drugs/toxins, lead poisoning, alcohol abuse or congenital (X-linked)

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23
Q

What are cellular features of sideroblastic anemia?

A

Basophilic stippling and Pappenheimer bodies, high RDW

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24
Q

How is sideroblastic anemia treated

A

BM biopsy, treat underlying disease. Transfusions for severe cases

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25
Q

What are some clinical features of thalassemia

A

Poor erythropoiesis, short stature, hemolysis, jaundice, splenomegaly

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26
Q

What are cellular features of thalassemia

A

Basophilic stippling, teardrop cells, target cells, nucleated RBCs, narrow RDW

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27
Q

What are treatments for thalassemia?

A

Fe chelation with deforoxamine, Fe transfusions

28
Q

What are 2 main umbrella causes of normocytic anemia?

A

Decreased RBC production and increased RBC turnover

29
Q

What are 4 types of normocytic anemia relating to decreased RBC production?

A

Pure red cell aplasia, aplastic anemia, myelophthisis, anemia of chronic inflammation

30
Q

What are 3 types of normocytic anemia relating to increased RBC turnover?

A

SCD, RBC loss, hemolytic anemia

31
Q

What are causes of pure red cell aplasia?

A

Diamond Blackfan anemia, autoimmune, MDS, marrow toxins

32
Q

How does pure red cell aplasia present?

A

normochromia with no splenomegaly

33
Q

How is pure red cell aplasia treated?

A

BM transplant, immunosuppressive therapy. Careful of Febrile neutropenia (Abx)

34
Q

What are causes of aplastic anemia?

A

Hereditary, idiopathic, marrow toxins

35
Q

How does aplastic anemia present?

A

Fanconi anemia (short stature, triphalangeal thumb, skin and heart defects) and dyskeratosis congenita (lacy skin)

36
Q

What are cellular features of aplastic anemia?

A

Pancytopenia
Hypocellularity of BM fat cells

37
Q

How is aplastic anemia treated?

A

BM transplant, immunosuppressive therapy. Careful of Febrile neutropenia (Abx)

38
Q

What is myelophthisis? Cellular features?

A

When BM is replaced by another cell type due to cancer and myelofibrosis, resulting in decreased RBC prodcution.
Cell features: teardrop cells and leucoerythroblastic picture

39
Q

How is SCD treated?

A

Folate supplements, hydroxyurea, prophylactic peniccilin

40
Q

What are the 2 main classes of macrocytic anemia?

A

Megaloblastic and non-megaloblastic

41
Q

What are 2 types of megaloblastic anemias?

A

B12 and folate deficiency

42
Q

What are cell features of megaloblastic anemia?

A

anisocytosis, neutropenia, thrombocytopenia, pancytopenia

Also oval macrocytes and hypersegmented neutrophils

43
Q

What are causes of non-megaloblastic macrocytic anemia?

A

liver disease, hypothyroidism, reticulocytosis, pseudo-macrocytosis

44
Q

Describe pseudo-macrocytosis

A

RBC clump together due to cold agglutinin disease or multiple myeloma, gives false reading of low RBC

45
Q

What are cellular features of liver disease non-megaloblastic anemia?

A

Target cells, reticulocytes

46
Q

What are causes of reticulocytosis?

A

Blood loss

47
Q

What are cellular features of reticulocytosis?

A

MArkers of hemolysis: high bilirubin and LDH, low haptoglobin

48
Q

What are 2 main branches of hemolytic anemia?

A

Hereditary or qcquired

49
Q

What are 3 types of hereditary hemolytic anemias?

A

Enzymopathies, membrane defects, and Hb abnormalities

50
Q

What is a type of enzymopathic hemolytic anemia? Describe presentation and cell features

A

G6PD deficiency, which causes oxidative stress and anemia. Presents as bite cells, blister cells, Heinz bodies, increased reticulocytes

51
Q

How do you treat G6PD deficiency?

A

Folate and splenectomy

52
Q

What are generally presentations/signs of hemolytic anemia?

A

Jaundice (due to inc bilirubin from RBC degradation)

53
Q

How do membrane defect-related hemolytic anemias pressent?

A

Spherocytes and elliptocytes

54
Q

How do you treat membrane-defect related hemolytic anemia?

A

Folate, prophylactic peniccilin

55
Q

What are some non-immune causes of hemolytic anemia?

A

Mechanical heart valves, physiological damage (e.g., burns), and membrane abnormalities (e.g. PIFA mutation)

56
Q

What are 3 types of immune-mediated hemolytic anemia?

A

infection, autoimmune, and alloimune

57
Q

How do immune-mediated hemolytic anemias present?

A

Spherocytes

58
Q

How do you diagnose immune-mediated hemolytic anemia?

A

DAT test

59
Q

Which Ig is linked with cold vs warm AIHA?

A

warm AIHA = IgG
cold AIHA = IgM

60
Q

How do you treat immune related hemolytic anemia?

A

Steroids, immunosuppresive drugs, splenectomy, cold avoidance (for cold AIHA)

61
Q

Compare oxygen affinity of Mb vs HbA vs HbF

A

Mb > HbF > HbA

62
Q

How does Hepcidin block iron transport?

A

Via ferroportin

63
Q

What are symptoms of MDS?

A

anemia, thrombocytopenia, neutropenia, progression ot AML

64
Q

How is MDS managed?

A

Transfusions if low Hb, EPO, BM transplant in severe cases

65
Q

When is EPO contraindicated?

A

With CKD, AIDS, chemotherapy

MS1 FOM (5 decks)

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