Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Lab Dx 1 > week 9- anemia > Flashcards

week 9- anemia Flashcards

1
Q

• What is anemia?

A

o Reduced # circulating RBCs, Hb, or HCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

• How do you begin work-up for anemia?

A

o good hx and physical exam

o asl about stool color, vomiting, NSAID use, menstrual hx, alcohol use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

• what are ssx of anemia? severe?

A

o Presenting: fatigue, lightheadedness, dyspnea, tinnitus
o Signs: tachycardia, palpitations, low blood pressure; pallor of conjunctiva, nail beds, palmar creases
o Severe: fainting, chest pain, angina, heart attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

• What are most common causes anemia?

A

o Decreased RBC production
o Increased RBC destruction
o Blood Loss
o 50% of cases are a result of iron deficiency and chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

• What basic labs are done for anemia?

A 
o	CBC with indices
o	Iron Studies
o	Peripheral blood smear evaluation
o	Reticulocyte count
o	Fecal occult blood
o	Urinalysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

• Why is Hb a good diagnostic evaluation of anemia?

A

o Reduced Hb may present as dec RBCs

o Blood Hb concentration is better marker of total cell mass than Hct, b/c Hct only falls after Hb falls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

• When should you begin work-up for anemia? Types?

A

o If low RBC, Hb, HCT -> asses indices, evaluate MCV and MCHC
o Normocytic normochromic
o Microcytic hypochromic
o Macrocytic normochromic
o Then use RDW to further categorize
o Then check reticulocyte ct/index for further assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

• What are classes of anemia based on MCV and RDW?

A

o Lo MCV, Norm RDW: thalassemia minor; anemia of chronic dz
o Low MCV, Hi RDW: Fe def, G6PD def
o Norm mcv, Norm RDW: acute bleeding; anemia of chronic dz
o Norm MCV, Hi RDW: early or partially treated Fe or vit def, sickle cell dz; MDS
o Hi MCV, Norm RDW: aplastic anemia, MDS; chemo, antiviral, alcohol
o Hi MCV, hi RDW: B12 or folate def, alcohol, liver dz; MDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

• when is basophilic stippling seen? Howell-Jolly bodies? Cabot’s ring bodies? Heinz bodies?

A

o BS=aggregated ribosomes; thalassemia syndromes, iron deficiency and lead poisoning.
o HJB: nuclear remnants; asplenia, pernicious anemia and severe iron deficiency
o CRB: nuclear remnants; lead toxicity, pernicious anemia and hemolytic anemias.
o HB: denatured aggregated Hb; in thalassemia, asplenia and chronic liver disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

• When is reticulocyte index most useful?

A

o With normo-normo anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

• What additional test can be done based on RBC morphology?

A

o Spherocytes
o 1. Coombs DATindicates AIAH
o 2. Osmotic fragility  increased indicates spherocytosis (HS)
o Fragments  Disseminated Intravascular Coagulation (DIC) screen to assess intravascular thrombus
o Sickle cells, target cells  Hemoglobin electrophoresis
o Nucleated RBC:
o 1. Hemoglobin electrophoresis (HGBE)
o 2. Bone marrow examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

• What labs should be done based on MCV?

A

o Lo: serum Fe and TIBC, ferritin, BM exam, HGBE (electrophoresis)
o Norm: serum Fe and TIBC, reticulocyte ct, haptoglobin, coomb’s test
o Hi: reticulocyte ct, serum B12 and folate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

• What are causes of microcytic hypochromic anemia?

A 
o	Most common: IDA, Thalassemia, Sideroblastic anemia
o	Anemia of chronic disease (some cases)
o	Pyridoxine Responsive anemia
o	Chronic blood loss
o	Lead poisoning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

• What are the 2 categories of causes of micro-hypo anemia? Causes?

A

o 1. Lack of iron or inability to use Fe for heme production:
o A. Fe def: chronic blood loss, dietary lack during high demand, poor absorption of food iron
o B. poor fe mobilization from body stores: inflammatory states
o C. sideroblastic anemia: failure of Fe incorporation into protoporphyrin ring leads to RBC Fe precipitation called Basophilic stippling and causes polychromasia.
o D. Pb poisoning: like c
o 2. Defective globin chain synthesis: alpha and beta thalassemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

• What is the most common microcytic hypochromic anemia?

A

o IDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

• How is iron normally absorbed?

A

o Food iron is absorbed in ferrous form, Fe2+
o Need gastric acid to release from food
o Absorbed by enterocytes
o Heme iron (from meat) is absorbed more easily than iron from non-meat sources
o In the GI tract, iron is chiefly absorbed from the Duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

• Why does the Roux-en-Y gastric bypass (RYGB) lead to IDA?

A

o Gastric acid secretion helps dietary Fe absorption
o Inorganic Fe is made soluble –> ionized to the ferrous form (2+) and chelated.
o Fe chelates absorbed in brush border -> oxidized to the ferric form (3+) & released into circulation.
o RYGB = “gold” standard operation for tx of morbid obesity.
o Exclusion of nearly all of the stomach & the entire duodenum predisposes RYGB patients to develop vitamin/mineral deficiencies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

• What are the facts of iron in the body?

A

o Avg western diet is 10-30 mg daily
o Absorption is 5-10% of intake
o Absorption increases 20-30% with deficiency
o Total body iron is about 4 grams
o Total absorption approximately 1 or 2 mg a day, balanced by about the same daily loss, mostly through skin desquamation and in the stool.
o Many common foods interfere with iron absorption: phytates in cereal & vegetables (very high in soy), casein in milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

• What is iron used for in the body?

A

o 70% of body total is incorporated into hemoglobin
o 30% of body total is stored as ferritin
o Transferrin: Transports absorbed iron from intestine to bone marrow
o Delivered to developing erythroblasts where it is released intracellularly
o Delivered to RE macrophages for storage as ferritin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

• What iron indices are used to diagnose IDA?

A

o serum iron level
o total iron-binding capacity
o percentage transferrin saturation
o serum ferritin level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

• what is serum iron? Normal levels?

A

o Measurement of the iron bound to transferrin:
o Males: 65-175 mg/dl
o Females: 50-170 mg/dl
o Levels fall between depletion of iron stores & development of anemia
o IDA patients have normal serum iron 10-15% of the time
o Severe stress decreases values 65%, recover to normal over the following week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

• What are interfering factors with Fe measurements?

A

o Recent blood transfusions
o Recent ingestion of high iron meal or supplements (cast iron)
o Hemolytic diseases
o Drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

• What can cause hi serum iron levels?

A 
o	Hemosiderosis or hemochromatosis
o	Iron poisoning
o	Hemolytic anemia
o	Massive blood transfusions
o	Liver disease
o	Lead toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

• What can cause lo serum Fe levels?

A 
o	Dietary deficiency
o	Chronic blood loss
o	Malabsorption
o	Pregnancy – late
o	Neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

• What is the TIBC test?

A

o Total iron binding capacity TIBC:
o Adults: 250-420 mg/dl
o Measurement of all proteins available for binding mobile iron
o Most iron in circulation is bound to transferrin
o TIBC is an indirect measurement of transferrin
o Ferritin not included in TIBC, only binds stored iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

• What causes hi TIBC or transferrin?

A

o Estrogen therapy
o Pregnancy – late
o Polycythemia vera
o Iron def. Anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

• What causes lo TIBC or transferrin?

A 
o	Malnutrition
o	Hypoproteinemia
o	Inflammatory diseases
o	Cirrhosis
o	Hemolytic, pernicious & sickle cell anemias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

• What is the ferritin test?

A

o Ferritin is the major iron-storage protein, primarily found in the liver.
o Good indicator of available iron stores in the body.
o Normally present in serum in concentrations directly related to iron storage.
o 1 ng/ml serum ferritin corresponds to about 8 mg of stored iron.
o < 11 in women and <24 in men mg/dl = diagnostic for IDA
o Levels rise persistently in males and post-menopausal females
o Severe protein depletion can decrease levels
o Normal levels does not exclude iron deficiency: Factitiously elevated in patient with chronic disease states; Acts as acute phase reactant protein; Ferritin increases 1-2 days after onset of acute illness, peak at 3-5 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

• What interferes with ferritin measurement?

A

o Recent blood transfusion, high iron intake
o Hemolytic diseases
o Excess iron storage diseases
o Menstruating females
o Recent administration of radionuclide if test is performed via RIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

• What causes hi serum ferritin?

A 
o	Hemochromatosis, hemosiderosis
o	Megaloblastic anemia
o	Hemolytic anemia
o	Alcoholism
o	Inflammatory disease
o	Advanced cancers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

• What causes lo serum ferritin?

A

o Iron deficiency anemia
o Severe protein deficiency
o Hemodialysis

32
Q

• What are normal lab findings for iron proteins? IDA?

A

o Serum ferritin: Males: 40-340 ng/ml; Females: 14-150 ng/ml
o Transferrin: Males: 215-365 mg/dl; Females: 250-380 mg/dl
o Transferrin saturation %: Serum Iron divided by TIBC; Determines how many binding sites are occupied by Iron; Males: 20-50%; Females: 15-50%
o IDA: hi transferrin, reduced iron, very lo ferritin

33
Q

• What are the 3 stages of IDA?

A

o iron depletion (reduced stores)
o early iron deficiency anemia (depleted stores, normal MCV, and red cell morphology)
o and advanced iron deficiency anemia.

34
Q

• What are other findings for IDA?

A

o PLT count may be increased secondary to BM stimulation
o Reticulocyte count decreased
o PB smear will show microcytic hypochromic RBC
o Free erythrocyte protoporphyrin (FEP) a precursor to HgB is increased in IDA but normal in thalassemia
o BM stain for iron
o Mentzer Index: Ratio of MCV/RBC; 13 indicates IDA

35
Q

• What is thalassemia?

A

o A micro-hypo anemia
o Inherited disorder of globin chain synthesis
o Homozygous = major, Heterozygous =minor form
o Can affect either alpha or beta chain production
o B-Thal Major smear exhibits micro-hypo cells, basophillic stippling, target cells, nRBC’s.

36
Q

• What are lab findings for thalassemia?

A

o Microcytic; poikilocytosis if severe
o Serum iron increased or normal
o TIBC decreased or normal
o % saturation increased
o Ferritin increased or normal
o Reticulocyte count increased
o Serum LDH may be increased with active hemolysis
o Haptoglobin- a carrier for FREE plasma Hb- levels tend to be reduced due to hemolysis
o Hb electrophoresis (diff for thalassemia)

37
Q

• When are lo and normal haptoglobin levels seen with diff retic #?

A

o LO Hp, hi retic: and decreased RBC/Hbg/Hct –> points to hemolytic anemia;
o Lo Hp: W/o signs of hemolytic anemia? Liver is not making enough Hp
o Norm hp, hi retic: –> RBC destruction in the spleen/liver with no free Hgb released and no Hp consumed.
o Hp norm, norm retic: –> Anemia present is not due to RBC breakdown as no Hp is being consumed

38
Q

• What is pyridoxine (B6) deficiency?

A

o A micro-hypo anemia
o B6 is required for synthesis of d-ALA for heme production
o Acquired form more common, associated most frequently with isoniazid therapy for TB, hereditary form very rare

39
Q

• What is sideroblastic anemia?

A

o Micro-hypo
o Acquired or Hereditary (often due to B6 deficiency)
o Ineffective RBC formation two RBC populations: normo & hypochromic
o Diagnosed by BM biopsy, find “Rings” of Fe in RBC

40
Q

• What is lead poisoning anemia?

A

o Micro-hypo
o Defect in Heme synthesis leads to anemia when Pb levels are very high.
o Significant lead intoxication will occur before micro-hypo anemia.
o Basophilic Stippling in RBCs & Retic Low

41
Q

• What are some causes of normo normo anemias?

A 
o	Acute blood loss
o	Anemia of Chronic Disease (ACD) Hemolytic Anemia from any cause 
o	Hereditary spherocytosis
o	Aplastic Anemia
o	G6PD deficiency
42
Q

• What are inflammatory dzs associated with ACD?

A

o Infections (acute and chronic): Viral, Bacterial, Parasitic, Fungal, Helminth
o Malignancies: Hematologic; Solid tumor
o Autoimmune: RA, SLE, and connective tissue diseases; Vasculitis; Inflammatory bowel disease
o Chronic kidney disease and inflammation

43
Q

• What is ACD?

A

o Mild normo-normo (sometimes micro-hypo) anemia that persists more than 1-2 months.
o Characterized by low serum iron despite high iron stores (ferritin)
o Iron is being sequestered by the body so as to not damage the tissue during inflammatory processes.
o Mediated by cytokines and regulated by hepcidin= an immunity driven dz
o Affects many aspects of RBC synthesis and lifespan

44
Q

• What is hepcidin?

A

o The master regulator of iron homeostasis

45
Q

• What are the multi-factoral aspects of ACD?

A

o Release of hepcidin (acute phase protein) from the liver
o Hepcidin blocks the absorption of iron through enterocytes in the duodenum and iron’s release from RE system in liver and spleen
o Cytokines down-regulate release of EPO from kidneys, down-regulating production of RBCs
o RBCs have a shorter lifespan during inflammation (cytokines??)

46
Q

• What are the positive effects of ACD?

A

o Withholding iron from infectious pathogens to limit their growth (need Fe for proliferation and pathogenicity)
o Reducing the supply of oxygen to rapid proliferating tissues
o Strengthening of immune response
o Iron affects cell-mediated immune function and thus host responses towards pathogens
o Cytokines and acute-phase proteins regulate iron metabolism genes under inflammatory conditions, leading to ACD, Iron limitation for pathogens
o Thus, ACD may result from body’s attempt to limit iron for pathogens and strengthen antimicrobial immune response

47
Q

• What are soluble transferrin receptors?

A

o Cell surface uptake sites: proportional in number to the need of iron within the cell. Elevated in IDA and normal in ACD
o The ratio between ferritin and sTfR is helpful in distinguishing between ACD and mixed ACD with IDA
o sTfR/ferritin >2 = mixed

48
Q

• what are the lab results for ACD, IDA, both?

A 
o	Iron: lo, lo, lo
o	Transferrin: lo/norm, hi, lo
o	Tf % sat: lo, lo, lo
o	Ferritin: norm/hi, lo, lo/norm
o	STfR: norm, hi, norm/hi
o	Rate of sTfR: lo 2, hi >2
o	Cytokines: hi, norm, hi
49
Q

• What is aplastic anemia?

A

o Cellular depletion with fatty replacement of marrow
o Pancytopenia
o Increased serum iron - because there aren’t enough RBCs to store the iron
o Patients given marrow transplants, but have to match HLA (human leukocyte locus A), usually with a family member

50
Q

• What is etio of aplastic anemia? Px?

A

o idiopathic, benzene, radiation, infections, Chloramphenicol. Almost always by environmental, or chemical factor.
o Patients need to be kept alive by transfusions of WBCs and platelets, but still die within 4-5 years of onset

51
Q

• What are lab findings of aplastic anemia?

A

o normocytic normochromic anemia, decreased platelets, increased risk of infection
o reticulocyte count of zero, elevated serum iron

52
Q

• what is found with hemolytic, normo-normo anemia? Intravascular? Extravascular?

A

o Increase bilirubin, urinary urobilinogen, iron, Increase ferritin, Increase reticulocytes
o Intra: dec Hp
o Extra: normal Hp

53
Q

• What is hemolytic anemia due to G6PD deficiency?

A

o =glucose 6-phosphate dehydrogenase)
o Required for production of NADPH
o NADPH required for regeneration of reduced glutathione
o Decreased ATP production leads to decreased membrane flexibility and increased oxidative damage to RBC leading to hemolytic anemia
o Sex-linked genetic disorder, X chromosome
o More common in Kurdish Jews & Af.-American
o Selective advantage to malaria
o Females can manifest if defect on both XX

54
Q

• What is the test for G6PD def?

A

o Assay of G6PD enzyme is most definitive test method
o Fluorescence flow cytometric analysis
o Like chromatography, (+) and (-) for enzyme elute at different times
o Note: homo def doesn’t mean pt is anemic?

55
Q

• What are causes of G6PD def anemia?

A

o Susceptible persons exhibit hemolysis under oxidative stress – usually drugs: antimalarials, sulfa, nitrofurantoins, aspirin
o Certain foods - fava beans
o High dose intravenous vitamin C has been reported to precipitate hemolytic episodes.

56
Q

• What is hereditary spherocytosis?

A

o hereditary and acquired forms
o 70% or more RBC are affected if hereditary
o elevated retic (>9%) count in 90% of pts with HS
o Labs: Normal to decreased MCV, decreased Hgb, normal to increased MCH, increased MCHC, and hemolytic anemia pattern
o Dt def spectrin protein (RBC membrane cytoskeleton)
o SM in 50-80%
o 50-60% compensate with marrow hyperactivity
o 50% jaundice
o 55-75% gallstones by old age

57
Q

• What is the osmotic fragility test for HS?

A

o Indicates ability of RBC to take up water without bursting
o Depends upon surface/volume ratio or shape
o In hypertonic solutions, cells shrink; in hypotonic solutions, cells swell
o Full/thick cells like spherocytes have an increased fragility
o Thin cells like target cells have a decreased fragility
o Normal cells tolerate ~0.45-0.5% saline solution w/o hemolyzing
o Spherocytes show hemolysis beginning at 0.5% to 0.7% and may be as high as 0.8%.
o Spherocytes are more fragile in a hypotonic solution than normal RBCs.

58
Q

• What are the AIHAs?

A

o All have in common autoantibodies to RBC antigens resulting in immune mediated hemolysis & subsequent anemia.
o Warm autoantibodies (WAIHA) - IgG antibodies that bind at 37 degrees, idiopathic & may be fatal
o Cold autoantibodies - IgM antibodies that bind at slightly below 37 degrees to 4 degrees C
o Drug induced - antibodies formed against drug cross-react with RBC membranes
o Paroxysmal cold hemoglobuniria (PCH) – Rare, associated with measles, mono, chicken pox; IgG Ab RBC’s sensitive at cold temp  hemolysis.
o PNH Paroxysmal Nocturnal Hemoglobinuria: complement activation Ab-Ag reaction which lead to hemolysis at night when body’s temperature drops. Free Hb is filtered by the kidneys, produces mild to moderate anemia. Used to be Dx with Ham’s test or sucrose lysis test
o NEW: Ham’s test being replaced with Flow Cytometry

59
Q

• What are common causes of macrocytic anemia?

A 
o	-B12 deficiency
o	Folate deficiency
o	Myelodysplastic Syndrome
o	Hypothyroidism - part of Polyglandular failure syndromes
o	Cancer chemotherapy
o	Alcohol abuse
o	Liver disease
o	MDS
o	Pernicious anemia
60
Q

• What are causes of megaloblastic anemias?

A 
o	Has to do with certain findings on BM bx
o	B12 or folate def
o	Drugs (Dilantin)
o	Inborn errors of metabolism
61
Q

• What are characteristics of megaloblastic anemias?

A

o Exhibit impaired DNA synthesis, leading to delayed division of rapidly proliferating cells – skin, gastrointestinal tract, mucosa, hematopoietic cells – leading to cellular gigantism.
o Maturation asynchrony, normally maturing cytoplasm, abnormally maturing nucleus, leads to a hemolytic state.
o Results in pancytopenia in severe cases

62
Q

• What are common lab features of macrocytic/megaloblastic anemia?

A

o Varying degrees of anemia
o Increased bilirubin secondary to hemolysis
o Macro-ovalocytes on blood smear
o Howell-Jolly bodies in RBCs
o Hypersegmented neutrophils on smear
o BM examination shows megaloblastic changes

63
Q

• What is folate deficiency?

A

o Macro-normochromic anemia
o Folate stores last weeks to 4 months, daily requirement 50-100 micrograms
o Common causes: Inadequate dietary intake; Increased utilization (pregnancy); Decreased absorption – bacterial overgrowth; Inhibition of folate synthesis – drugs; Dialysis

64
Q

• What is serum folate?

A

o Measure methylfolate
o May be increased in about 1/3 of B-12 deficient patients because B12 is needed to to transfer methyl group to form tetrahydrofolate THF = metabolically active form in tissues.
o decreased serum folate may be unreliable due to recent low folate diet, or absorption problems.
o Not reliable to prove that tissue stores of folate are decreased.

65
Q

• What is RBC folate?

A

o best method to assess folate levels in tissues. Levels remain constant throughout the cell’s life span. Still advisable to measure B12 levels to help determine which vitamin is truly deficient.

66
Q

• What is B12 def?

A

o B12 stores: usually a 2-5 year supply in the liver
o Irreversible neurological damage can result from deficiency!!
o 3 most common causes of deficiency are:
o 1. Malabsorption: Low/lack IF: Pernicious anemia, achlorhydria
o 2. B12 degradation: bacterial overgrowth, parasites
o 3. Low dietary intake: veganism

67
Q

• What is pernicious anemia?

A

o Autoimmunity against intrinsic factor and the parietal cells that produce it.
o Leads to decrease in absorption of B12.
o Increased B12 intake will not correct anemia in these cases.
o CBC will show pattern of megaloblastic anemia
o Follow up with intrinsic factor testing for antibodies

68
Q

• What tests are done for megaloblastic anemia?

A

o B12 assays using intrinsic factor (IF) only as the binding protein give true values for serum B12
o Serum B12 decreased in 30% of folate def. (mechanism unknown)
o Urine Methylmalonic acid (MMA) Assay: excretion is increased in 95% of patients with B12 deficiency even before other signs and symptoms develop; MMA conversion to succinic acid requires B12 co-factor.
o Can also test homocysteine levels

69
Q

• What is MCV for megaloblastic anemias?

A

o Usually >100 fl
o 15-30% of patients with folate or B12 deficiency will have MCV in upper half of normal range, e.g. 90-100 fl
o Optimal range naturopathically is 82-89 fl
o May show hypersegmented neutrophils & high MCV before anemia

70
Q

• What are lab findings for non-megaloblastic macrocytic anemias?

A

o Peripheral blood smear: macrocytes, typically round instead of oval; If underlying cause is liver disease or alcoholism, may see Target cells as well
o Retic: mb elevated if macrocytosis is due to overstimulated BM response to an underlying hemolytic anemia.
o Consider thyroid function testing: To determine if hypothyroidism is causing the macrocytosis.

71
Q

• Pattern: IDA

A 
o	RBC: depressed
o	Hemoglobin: depressed
o	Hematocrit: depressed
o	MCV: depressed
o	MCH: depressed
o	MCHC:	depressed
o	RDW: normal to elevated
o	Ferritin:	 depressed
o	Iron: depressed
o	Iron saturation:	depressed
o	TIBC: increased
72
Q

• Pattern: ACD or acute blood loss?

A 
o	RBC: depressed
o	Hemoglobin: depressed
o	Hematocrit: depressed
o	MCV: normal
o	MCH: normal
o	MCHC:	normal
o	RDW: normal
o	Ferritin:	 normal to elevated
o	Iron: normal 
o	TIBC: normal to depressed
73
Q

• Pattern: hemolytic anemia

A 
o	RBC: depressed
o	Hemoglobin: depressed
o	Hematocrit: depressed
o	MCV: normal
o	MCH: normal
o	MCHC: normal
o	RDW: normal
o	Iron: elevated
o	Iron saturation:	elevated
o	Ferritin:	 elevated
o	TIBC: decreased
o	Bilirubin: elevated
o	Haptoglobin: depressed
o	Urinalysis: positive for urobilinogin
74
Q

• Pattern: asplastic anemia?

A 
o	RBC: depressed
o	Hemoglobin: depressed
o	Hematocrit: depressed
o	MCV: normal
o	MCH: normal
o	MCHC:	normal
o	RDW: normal
o	WBC: depressed
o	Platelets: depressed
75
Q

• Pattern: Pernicious anemia?

A 
o	RBC: depressed
o	Hemoglobin: depressed
o	Hematocrit: depressed
o	MCV: elevated
o	MCH: elevated
o	MCHC: normal
o	RDW: elevated
o	Intrinsic Factor Antibody: positive
76
Q

What is the lab definition of anemia, based on Hb?

A

Men > 17: 17: <11.9

Lab Dx 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions