12. Hematology Flashcards Preview

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Flashcards in 12. Hematology Deck (23):
1

Spoon nails/koilonychia and pale conjunctiva?

Iron deficiency

2

What is the carrier protein for iron?

Transferrin

3

Transferrin and TIBC relationship?

They are the same!

4

Ferritin and TIBC relationship?

Inverse/opposite

5

What is the shared problem in all microcytic anemias?

No hemoglobin

6

What happens in anemia of chronic disease?

Body locks iron up in the macrophages in the bone marrow

7

How do we differentiate ACD from iron deficiency?

Ferritin is increased in ACD vs. decreased in iron deficiency

8

What are sideroblastic anemias?

Iron accumulates because of defect in the synthesis of protoporphyrin

9

What is the rate limiting enzyme in the formation of heme?

ALAS

10

What is the most common cause of sideroblastic anemia?

Alcohol - mitochondrial poison

11

What vitamin deficiency leads to sideroblastic anemia?

B6 (pyridoxine) - associate with Isoniazid

12

What enzyme does lead poisoning affect?

Ferrochelatase (also has a little bit of effect on ALAD but mostly ferrochelatase)

13

Genetic inheritance of thalassemias?

Autosomal recessive

14

Who do we see alpha thalassemia in?

Black and Asian

15

How do we diagnose beta thalassemia?

Hgb electrophoresis

16

4 gene deletion in alpha thalassemia?

Hydrops fetalis, formation of tetramer of gamma chains (Hb Barts)

17

What do you form in 3 gene deletion of alpha thalassemia?

Tetramer of alpha chains - HbH

18

Why is there an increased rate of choriocarcinomas in Asia?

Increased spontaneous abortions from increased rate of hydrops fetalis from alpha thalassemia; the spontaneous abortions are correlated with increased rate of choriocarcinomas

19

How does alpha thalassema with 2 deletions show up on Hgb electrophoresis?

It doesn't since you need alpha chain for all the hemoglobins- they are all decreased so the percentages stay constant. You can only see alpha thalassemia on electrophoresis with 3 gene deletion when you start to form HbH.

20

What is the most common cause of iron deficiency in women under 50?

Menorrhagia

21

What is the most common cause of iron deficiency in men under 50?

Peptic ulcer disease

22

What is the most common cause of iron deficiency in adults over 50?

Colon cancer

23

What is the most common cause of iron deficiency in child under 4?

Meckel diverticulum - bleed