Anemias and UTI's

Question 1

UTI symptoms

Answer 1

Frequency
Urgency
Dysuria: burning sensation
Hematuria
Cloudy, foul-smelling urine 
Flank pain (lower back)
Elderly: Vague, abdominal discomfort & confusion 

E.Coli causes the most UTI’s

Question 2

Anemia Manifestations

Answer 2

Classic signs of Anemia:
Pallor
Fatigue
Dyspnea on Exertion (DOE)
Dizziness

Compensatory Manifestations:
CV: Tachycardia, palpitations, & vasoconstriction
Respiratory: Tachypnea & increased depth of breathing

Question 3

Iron Deficiency Anemia

Answer 3

Etiology
Inadequate intake
Increased demand (growth, pregnancy)
Bleeding

Signs & symptoms
Classic signs of anemia PLUS…
Angular cheilosis. (cracking lips), brittle hair & nails, smooth tongue (“glossitis”), pica (craving non-foods), koilonychia (moon-shaped)

Evaluation
CBC analysis
Serum Iron profile
Total Fe, TIBC, Ferritin

Question 4

Vitamin B12 Anemia

Answer 4

Etiology
Defective gastric secretion of intrinsic factor (IF)
Interference of IF binding to B12 caused by chronic conditions of malabsorption and atrophic gastritis; gastrectomy.
Dietary deficiency (rare)

Signs and Symptoms
Classic signs of anemia
Glossitis
Neuro changes!
Vit. B12 is necessary for the synthesis of myelin
Paresthesias, loss of vibratory & position sense, ataxia, dementia

Question 5

Folate Deficiency Anemia

Answer 5

Etiology
Dietary deficiency & malnutrition
Commonly seen in alcoholism (ETOH interferes w/ folate metabolism)
Malabsorption

Symptoms
similar to B12 def. but NO neuro manifestations
Classic signs of anemia

Question 6

Anemia of Chronic Disease

Answer 6

Decreased lifespan of erythrocyte & ↓ response to erythropoietin
In response to cell injury-
Macrophages sequester iron in the spleen
Lymphocytes release cytokines that ↓ erythropoetin response

Etiology
Chronic infections (HIV/AIDS)
Chronic inflammatory diseases (RA, SLE, CRF)
Malignancies
Clinical manifestations 
Classic signs of anemia

Question 7

Hemolytic Anemia

Answer 7

Premature, accelerated destruction of RBCs
Erythropoiesis is normal & often accelerates in an effort to compensate for the increased destruction
Elevated bilirubin as result of increased destruction
Jaundice & icterus
Elevated reticulocytes as result of hyperactive bone marrow
Acquired
Immune mediated (autoimmune; transfusion reaction, hemolytic disease of the newborn); physical trauma; drugs

Clinical Manifestations
Classic signs of anemia
Jaundice
Splenomegaly