Brainscape's Knowledge GenomeTM

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


See full index

MC > Anemia > Flashcards

Anemia Flashcards

1
Q

_______
is defined as a reduction in red blood cell numbers or
a haemoglobin (Hb) level below the normal reference
level for the age and sex of that individua

A

Anaemia

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

The WHO defines anaemia as haemoglobin
_______ for men,_______ for women and______
in pregnant women and school-aged children.

A

<130 g/L
<120 g/L
<110 g/L

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

In Australia, most people with anaemia will have
iron deficiency ranging from up to _______ for children
to ________ for menstruating females.

A

5%

20%

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

The incidence of haemoglobinopathy traits,
especially _________ is increasing in
multicultural Western societies

A

thalassaemia,

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

If a patient presents with precipitation or
aggravation of myocardial ischaemia, heart failure
or intermittent claudication, consider the possibility
of _________

A

anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The serum ________level, which is low in cases of
iron-deficiency anaemia, is probably the best test to
monitor iron-deficiency anaemia as its level reflects
the amount of stored iron.

A

ferritin

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

Give some unusual features of anemia:

A 
• dyspnoea on exertion
• palpitations
• angina on effort
• intermittent claudication
• pica—usually brittle and crunchy food, e.g. ice
(iron-deficiency anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Non-specific of anemia signs include

A

pallor, tachycardia, systolic

flow murmur and angular cheilosis.

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

Specific of anemia signs include

A

jaundice—haemolytic
anaemia, and koilonychias (spoon-shaped nails)—
iron-deficiency anaemia

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

The history may indicate the nature of the problem

___________: inadequate diet, pregnancy, GIT
loss, menorrhagia, NSAID and anticoagulant
ingestion

A

iron deficiency

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

The history may indicate the nature of the problem

___________inadequate diet especially
with pregnancy and alcoholism, small bowel
disease

A

folate deficiency:

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

The history may indicate the nature of the problem

__________previous gastric surgery,
ileal disease or surgery, pernicious anaemia,
selective diets (e.g. vegetarian, fad)

A

vitamin B12 deficiency:

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

________abrupt onset anaemia with mild

jaundice

A

haemolysis:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The various types of anaemia are classified in terms

of the red cell size—the_______

A

mean corpuscular volume

(MCV):

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  • microcytic—MCV _____
  • macrocytic—MCV_____
  • normocytic—MCV _______
A

≤ 80 fL
>100 fL
80–100 fL

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

the anaemia of
______ can be macrocytic in addition to the
more likely normocytic;

A

hypothyroidism

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

_____ is the most common cause of anaemia
worldwide

It is the biggest cause of microcytic
anaemia,

A

Iron deficiency

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

the main differential diagnosis of

microcytic anaemia being a _____ and ____

A

haemoglobinopathy such

as thalassaemia

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

Lab features of IDA

• Microcytic anaemia
• Serum ____ level low (NR: F 15–200 mcg/L: M
30–300 mcg/L)
• Serum _____ level low

A

ferritin

iron

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

Non-haematological effects

of chronic iron deficiency

A
  • Angular cheilosis/stomatitis
  • Glossitis
  • Oesophageal webs
  • Atrophic gastritis
  • Brittle nails and koilonychias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cause of IDA: physiological
1
2
3

A
  • Prematurity, infant growth
  • Adolescent growth
  • Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

s.Fe ↓; s.ferr ↓; transferrin ↑

Investigations: Therapeutic trial of iron; GIT
evaluation for blood loss

A

Iron deficiency

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

s.Fe N or ↑; s.ferr N or ↑

Investigations: Haemoglobin investigation,
e.g. electrophoresis

A

Haemoglobinopathy (e.g.

thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

s.Fe N or ↑; s.ferr N or ↑

Investigations: Bone marrow examination

A

Sideroblastic anaemia (hereditary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Occasionally microcytic

s.Fe ↓; s.ferr N or ↑; transferrin ↓

A

Anaemia of chronic disease

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

Example of macrocytic
With megaloblastic changes

1
2
3

A

Vitamin B12 deficiency
Folate deficiency
Cytotoxic drugs

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

s.B12 ↓; rc.Fol N or ↑

Investigations: IF antibody assay; Schilling test

A

Vitamin B12 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

s.B12 N; rc.Fol ↓

A

Folate deficiency

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

Appropriate setting; s.B12 N; rc.Fol N

A

Cytotoxic drugs

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

Examples of macrocytic without megaloblastic

A
  1. Liver 2. disease/alcoholism
    Myelodysplastic disorders (including
    sideroblastic anaemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Appropriate setting; uniform
macrocytosis; s.B12 N; rc.Fol N

Liver function tests

A

Liver disease/alcoholism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Specific peripheral blood findings;
s.B12 N; rc.Fol N

Bone marrow examination

A 
Myelodysplastic disorders (including
sideroblastic anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Examples of normocytic

A

Myelodysplastic disorders (including
sideroblastic anaemia
Chronic kidney disease
Endocrine disorders (e.g. hypothyroidism

34
Q

Isolated anaemia; Retic ↑

A

Acute blood loss/occult

35
Q

Specific red cell changes; Retic ↑

Investigations: s.Bil and s.LDH ↑; s.hapt ↓ specific
tests for cause

A

Haemolysis

36
Q

Isolated anaemia; Retic ↓

A

Chronic kidney disease

37
Q

T or F, if GI bleeding is suspected, do FOBT

A

false. Do gastroscopy and colonoscopy

38
Q

CBC of IDA

  • Microcytic, hypochromic red cells
  • ____________ (variation in size), _______(shape)—pencil-shaped rods
A

Anisocytosis

poikilocytosis

39
Q

IDA

  • Low serum iron level
  • Raised _________
  • _________low (the most useful index
A

iron-binding capacity

Serum ferritin level

40
Q

__________is increased in iron deficiency, but not in
chronic disease. It is very helpful therefore in
differentiating iron deficiency from other forms.
It is an indirect marker of what is happening in
the bone marrow

A

Soluble transferrin receptor factor

41
Q

in iron deficiency, the serum iron and ferritin levels
are low and the transferrin high, but the serum iron
level is also low in ___________

A

all infections—severe, mild and
even subclinical—as well as in inflammatory states,
malignancy and other chronic conditions

42
Q 
Serum
ferritin estimations are spuriously raised in 
1
2
3
A

liver
disease of all types, chronic inflammatory conditions
and malignanc

43
Q

______is normally raised in

pregnancy.

A

transferrin

44
Q

How to give oral Iron

A

oral iron (ferrous sulphate 1–2 tablets daily
between meals for 6 months) e.g. Ferro-
Gradumet with orange juice or ascorbic acid
until Hb is normal

45
Q

How to give parenteral iron

A

parenteral iron preferably by IV infusion
is probably best reserved for special
circumstances (there is a risk of an allergic
reaction). Avoid blood transfusions if
possible

46
Q

• Anaemia responds after about _____weeks and is
usually corrected after _____months (if underlying
cause addressed). 1
• Oral iron is continued for ______months to
replenish stores.
• Monitor progress with regular serum levels.

• A serum ferritin level ______ generally
indicates adequate stores.

A

2

2

3 to 6

ferritin

> 50 mcg/L

47
Q

Things to consider in failure to tx

A

• poor compliance
• continuing blood loss
• malabsorption (e.g. severe coeliac disease)
• incorrect diagnosis (e.g. thalassaemia minor,
chronic disease)
• bone marrow infiltration

48
Q

This inherited condition is seen mainly (although not
exclusively) in people from the Mediterranean basin,
the Middle East, north and central India and South-
East Asia, including south China

A

Thalassaemia

49
Q

The ______form is a very severe congenital
anaemia needing lifelong transfusional support but
is comparatively rare, even among the populations
prone to thalassaemia

A

homozygous

50
Q

The key to the diagnosis of _______thalassaemia minor is significant microcytosis
quite out of proportion to the normal Hb or slight
anaemia, and confirmed by finding a raised HbA 2 on
Hb electrophoresis.

A

heterozygous

51
Q

Treatment of thalassaemia major is transfusion
to a high normal Hb with packed cells plus
______

A

desferrioxamine.

52
Q

This Hb variant is common throughout South-East
Asia. 4 It has virtually no clinical effects in either the
homozygous or heterozygous forms, but these people
have microcytosis, which must be distinguished from
iron deficiency

A

Haemoglobin E

53
Q

if the HbE gene is combined
with the thalassaemia gene, the child may have a
lifelong anaemia almost as severe as ______

A

thalassaemia

major.

54
Q

AED associated with Marcocytosis

A

Phenytoin
Primidone
Phenobarbitone

55
Q

Abx associated with Marcocytosis

A

Cotrimoxazole Pyrimethamine
(incl. Fansidar and Maloprim)
Zidovudine

56
Q

Cytotoxics associated with Macrocytosis

A

Azathioprine

Methotrexate 5-fluorouracil

57
Q

These conditions have been recognised under a
variety of names, such as ‘refractory anaemia’ and
‘preleukaemia’, for a long time, but only relatively
recently have they been grouped together. They are
quite common in the elderly but may be seen in any
age group

A

Myelodysplastic syndromes

58
Q

MDS:

They are usually
associated with progressive intractable _________ and ___________or both, and progress slowly but
relentlessly to be eventually fatal, terminating with
infection, haemorrhage or, less often, acute leukaemia

A

neutropaenia

or thrombocytopenia

59
Q

Although well recognised, this is a much less common
cause of macrocytosis than the foregoing conditions.
It is usually caused by lack of intrinsic factor due to
autoimmune atrophic changes and by gastrectomy

A

Vitamin B12 deficiency

(pernicious anaemia

60
Q

Vitamin B12 deficiency may also
be seen together with other deficiencies in some cases
of ______ and _____

A

malabsorption and Crohn disease

61
Q

causes of Vit B12 deficiency:

A
  • atrophic gastritis
  • H. pylori infection
  • H 2 receptor blockers
  • PPI drugs
  • other drugs, e.g. OCP, metformin
  • chronic alcoholism
  • HIV
  • strict vegan diet
62
Q

B12 deficiency:

The clinical features are anaemia (macrocytic),
weight loss and neurological symptoms, especially a
_____. It can precipitate ________of the cord.

A

polyneuropathy

subacute combined
degeneration

63
Q

Tx of B12 replacement therapy

• Vitamin B 12 (1000 mcg i.e. 1 mg) IM injection;
body stores (3–5 mg) are replenished \_\_\_\_\_\_\_
• Maintenance with \_\_\_\_\_

• Can use crystalline oral B12

A

after 10–15
injections given every 2 to 3 days

1000 mcg injections every
third month

64
Q

Folic acid deficiency:

Diagnostic test: serum folate (normal range 7–45
nmol/L) and ______—best test (normal
>630 nmol/L)

A

red cell folate

65
Q

Folic Acid Def

The main cause is poor intake associated with
old age, poverty and malnutrition, usually associated
with ____

A

alcoholism

66
Q

Folic Acid Def

It may be seen in malabsorption
and regular medication with anti-epileptic drugs
such as ______.

A

phenytoin

67
Q

Folic Acid deficiency

It is rarely, but very importantly,
associated with pregnancy, when the demands of
the developing fetus together with the needs of the
mother outstrip the dietary intake—the so-called
_______which, if not
recognised and treated immediately, can still be a
fatal condition.

A

‘pernicious anaemia of pregnancy’

68
Q

Folic acid requirement per day

A

5–10 mcg/day.

69
Q

Oral folate 5 mg/day to replenish body stores (5–10 mg).

This takes ____________.

Vitamin B 12 is usually given unless levels normal.

A

about 4 weeks but continue for 4 months

70
Q

This is the most common cause of normocytic
anaemia and is usually due to haematemesis and/or
melaena

A

Acute haemorrhage

71
Q

Intercellular iron transport within the marrow is
suppressed in inflammation so that, despite normal
iron stores, the developing red cells are deprived of iron
and erythropoiesis is depressed

A

Anemia from chronic inflammation

72
Q

This is often associated with anaemia due to failure
of erythropoietin secretion and is unresponsive to
treatment, other than by alleviating the insufficiency
or until erythropoietin is administered

A

Anemia from CKD

73
Q

Suspect_______if there is a reticulocytosis,
mild macrocytosis, reduced haptoglobin, increased
bilirubin and urobilinogen

A

haemolytic anaemia

74
Q

Hemolytic anemia:

The more common of the
congenital ones are hereditary spherocytosis, sickle
cell anaemia and deficiencies of the red cell enzymes,
pyruvate kinase and G-6-PD, although most cases of
G-6-PD deficiency haemolyse only when the patient
takes oxidant drugs such as ______ and _______

A

sulphonamides or eats

broad beans—‘favism’.

75
Q

_______include those of
the newborn due to maternal haemolytic blood group
antibodies passing back through the placenta to the
fetus, and adult anaemias due to drug toxicity or to
acquired auto-antibodies

A

Acquired haemolytic anaemias

76
Q

Acquired antibodies resulting on hemolytic anemia include:

A

About half of the latter
are idiopathic and half associated with non-Hodgkin
lymphomas, and the anaemia may be the presenting
sign of lymphoma

77
Q

Acquired antibodies resulting on hemolytic anemia

Some of these antibodies are active
only at cool temperatures—__________;
others act at body temperature and are the more
potent cause of autoimmune haemolytic anaemia

A

cold agglutinin disease

78
Q

This may be due to foreign tissue, such as carcinomatous
metastases or fibrous tissue as in myelofibrosis;
it may also be due to overgrowth by one or other
normal elements of the bone marrow, as in chronic
myeloid leukaemia, chronic lymphocytic leukaemia
and lymphoma, as well as by acute leukaemic tissue

A

Bone marrow replacement

79
Q

Bone Marrow replacement:

A _______picture, in which immature red
and white cells appear in the peripheral blood, is often
seen when the marrow is replaced by foreign tissue.

A

leuco-erythroblastic

80
Q 
Important causes of anaemia in childhood
include 
1
2
3
A

iron-deficiency anaemia (quite common),
thalassaemia major, sickle-cell anaemia and
drug-induced haemolysis

81
Q

Key to dx of hemoglobinopathies

A

children of Mediterranean,
South-East Asian, Arabic or African–American
descent, especially with a family history, normal
ferritin level or anaemia resistant to iron therapy.

MC (90 decks)

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