Anemia

Question 1

what makes someone anemic

Answer 1

low iron
low b12
low folate
splenomegaly - hemolytic anemia
cancer
EPO - kidneys

Question 2

what are the hormonal regulation for erythropoiesis

Answer 2

liver will make building blocks, stimulate
kidney
thyroid

Question 3

what are the different types of anemias

Answer 3

poor production
blood loss
more EBCs being destroyed
combination

Question 4

what does -cytic mean

Answer 4

cell size

Question 5

what does -chromic mean

Answer 5

amount of hemoglobin

Question 6

what is the presentation of anemia

Answer 6

depend on severity: may be asymptomatic
fatigue, weakness, pallor, palpitations, HA, exertional dyspnea, light headedness

Question 7

what do the RBC indices help with

Answer 7

give information about size, weight, hemoglobin concerntation of the RBC
assists with classifying anemia

Question 8

what is the MCV

Answer 8

mean corpuscular volume: average volume/size of one RBC

Question 9

what is MCH

Answer 9

mean corpuscular hemoglobin: how much hemoglobin is within one RBC

Question 10

what is MCHC

Answer 10

mean corpuscular hemoglobin concerntation: percentage of hemoglobin in one RBC

Question 11

what is RDW

Answer 11

RBC distrubution width: indicates the variation in width of the RBCs

Question 12

what is microcytic anemia

Answer 12

small RBC (defined as decreased MCV, seen on peripheral blood smear compared to other indicators)

Question 13

what is the cause of microcytic anemia

Answer 13

iron deficinecy anemia
anemia of chronic disease
thalassemia

Question 14

what is heme

Answer 14

a porphyrin ring that binds iron

Question 15

what is globin

Answer 15

2 alpha gains and 2 beta chains (normal adult hemoglobins)

Question 16

what is iron

Answer 16

binds oxygen to heme

Question 17

what is iron deficiency anemia

Answer 17

iron binds to heme so that it can carry oxygen
low iron will cause small, pale RBCs
serum ferritin measure amount of total body stores of iron (<12mcg)

Question 18

what is transferrin

Answer 18

a protein that assists with transport of the iron to where it needs to be - the blood, liver, spleen, marrow

Question 19

what is seen on labs for iron deficiency anemia

Answer 19

low H&H
low MCV
Increased RBC distrubution width
low serum iron
low serum ferritin(most important test)
high total iron binding capacity (TIBC)
low transferrin iron percent saturation

Question 20

What is thalassemia

Answer 20

hereditary hemolytic anemia
autosomal recessive
mutation that results in problems iwth globin chain synthesis
microcytic anemia

Question 21

what is macrocytic anemias

Answer 21

big RBC (defined as increased MCV or seen on peripheral blood smear compared to other indicators) - may also see increased RDW
may be associated with increased reticulocytes

Question 22

what are the causes of macrocytic anemias

Answer 22

ETOH induced anemia
B12 deficiency anemia
Folate deficiency anemia
Hemolytic anemia

Question 23

what type of anemia may be associated with increased reticulocytes

Answer 23

macrocytic anemias

Question 24

where is folate absobed

Answer 24

in the duodenum

Question 25

what is folate needed for

Answer 25

DNA synthesis during erythropoiesis and helps with cellular maturation - if not enough will result in megaloblastic anemia

Question 26

if there is not enough folate, what type of anemia will result

Answer 26

megaloblastic anemia

Question 27

what type of anemia is folate anemia

Answer 27

macrocytic anemia

Question 28

where is folate typically produced

Answer 28

produced by bacteria within the gut flora

Question 29

what are folate deficiencies associated with

Answer 29

poor dietary intake, increase requirements (pregnancy), malabsorption, ETOH abuse and medications

Question 30

how are folate anemias diagnosed

Answer 30

elevated MCV elevated RDW low serum folate

Question 31

what is cobalamin

Answer 31

Vitamin B12

Question 32

what absorbes vitamin b12

Answer 32

through the parietal cells in the stomach needs intrinsic factor for absorption absorbed within the terminal ilium

Question 33

what is the purpose of B12

Answer 33

assists with maturation process, DNA synthesis and helps with folate synthesis

Question 34

what type of anemia is associated with B12 deficiency anemia

Answer 34

macrocytic anemia

Question 35

what are hallmark signs of B12 deficiency anemia

Answer 35

will have neurologic findings as well but folate deficiency will not

Question 36

what are the presentation of B12 deficiency

Answer 36

neuropathy (early) dementia Neuropsychiatric Optic nerve atrophy

Question 37

what is normocytic anemias

Answer 37

normal RBCs just not enough

Question 38

what causes normocytic anemia

Answer 38

blood loss (acute) anemia of chronic disease hemolytic aplastic anemia

Question 39

what is aplastic anemia

Answer 39

bone marrow failure resulting in pancytopenia loss of hematopoietic stem cells within the marrow

Question 40

what is aplastic anemia associated with

Answer 40

autoimmune disease direct injury to the hematopoietic stem cells viral infections clonal and genetic disorders

Question 41

what is sickle cell anemia

Answer 41

autosomal recessive disorder results in hemoglobin S (s - sickle) when there is decreased O2, dehydration, the HbS will change shape causing RBCs to "sickle"

Question 42

what causes sickle cell anemia to result in hemolytic anemia

Answer 42

the removal of the sickled cells

Question 43

what is sickle cell crisis

Answer 43

if healthy and well oxygenation - likely asymptomatic if hypoxic, decreased pH, dehydration the abnormal B-globin chill will polymerize leads to change in shape of RBC unable to conform well within the vessels and can cause obstruction

Question 44

what is the duration of sickle cell crisis

Answer 44

typically lasts days to weeks

Question 45

what is associated with the pain in sickle cell crisis

Answer 45

vasoocculsive crisis (thrombotic crisis)

Question 46

what is sequestration crisis

Answer 46

especially in children, the sleep and liver can sequester large amounts of sickled cells and cause significant anemia