ANEMIA Flashcards
(92 cards)
1
Q
RETICULOCYTES Normal%
A
2%
2
Q
HEME
A
IRON that binds to prophoryin to form hemoglobin
3
Q
GLOBIN
A
2 alpha + 2 beta chains
4
Q
THALASEMIA
A
Changes in alpha or beta chain
5
Q
NORMAL Hemoglobin in adults
A
A and D
6
Q
HEMOLYSIS
A
Reticulocytes more than 2%
7
Q
Things that increase ESR
A
A nemia
M yocardial infarction
I nflammation
I nfection
8
Q
Above 100 ESR
A
Malignancy
Collagen
Multiple Myeloma
TB
9
Q
LOW ESR
A
HYPOFIBRINOGENMIA
Polycythemia
SPHEROCYTOSIS
SICKLE CELL Anemia
10
Q
To decide anemia
A
1) RBC less than 4.5
2) Hemoglobin less than 11
3) Size of RBC (macro,normally,microcytic)
11
Q
NORMAL corpscular Hemoglobin
A
27-32
12
Q
Normocytic
A
78%-98%
13
Q
Macrocytic
A
> 100
14
Q
Microcytic
A
<100
15
Q
Blood film
A
RBC appearance
16
Q
IRON Deficiency anemia Blood film
A
ANSICYTOSIS and POIKILOCYTISIS
17
Q
HEMOLYTIC UREMIC SYNDROME
A
SCHISTOCYTE
18
Q
DIC
A
SCHISTOCYTES
19
Q
Anemia on etiology
A
Iron deficiency anemia
VITAMIN B12 DEFICIENCY
FOLIC ACID deficiency
20
Q
ANEMIA on morphological changes
A
Micro cytic
Macro cytic
Normocytic
21
Q
Microcytic
A
Sideroblastic anemia
Lead poison
Iron deficiency anemia
Thalassemia
22
Q
Normocytic anemia
A
Bone marrow unable to form enough Rbcs
Acute blood loss
Hemolytic anemia
EXCEPT THALASSEMIA
23
Q
MACROCYTIC ANEMIA
A
Megaloblastic Anemia
Non Megaloblastic anemia
Chronic liver disease
Hypothyroidism
24
Q
How does body react to anemia?
A
Erythropoeitin increases to increase RBC production
Increase cardiac output
Increase plasma volume
Increase in lactic acid
25
CLINICAL PICTURE OF anemia
FATIGUE
WEAKNESS
increase cardiac output
DYSPNEA
Palpitation
Claudication pain
26
Signs of anemia
H eart failure but only if Hemoglobin 2 or 3
T achycardia
P allor
27
Pilonychia
IRON deficiency anemia
28
JAUNDICE/yellow lemon
HEMOLYTIC ANEMIA
29
SPHEROCYTOSIS
SPLEENOMEGALY/huge spleen
30
What increases iron absorption ?
Vitamin C
31
Decreases iron absorption
TANNIC ACID
MALBSORPTION (DUODENUM/JEJUNUM PROBLEMS)
phytate
32
IRON stored as
FERRITIN
33
CAUSES OF iron deficiency anemia
1) Decrease iron intake (malignancy,anorexia,old age)
2)increase iron requirement (pregnancy(hemodilution))
3)decreased absorption of iron(phytate/malabsorption)
34
For C section Hemoglobin has to be:
10
35
Most common reason for blood loss in Egypt
Oesophageal varices
36
Causes of Iron deficiency anemia
*Oesophageal varices (chronic liver disease hepatitis C&D
Bilharizia Chronicity)
*Multipara(bleeding from IUD)
*Intravascular hemolysis( Paroxysmal nocturnal hemoglobinuria)
37
CBC of Iron deficiency anemia
Microcytic
Hypochromic
38
Finding of Iron deficiency anemia
Spooning of nails
Loss of hair
39
In iron deficiency anemia if patient says they've been on treatment for one year but change isn't seen:
WRONG TREAMENT
40
Cases of Iron deficiency anemia
*ANKLYSTOMA PARASITE
*VAGINAL BLEEDING
*Esophageal varices
*ESOPHAGEAL WEB DUE To plant based syndrome (dysphagia)
41
IRON DEFICIENCY Anemia LAB:
EVERYTHING decreases except total iron binding capacity
42
Iron deficiency anemia on bone marrow:
HYPERPLASIA (DUE TO matured RBCS)
43
Extra investigations for iron deficiency anemia:
*For esophageal varices=upper endoscopy
*Stool analysis= to see if there is occult blood in stool
*Investigation for anklyostoma
44
Treatment of Iron deficiency anemia
ORAL +Parental + Intravenous+ Intramuscular
45
Oral therapy for iron deficiency anemia
Iron sulphate or Ferrous sulphate
46
IRON DEFIECIENCY TREATMENT FOR PREGNANT WOMAN:
Intravenous
47
Iron deficiency anemia treatment for malabsorption:
INTRAVENOUS
48
SIDE EFFECT OF INTRAMUSCULAR IRON
GLUTEAL ABSCESS & PAIN
49
Blood transfusion not used in:
HEMOGLOBIN 8 OR 9
50
To check for oral iron therapy efficiency
Wait for 3 months to check if hemoglobin has increased in grams
51
If oral iron therapy has failed
We check reticulocytosis(from 4 days to 1 week after oral iron therapy)
52
Side effect of intravenous injection
Anaphylactic shock
53
Megaloblastic anemia
Folic acid and Vitamin B12 deficiency
54
Megaloblastic anemia
Nucleus maturation arrest
Or
Asynchronicity between nucleus or cytoplasm
55
NON AUTOIMMUNE CAUSE OF DECREASE IN INTRINSIC FACTOR ( Type 2 Megaloblastic anemia)
H PYLORI
56
Diseases where there is antibody against intrinsic factor:
PERINICOUS Anemia
57
Pernicious anemia is seen in people with
VITILGO,
ADDISON,
AUTOIMMUNE Thyroid
58
BONE MARROW Megaloblastic anemia
BIG RBCs from bone marrow
But absent Vitamin b12 and folic acid in both peripheral cell and bone marrow
59
*NON MEGALOBLASTIC anemia*
*In chronic liver disease
*HEMOLYTIC crisis
*Hypothyroidism
They all lead to hemolysis
60
Bone Marrow non megaloblastic anemia
Normal cells in bone marrow buy absent megaloblastic adherence peripherally
61
NEUROLOGICAL SYMPTOMS of Perinicious anemia
SUBACUTE COMBINED DEGENERATION:
Peripheral Neuropathy
Posterior column affection (walking on cotton)
Hemiplegia
62
GIT SYMPTOMS OF Perinicious anemia
Diarrhea
Angular stomatitis
Dyspepsia
63
Perinicious anemia
VITAMIN b12 deficiency
64
Investigation of Megaloblastic anemia
*Low Hemoglobin
*Low RBCs
*Mean Corpscular volume above 100(macrocytosis normochromia)
*Bone marrow megaloblastic appearance
65
Drugs that lead to folic acid deficiency
Salicylic acid
Neomycin
Phenytoin
Methotrexate
Drugs of Rheumatoid arthritis/Systemic lupus Erythematosis
66
FINDING THAT MAYBE PRESENT IN MEGALOBLASTIC ANEMIA
ANSCIYTOSIS
67
Folic acid and Vitamin B are
Never measured
68
If there are neurological manifestations
NEVER GIVE FOLIC ACID
69
Treatment of megaloblastic anemia
FOLIC ACID FOR PREGNANT WOMAN
Vitb12 given to patient with diabetes IM/IV
70
Parasitic causes of anemia
Anklyostoma
Diphyllobothrum latum
Malaria
71
PANCYTOPENIA
APLASTIC ANEMIA (all blood cells are absent)
72
Hypersplenism
Megaloblastic anemia+Systemic lupus
73
Sideroblastic anemia
Iron twists around protophoryin giving sideroblastic appearance.
74
Sideroblastic anemia may be associated with
Vitamin B
75
Sideroblastic anemia may be due to
Heme synthesis problem
76
Sideroblastic anemia
May be carcinogenic
77
Sideroblastic anemia= investigation
NORMOBLAST IN BONE MARROW
78
SIDEROBLASTIC ANEMIA peripheral blood
Microcytic hypochromic anemia
79
Things that increase in sideroblast
Iron in excess
Transferrin
Ferritin
Serum iron
80
What remains normal in sideroblastic anemia
Iron binding capacity
81
Fatal mistake in Thalasemia treatment
Giving iron
82
Thalassemia is
Microcytic hypochromic
83
ANEMIA OF CHRONIC LOSS (eg kidney/liver disease)
Ferritin high,iron low,iron binding capacity
84
Causes of Pancytopenia/aplastic anemia
*Organophoshorus compound
*HIV
* Hepatitis B
*EpesteinBarrVirus
85
In Inflammatory diseases such as Systemic lupus/rheumatoid,what increases?
FERRITIN/Acute phase reactant
86
Why do we give iron even though Ferritin is high in COVID?
Because virus hides iron
87
APLASTIC ANEMIA
Hemoglobin,white blood cells and platelets are low
88
Cause of APLASTIC ANEMIA
Idiopathic
/fanconi/
unknown cause
89
Complains of aplastic anemia
Pallor
Repeated infection
BLEEDING
IMMUNOCOMPROMISED
90
Investigation of aplastic anemia
PANCYTOPENIA AND BONE MARROW TO KNOW CAUSE
91
TREATMENT OF APLASTIC anemia
Blood transfusion
Androgen
Monoclonal antibody
92
Acquired cause of aplastic anemia
Cytotoxic drugs and drugs that treat
rheumatoid arthritis +antithyroid drugs because they lead to agranulocytosis
