- skin - eyes - mouth - Sternal tenderness - Lymphadenopathy - Cardiac murmurs - splenomegaly - hepatomegaly

anemia Flashcards by Ruth Joy De Guzman

a condition in which number
of RBC or Hgb concentration is lower than the normal.
 is a manifestation of a certain disease associated with a
decrease in the red blood cell, decrease in hematocrit and
a decrease in hemoglobin.

Anemia

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decrease in the oxygen carrying capacity of the blood.

functional

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reduction from the baseline value for the total
number of RBCs, amount of circulating hemoglobin,
and RBC mass for a particular patient.

operational

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decrease in RBCs, Hb and Hct below the previously
established reference values for healthy individuals of
the same age, gender, and race and under similar
environmental conditions.

conventional

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Clinical Findings of Anemia

history
physical examination
signs and symptoms
laboratory procedures

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History of Patient

Diet
Bleeding history
Drug ingestion
Occupation
Exposure to chemicals
Travel
Previous medication
Ethnic group
Family history of disease
Hobbies
Neurologic symptoms

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Physical Examination

skin
eyes
mouth
Sternal tenderness
Lymphadenopathy
Cardiac murmurs
splenomegaly
hepatomegaly

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General causes of Anemia

Decreased red blood cell production
Increased red blood cell destruction
Blood loss

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Anemia due to decreased production of RBC

Iron Deficiency Anemia
Anemia due to Chronic Inflammation
Sideroblastic Anemia
Megaloblastic Anemia
Aplastic Anemia
Thalassemia
Anemia due to Chronic Renal Failure
Anemia due to Endocrine Disorder
Anemia due to Marrow Infiltration

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Anemia due to increased destruction of RBC

Intracorpuscular Abnormality (Intrinsic)
Extracorpuscular Abnormality (Extrinsic)

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Intracorpuscular Abnormality

Membrane Defect
Enzyme deficiency
Paroxysmal Nocturnal Hemoglobinuria
Globin abnormality

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Extracorpuscular Abnormality

Mechanical
Infection
Chemical and Physical Agents
Antibody-mediated Anemia (AMA)

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Anemia due to blood loss

Acute post hemorrhagic anemia
Chronic post hemorrhagic anemia

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Laboratory test for Anemia assessment

complete blood count
reticulocyte count
Peripheral smear
bone marrow examination
Iron studies
Blood Chemistry
Urinalysis
Fecalysis
Hematological special test procedures

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Morphological Classification of Anemia

Microcytic hypochromic anemia (found in SIGA)
Macrocytic normochromic anemia
Normocytic normochromic anemia

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Causes of Iron Deficiency Anemia

Inadequate intake of iron
Increased need of iron
Chronic blood loss

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Stage I of iron deficiency

Iron Depletion

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Iron depletion

Hemoglobin - normal
Serum Iron - normal
Total Iron Binding Capacity - normal
Ferritin - low

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Stage II of Iron deficiency

Exhaustion of the storage pool of iron

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Stage III of Iron deficiency

– Frank Anemia

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Exhaustion of the storage pool of iron

Hemoglobin - normal
Serum Iron - decreased
Total Iron Binding Capacity - increased
Ferritin - decreased

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Frank Anemia

Hemoglobin - decreased
Serum Iron - decreased
Total Iron Binding Capacity - increased
Ferritin - decreased

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Blood Features of IDA

decreased normal retic
decreased serum iron
decreased serum ferritin
increased total iron-binding capacity (TIBC)
decreased in osmotic fragility test
Microcytic hypochromic type of Anemia
Anisocytosis
Poikilocytosis

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Treatment for IDA

Ferry sulfate supplement with vitamins C

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CATEGORIES OF LAB DIAGNOSIS FOR ANEMIA

- screening - diagnostic - specialize

Screening for anemia

- cbc - rbc indices

Diagnostic for anemia

- Iron studies

Specialize for anemia

Hb electrophoresis

SEVERE TYPE OF IRON DEFICIENCY

- Smooth tongue - koilonychia - PICA

Iron deficiency can result in a painless, smooth, shiny, and reddened tongue

Smooth tongue

a condition also referred to as “spoon-shaped nails,” is associated with iron deficiency in which the fingernails are thin, brittle, and concave with raised edges

koilonychia

Condition where there’s a craving for uncertain food. Ex: dirt, clay, chalk Craving for non-edible food

PICA

develop when the incorporation of iron into heme is blocked

SIDEROBLASTIC ANEMIA

2 types of SIDEROBLASTIC ANEMIA

- Hereditary Sideroblastic Anemia - Primary Acquired Sideroblastic Anemia

due to a congenital enzyme defect delta amino-levulinic acid synthetase or heme synthetase

Hereditary Sideroblastic Anemia

due to somatic mutation of the erythroid progenitor cells that cause either defects in heme synthesis or defects in DNA synthesis

Primary Acquired Sideroblastic Anemia

Lead interferes with iron storage in the mitochondria Lead damages the activity of enzymes used for heme synthesis

Lead poisoning

second most common type of anemia

ANEMIA DUE TO CHRONIC INFLAMMATION

inherited disorders caused by genetic alterations that reduce or preclude the synthesis of the globin chains of hemoglobin tetramer

THALASSEMIA

 predominant in Mediterranean, African and Asian ancestry.

THALASSEMIA

Who first described THALASSEMIA?

COOLEY and LEE in 1925

Types of Thalassemia

1. Beta (β) Thalassemia 2. Alpha (α) Thalassemia 3. Hereditary Persistence of Hb F (HPHF) 4. Hemoglobin Lepore 5. Hemoglobinopathy + Thalassemia

which chromosome beta chain is found?

chromosome 11

other name for alpha Thalassemia minor

Heterozygous thalassemia Cooley's trait Rietti-Greppi Micheli disease

hemoglobin range for thalassemia minor

10-13 mg/dL

other name for Intermediate B-thalassemia

Thalassemia Intermedia

results when one of the 2 genes that produce beta globin is defective

Thalassemia minor

more severe anemia than minor B-thalassemia but do not require regular transfusion

Intermediate B-thalassemia

Other name for beta Thalassemia major

Homozygous thalassemia Cooley's anemia Mediterranean anemia Target cell anemia

decrease or complete lack of beta globin production

Thalassemia major

which chromosome alpha chain is found?

chromosome 16

deletion of one α globin gene, leaving 3 functional α globin genes

Silent Carrier

deletion of two α globin gene

α Thalassemia Trait homozygous

caused by the presence of only one gene producing α chains.

Hemoglobin H Disease

results in the absence of all α chains synthesis

Hydrops Fetalis

thalassemia with increased levels of fetal hemoglobin

Hereditary Persistence of Hb F (HPHF)

a rare class of thalassemia caused by crossing over of beta and delta genes

Hemoglobin Lepore

is a double heterozygous abnormality

Hemoglobin S- Thalassemia

co-inherited of Hemoglobin E and β thalassemia that results to a marked reduction of β chain production.

Hemoglobin E-Thalassemia

LABORATORY FINDINGS OF THALASSEMIA

- CBC - Peripheral smear - . increased reticulocyte count - . bone marrow examination - . decreased OFT - supravital stain - electrophoresis - Mass spectrophotometry - DNA analysis (sophisticated test) - . increased indirect bilirubin

disorder in the DNA synthesis of RBC the maturation of nucleus is delayed relative to that of cytoplasm

Megaloblastic anemia

Causes of Megaloblastic Anemia

- dietary deficiency - increased need during pregnancy and lactation - impaired absorption in the intestine - impaired use due to drugs - excessive loss during renal dialysis

Laboratory Findings of Megaloblastic Anemia

- cbc - peripheral smear - Decreased in absolute reticulocyte count - . Chemistry Analysis - Schilling Test - hypersegmented neutrophil

used to distinguish malabsorption of vitamin B12 from other causes of malabsorption

Schilling Test

anemia caused by conditions such as a. alcoholism b. chronic liver disease

Non-megaloblastic anemia

characterized by premature RBC destruction caused by autoantibodies that bind the RBC surface.

Autoimmune Hemolytic Anemia

- responsible for approximately 70% of Immune hemolytic cases - mediated by antibody with maximum binding affinity at 37°C

Warm-Reactive Autoimmune Hemolytic Anemia

mediated by antibody with maximum binding affinity at 4°C or below 32°C

Cold-Reactive Autoimmune Hemolytic Anemia

a rare acute form of cold-generated hemolysis - hemolysis occurs when blood is warmed after previous exposure to chilling

Paroxysmal Cold Hemoglobinuria (PCH)

self-limiting, but severe even fatal following the administration of drug that can cause immune hemolytic anemia

Drug-Induced Immune Hemolytic Anemia

usually occurs in newborns following the transplacental passage of maternal anti-fetal red cells antibody.

Alloimune Hemolytic Anemia

2 Causes Alloimune Hemolytic Anemia

1. Erythroblastosis fetalis 2. Isoimmune HDN due to ABO incompatibility

anemia Flashcards

(72 cards)