Anemia

Question 1

What are the three main broad differentials for an anemic patient?

Answer 1

(Loss, destruction, and hypoplasia)

Question 2

Noticing a heart murmur and bounding pulses is associated with a change in what characteristic of blood?

Answer 2

(A change in viscosity of the blood)

Question 3

Clinical signs associated with anemia depend on what characteristics of the RBC loss?

Answer 3

(The severity and the chronicity)

Question 4

What do you expect your PCV and TS results to be in early vs later blood loss anemia?

Answer 4

(Early - normal PCV, potentially slight increase in TS or normal; later - low PCV and low TS)

Question 5

What do you expect your PCV and TS results to be in a case of RBC destruction anemia?

Answer 5

(Low PCV and normal to increased TS, serum will also likely be icteric)

Question 6

What do you expect your PCV and TS results to be in a case of lack of RBC production anemia?

Answer 6

(Low PCV and normal to increased TS)

Question 7

What do you expect your CBC results to be in a case of early vs later blood loss anemia?

Answer 7

(Early will be pre-regenerative so low to “normal” retics, normocytic, normochromic; later will be regenerative so high retics, macrocytic, hypochromic)

Question 8

What do you expect your CBC results to be in a case of RBC destruction anemia?

Answer 8

(Inflammatory leukogram, regenerative anemia, and evidence of destruction (spherocytes))

Question 9

What do you expect your CBC results to be in a case of lack of RBC production anemia?

Answer 9

(Nonregenerative anemia → low retics, normocytic, hypochromic, possibly pancytopenia)

Question 10

Sort the following causes of blood loss anemia into more likely to be causing acute vs chronic loss:

Trauma
Parasites
Cancer
Ulcers
Coagulopathy

Answer 10

Trauma (Acute)
Parasites (Chronic)
Cancer (Either or)
Ulcers (Chronic)
Coagulopathy (Acute)

Question 11

What is the main way to tell if a patient has extravascular versus intravascular hemolysis?

Answer 11

(Look at the serum, yellow if extravascular, red if intravascular; but apparently distinguishing between the two doesn’t matter)