Anemia

Question 1

What is the physiological definition of anemia?

Answer 1

Hemoglobin level too low to meet cellular oxygen demands.

Question 2

What factors determine hemoglobin values?

Answer 2

Age, gender, race, degree of sexual maturation, altitude, heredity.

Question 3

What do RBC indices describe?

Answer 3

Size, shape, hemoglobin content of RBCs, and uniformity of RBC population.

Question 4

What does a low Mean Corpuscular Hemoglobin (MCH) indicate?

Answer 4

Hypochromia.

Question 5

What does a high Red Cell Distribution Width (RDW) signify?

Answer 5

Underlying condition, such as anemia, autoimmune conditions, and liver or kidney disease.

Question 6

What are the pathophysiologic mechanisms of anemia?

Answer 6

Decreased production, acute blood loss, increased destruction (hemolysis).

Question 7

What are the types of anemia based on erythrocyte size?

Answer 7

Microcytic, normocytic, macrocytic.

Question 8

What are the causes of microcytic anemia?

Answer 8

Iron deficiency, sideroblastic, thalassemia, anemia of chronic disease.

Question 9

What are the causes of macrocytic anemia?

Answer 9

B12, folate deficiency.

Question 10

What are the causes of normocytic anemia?

Answer 10

Chronic disease, aplastic.

Question 11

What are the types of increased RBC destruction?

Answer 11

Hemolysis (acquired or congenital).

Question 12

What are the protective mechanisms against too much iron?

Answer 12

Highly regulated iron absorption, iron tightly bound to proteins.

Question 13

What are the symptoms of iron deficiency anemia?

Answer 13

Weakness, fatigue, SOB, pallor, dizziness, irritability, decreased exercise tolerance, pica.

Question 14

What is the most specific and reliable indicator of iron deficiency?

Answer 14

Ferritin levels

Question 15

How should iron studies be interpreted?

Answer 15

In combination with RBC indices, peripheral smear, and history

Question 16

What are the lab indicators of iron deficiency anemia?

Answer 16

High TIBC, low serum iron, low transferrin saturation, low ferritin.

Question 17

What is the primary treatment for iron deficiency anemia?

Answer 17

Oral iron therapy

Question 18

What are common side effects of oral iron therapy?

Answer 18

Nausea, constipation, diarrhea

Question 19

What is a characteristic feature of sideroblastic anemia?

Answer 19

Iron retained in mitochondria

Question 20

What is the function of Vitamin B12?

Answer 20

Methionine synthesis and formation of succinyl coenzyme A

Question 21

What results from folate or Vitamin B12 deficiency?

Answer 21

Megaloblastic anemia

Question 22

What are clinical findings of Vitamin B12 deficiency?

Answer 22

Neurological abnormalities

Question 23

What lab findings are associated with folate and Vitamin B12 deficiency?

Answer 23

Macrocytosis, Howell-Jolly bodies, hypersegmentation of neutrophils

Question 24

What are common causes of folic acid deficiency?

Answer 24

Decreased intake, excessive alcohol consumption, intestinal malabsorption

Question 25

What is the treatment for Vitamin B12 deficiency?

Answer 25

Daily oral supplement or monthly IM injection

Question 26

What induces the production of hepcidin in anemia of chronic disease?

Answer 26

Inflammatory cytokines

Question 27

What is the hallmark of aplastic anemia?

Answer 27

Hypocellularity and hypoplasia of all cell lines in bone marrow

Question 28

What is the most common cause of acquired aplastic anemia?

Answer 28

Autoimmune T cell-mediated destruction

Question 29

What is the most common cause of acquired aplastic anemia?

Answer 29

T cell mediated autoimmune response

Question 30

What are the primary symptoms of thrombocytopenia?

Answer 30

Easy bleeding/bruising and epistaxis

Question 31

What diagnostic test is required for confirming aplastic anemia?

Answer 31

Bone marrow biopsy and aspirate

Question 32

What is a highly effective treatment for autoimmune aplastic anemia?

Answer 32

Immunotherapy

Question 33

What is the most common cause of death in aplastic anemia?

Answer 33

Infection

Question 34

What characterizes hemolytic anemia?

Answer 34

Increased destruction of erythrocytes

Question 35

What are the two main types of hemolysis?

Answer 35

Intravascular and extravascular

Question 36

What is the most common cause of non-immune hemolytic anemia?

Answer 36

Hereditary spherocytosis

Question 37

What is the primary treatment consideration for hereditary spherocytosis?

Answer 37

Splenectomy, weighing risk/benefit.

Question 38

What lab marker is elevated due to non-specific cell damage in hemolytic anemia?

Answer 38

LDH

Question 39

What does a positive direct Coombs test indicate?

Answer 39

Immune etiology

Question 40

What is the clinical presentation of Thalassemia Minor?

Answer 40

Clinically normal with mild microcytic anemia, usually asymptomatic.

Question 41

What characterizes Hemoglobin H disease?

Answer 41

Presence of hemolysis, jaundice, and splenomegaly.

Question 42

What is the outcome of Hydrops Fetalis?

Answer 42

Incompatible with life due to no alpha chains.

Question 43

What is the most common cause of α-Thalassemia?

Answer 43

Point mutations leading to reduced or absent β-chain synthesis.

Question 44

What are the complications of untreated β-Thalassemia Major?

Answer 44

Severe anemia, bony deformities, iron overload, and early death from cardiac failure.

Question 45

How is β-Thalassemia Intermedia different from β-Thalassemia Major?

Answer 45

Less severe anemia, diagnosed later, and survival into adulthood.

Question 46

What is the clinical significance of β-Thalassemia Minor?

Answer 46

Asymptomatic carriers with mild microcytic anemia and normal life expectancy.

Question 47

What are the treatment options for Thalassemias?

Answer 47

Genetic counseling, supportive care, transfusions, iron chelation, stem cell transplant, and gene therapy.

Question 48

What genetic mutation causes Hemoglobin S?

Answer 48

Mutation in the β-globin gene leading to polymerization of Hgb-S.

Question 49

What are the chronic complications of Sickle Cell Disease?

Answer 49

Chronic hemolytic anemia, jaundice, organ damage, and increased risk of infections.

Question 50

What is a common neurological event in sickle cell disease that can be clinically apparent?

Answer 50

Stroke

Question 51

What triggers Vaso-occlusive Pain Crisis in Sickle Cell Disease?

Answer 51

Often unknown, but can include skin cooling, infection, stress, and dehydration.

Question 52

What is the significance of Acute Chest Syndrome in Sickle Cell Disease?

Answer 52

Frequent cause of death and second most common reason for hospitalization.

Question 53

What are some common symptoms of a stroke in sickle cell disease?

Answer 53

Hemiparesis, aphasia, dysphagia, seizures, headache, cranial nerve palsy, stupor, coma

Question 54

How is Acute Chest Syndrome managed?

Answer 54

Empiric antibiotics, transfusion, supportive care, and bronchodilators.

Question 55

What imaging techniques are used for diagnosing a stroke in sickle cell patients?

Answer 55

MRI, MRA, CT without contrast

Question 56

What is the primary treatment for stroke in sickle cell disease?

Answer 56

Transfusion

Question 57

What screening tool is used for stroke risk in sickle cell disease?

Answer 57

Transcranial Doppler Ultrasound

Question 58

What are the key components of managing sickle cell disease?

Answer 58

Early identification, family education, preventive measures, screening, prophylactic penicillin, immunization, treatment of acute complications, disease-modifying agents, chronic transfusion, hydroxyurea, stem cell transplantation, gene therapy

Question 59

When is transfusion indicated in sickle cell disease?

Answer 59

Acute stroke or TIA, acute chest syndrome, priapism, splenic sequestration, pre-operative, symptomatic anemia, aplastic crisis, abnormal transcranial doppler

Question 60

When is transfusion not indicated in sickle cell disease?

Answer 60

Pain crisis, anemia