Flashcards in Anemia 2 Deck (75):
What level of Hb defines anemia in adults (men, women, pregnant women)?
What is the most common cause of B12 deficiency? Folate?
How long does it take for B12 deficiency to present? Folate?
What is the treatment for B12 deficiency? Folate?
What is the chemical released by the kidneys that stimulate bone marrow production of RBCs?
What are the three measures that define anemia?
High hb = ?
HIgh HCT = ?
High RBC count = ?
What is the equation for the absolute reticulocyte count?
(RBC count)*(% reticulocytes) /100
Under what number can reticulocytosis be excluded (for the reticulocyte count)?
What are the three ways in which we classifty anemias?
Onset (acute vs chronic)
What are the two different categories of pathophysology for anemia?
What is the usual cause of macrocytic anemia?
Defect in the maturation of RBCs
Normocytic anemia is usually caused by what?
Decreased production or increased destruction
Micro or macrocytic anemia: iron deficiency?
Micro or macrocytic anemia: anemia of chronic disease
Micro or macrocytic anemia: thalessemias?
Micro or macrocytic anemia: siderblastic anemia?
Micro or macrocytic anemia: B12 deficiency
Micro or macrocytic anemia: folic acid deficiency
Micro or macrocytic anemia: drug related?
Micro or macrocytic anemia: hypothyroidism
Micro or macrocytic anemia: liver disease
Micro or macrocytic anemia: alcoholism
Micro or macrocytic anemia: myelodysplastic syndrome
What are the three general causes of intrinsic hemolytic anemia?
What are the three general causes of extrinsic hemolytic anemias?
What is the PMN findings for megaloblastic anemias?
What are the sources for B12? Folate?
B12 = meat
Folate = green leafy vegetables
Where is B12 absorbed? Folate?
B12 = ileuem
Folate = proximal jejunum
What are the daily requirements for B12?
What are the daily requirements of folate?
How long does it take to become folate deficient? B12?
Folate = 3-4 months
B12 = 3-4 years
Which has a more rapid onset: B12 deficiency d/t malabsorption or dietary deficieny
What are the two reactions that B12 is necessary in?
Conversion of methylmalonic acid to succinyl-CoA
What intestinal disease is known to lead to B12 deficiency?
What are the two drugs that can lead to B12 deficiency?
B12 deficiency that presents a few weeks after birth = ?
Congential transcobalamin deficiency
B12 deficiency that presents at birth?
Congenital methylmalonic acidemia
Why are parethesias common in B12 deficiencies?
True or false: babinski's sign may be present with B12 deficiency
What happens to the reticulocyte count with B12 deficiencies?
What are the histological characteristics of PMNs in b12 deficiencies?
Hypersegmented (may lobes)
What is the treatment for B12 deficiency?
B12 1000mcg IM/SQ weekly, then monthly
What mineral must be monitored carefully during the treatment for B12 deficiency?
How long does it take Hb levels to return to normal following treatment with B12?
What causes the paresthesias with B12 deficiency?
Demyelination of the dorsal colums/ML pathways
Pts who have undergone what surgical procedure require B12 supplementation?
What is the most common cause of pernicous anemia?
Autoimmune attack against parietal cells
What are the tests for pernicous anemia now-a-days?
Parietal cell / IF antibody test
What would you expect gastric serum levels to be in a patient with pernicious anemia? Serum pepsinogen levels?
What would a biopsy of a stomch of a pt with pernicious anemia show?
Death of parietal cells, repalced with mucus cells
Borderline B12 levels is accompanied by what lab values in a pt with subclinical B12 deficiency?
Elevated Homocysteine /methylmalonic acid levels
What is the most common cause of folate deficiency anemia?
Inadequate dietary intake
Folate deficiency signs/symptoms are the same as B12, except for what?
B12 has neurological symptoms, while Folate does not
What are the signifiant lab findings with folate deficiency?
Low serum RBC/folate level
What is the methylmalonic acid level in pts with folate deficiency?
What is the treatment for folate deficiency?
1-5 mg/day oral folate
How long does it take for folate to reach normal levels?
What are the homocysteine levels in folate deficiency?
What are the two autoimmune causes of aplastic anemia?
What is the congenital cause of aplastic anemia?
Defected in telomere length maintenance
What are the toxins that can cause aplastic anemia? (3)
What is the virus that can cause aplastic anemia in the post-viral state?
What treatment can cause aplastic anemia?
What are the CBC findings with aplastic anemia?
What are the signs/symptoms of aplastic anemia? (4)
True or false: LA / bone pain can be symptoms of aplastic anemia
False-- think osteosarcoma if these are present
True or false: reticulocytoenia is always present with aplastic anemia
What is the test that you should always order for patients with aplastic anemia?
Bone marrow biopsy
What is the treatment for mild aplastic anemia? Severe?
Symptomatic treatment for mild
Bone marrow transplant for severe
What are the methylmalonic acid levels in B12 deficiency? Folate deficiency?
b12 = high
Foalte = low
What are the serum folate levels in folate deficiency? B12/
B12 = normal
Folate = low