Anemia 2 Flashcards Preview

Blood > Anemia 2 > Flashcards

Flashcards in Anemia 2 Deck (19):
1

macrocytic anemia: why are the cells big (in general)

disconnect between cell content and membrane quantity (RBC is still large after losing its nucleus, organelles)

2

vit B12/folate deficiency, myelodysplasia, drugs - pathophysl

impaired DNA synthesis: nuclear and cytoplasm maturation are mismatched

3

alcoholism, liver disease, thyroid disturbances: pathophysl

altered/increased content in cell membrane = redundant membrane

4

reticulocytes: why are they bigger

(already lost nucleus) contain residual protein synthesis machinery = haven't yet achieved final compact RBC size

5

limitations of MCV

lists aren't mutually exclusive, and usually the patient will be normocytic - use is to suggest further testing

6

bone marrow response: measured by?

reticulocyte count

7

all patients with persistent unexplained anemia: order what 2 things

blood film. reticulocyte count.

8

what is the bone marrow response to anemia

low O2 detected by kidney = EPO production to stimulate RBC production. Within 2/3 days, young RBCs aka reticulocytes should be detectable in blood

9

limitations of reticulocyte count

hard to know what an appropriate reticulocyte response is in a given situation

10

rule of thumb for reticulocyte counts

someone with anemia: should go above 2%, if not their bone marrow has not adequately responded

11

failure of adequate reticulocyte production indicates?

bone marrow isn't optimally functioning

12

classifying anemia by reticulocyte count (2)

low count = hypoproliferative anemia aka marrow can't respond. high = proliferative anemia = marrow is responding, but cells are being lost or destroyed too fast

13

causes of hypoproliferative anemia

abnormal marrow, hemantinic deficiency, low metabolic state, low erythropoietin (renal failure), anemia of inflammation

14

causes of proliferative anemia

bleeding, hemolysis, response to hematinic therapy

15

anemia by pathologic category: what causes increased loss/destruction

bleeding: obvious or occult. destruction by hemolysis

16

anemia by pathologic category: what causes sequestration

cells sequestered in the spleen. can also be dilutional: from pregnancy, or large IV boluses like getting saline

17

anemia from blood loss: chronic blood loss leads to?

iron deficiency. usually iron is in RBCs and is recycled

18

hemolysis: two categories and examples

extrinsic: immune mediated, drugs/toxins, osmotic, mechanical. intrinsic: enzyme deficiency, hemoglobinopathy, membrane protein defects - usually congenital.

19

hemolytic workup: order what tests?

blood film. reticulocyte count LDH. total and unconjucated bilirubin. haptoglobin. DAT aka direct antiglobulin test