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Flashcards in Anemia Deck (36):
1

Right shift Hgb-O2 curve

Increases O2 delivery to tissues
Acidosis
Increased temp
High altitude
Exercise
Increased CO2
Increased 2,3-DPG

2

Left shift Hgb-O2 curve

Decreases O2 delivery to tissues
Alkalosis
Decreased temp
Increased Hgb F concentration
Decreased CO2
Decreased 2,3-DPG

3

Microcytic anemias

Iron deficiency (MC)
Lead poisoning
Sideroblastic
Thalassemias
Chronic disease (usu normocytic)

4

Normocytic anemias

Hemolytic
Chronic disease (rarely microcytic)
Hypovolemia

5

Macrocytic anemias

Folate deficiency
B12 deficiency
Liver disease
Alcohol abuse

6

Hemolytic anemia labs

Decreased H/H
Increased reticulocytes
Increased bilirubin (indirect)
Increased LDH (from RBC lysis)
Normal MCV
Decreased serum haptoglobin (used up)

7

Hemolytic anemia blood smear

Schistocytes, spherocytes, burr cells

8

Coombs test, direct

Agglutination indicates presence of IgG and complement on RBC membranes (eg warm/cold agglutinin)

9

Coombs test, indirect

Agglutination indicates presence of anti-RBC antibodies in serum (eg Rh alloimmunization)

10

Direct Coombs+ hemolytic anemia + antidrug antibodies, immune complexes or anti-Rh antibodies

Drug-induced hemolytic anemia

11

Drugs causing drug-induced hemolytic anemia

Penicillin
Methyldopa
Quinidine
Cephalosporins
NSAIDs

12

Drugs causing G6PD deficiency hemolysis

High dose ASA
Sulfa drugs
Dapsone
Quinine,quinidine, primaquine
Nitrofurantoin

13

Direct Coombs+ hemolytic anemia + anti-RBC antibodies

Warm-reacting (IgG) or cold-reacting (IgM) immune mediated hemolytic anemia

14

Hemolytic anemia + schistocytes

Mechanical (eg prosthetic heart valve)

15

Hemolytic anemia + spherocytes

Hereditary spherocytosis (+osmotic fragility test, +MHCH, decreased diameter)

16

Hemolytic anemia + bite cells or Heinz bodies

G6PD deficiency

17

Iron labs for iron deficiency anemia

Low iron, low ferritin
High TIBC/transferrin
Low Iron:TIBC ratio (<12%)

18

Iron labs for lead poisoning anemia

Normal/high iron
Normal ferritin, TIBC/transferrin

19

Iron labs for anemia of chronic disease

Low iron
Normal/high ferritin
Low TIBC/transferrin
Normal Iron:TIBC ratio (>18)

20

Iron labs for sideroblastic anemia

High iron, ferritin
Low TIBC/transferrin

21

Iron labs for thalassemia

Normal

22

Blood smear for iron deficiency anemia

Microcytic, hypochromic

23

Blood smear for lead poisoning anemia

Microcytic
Basophilic stippling
May have ringed sideroblasts in BM

24

Blood smear for anemia of chronic disease

Hypochromic
Normocytic or microcytic

25

Blood smear for sideroblastic anemia

Microcytic
May have ringed sideroblasts in BM

26

Blood smear for thalassemia

Microcytic
Target cells (alpha)
Basophilic stippling (beta)

27

Megaloblastic anemia

Macrocytic; hypersegmented neutrophils
B12/folate deficiency (Folate = MC)
Caused by problem w/ DNA synthesis

28

Causes of aplastic anemia

Radiation = MC
Drugs (chloramphenicol, sulfonamides, phenytoin, chemo)
Toxins
Viral (parvovirus, EBV, HIV)
Idiopathic
Congenital

29

Schistocytes

Hemolytic anemia
DIP/TIP/HUS

30

Acanthocytes (spur cells)

Irregular spokes
Abetaproteinlipidemia

31

Echinocytes (burr cells)

Regular spokes
Hemolytic anemia

32

Bite cells

G6PD deficiency

33

Basophilic RBC stippling

Lead poisoning
Thalassemia

34

Peripheral neuropathy + ringed sideroblasts in BM

Lead poisoning

35

Hypersegmented neutrophils

Megaloblastic anemia (folate/b12)

36

Heinz bodies (denatured Hgb in RBC)

G6PD deficiency