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Clin Med 1 > Anemia > Flashcards

Anemia Flashcards

0
Q

normal HGB and HCT in men

A

HGB 14-18 g/dl

HCT 40-50%

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1
Q

normal HGB and HCT for women

A

HGB 12-16 g/dl

HCT 35-45%

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2
Q

causes of decreased RBC production (4)

A

iron deficiency
B12 deficiency
folate deficiency
chronic disease

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3
Q

3 big etiologies of anemia

A

decreased RBC production
increased RBC destruction
Blood loss

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4
Q

causes of anemia due to blood loss

A

menstrual
GI bleeding
trauma

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5
Q

hypochromic, microcytic anemias (3)

A

iron deficiency anemia
thalassemias
sideroblastic anemia

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6
Q

normochromic, normocytic anemia (3)

A

hypothyroidism
liver disease
chronic disease

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7
Q

macrocytic/megaloblastic anemia causes

A

folate &/or B12 deficiency

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8
Q

causes of iron deficiency anemia

A

menses
pregnancy
GI blood loss
decreased iron absorption

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9
Q

iron deficiency anemia on a smear

A

biconcave appearance, central pallor on RBCs

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10
Q

iron deficiency anemia test results (4)

A

decreased serum ferritin
decreased serum Fe
elevated TIBC
** Elevated RDW

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11
Q

alpha 2 thalassemia presents as

A

mild hypochromic, microcytic anemia

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12
Q

alpha 3 thalassemia presents as

A

hemolytic anemia w/ splenomegaly

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13
Q

Beta thalassemia presents as

A

asymptomatic, hypochromic, microcytic anemia

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14
Q

lab findings for thalassemia

A

decreased MCV
Smear: poikilocytosis, target cells, nucleated RBCs
Normal RDW

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15
Q

good DDX finding for iron deficiency anemia

A

Elevated RDW

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16
Q

thalassemia tx (3)

A

transfusions to keep HGB > 9 g/dl
possible splenectomy
iron chelation therapy needed due to transfusion

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17
Q

how is anemia of chronic disease diagnosed?

A

exclusion, hx

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18
Q

an acquired disorder of hematopoetic stem cells, resulting in refractory anemia

A

MDS

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19
Q

refractory anemia due to drugs, lead toxicity, malignancy, inflammation, infection

A

sideroblastic anemia

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20
Q

variable MCV
anisocytosis & poikilocytosis
ringed sideroblasts may be present

A

sideroblastic anemia

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21
Q

elevated reticulocyte count w/ no other findings indicates

A

prior/recent hemorrhage, recent hemolysis

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22
Q

MCV > 100 =

A

macrocytic anemias

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23
Q

etiology/process of macrocytic anemia

A

defective DNA synthesis –> larger RBCs

24
additional symptoms of macrocytic anemia
glossitis, jaundice, splenomegaly, neuro***
25
macrocytic anemia smear's most significant finding
hypersegmented neutrophils
26
Labs for Macrocytic Anemia (4)
serum B12 Schilling Test IF antibodies serum methylmalonic acid & homocysteine levels
27
autoantibodies against intrinsic factor
pernicious anemia- results in B12 deficiency
28
Lab ddx between B12 and folic acid deficiency
B12: elevated serum methylmalonic acid and homocysteine levels Folate: elevated homocysteine but normal methylmalonic acid levels
29
tx for folic acid deficiency
replacement therapy | Treat B12 as well
30
how do elevated reticulocytes look on a smear?
blue
31
elevated reticulocyte count, nucleated RBCs and schistocytes on smear, elevated plasma Hb ---> ?
hemolytic anemia
32
how to differentiate between intravascular and extravascular hemolytic anemia (lab test)
serum haptoglobin decreased in intravascular hemolysis
33
causes of intravascular hemolysis
fragmentation syndromes: traumatic (macroangiopathic) from prosthetic heart valve; fibrin strands in vessels (microangiopathic) G6PD deficiency
34
causes of extravascular hemolysis (4)
hereditary spherocytosis sickle cell hemolytic anemia (drug induced or autoimmune) incompatible blood transfusion
35
RBCs w/ decreased surface area, poorly deformable. RBCs get trapped in splenic sinusoids & are phagocytized by macrophages
hereditary spherocytosis
36
hereditary spherocytosis etiology
autosomal dominant
37
lab findings for hereditary spherocytosis (2)
osmotic fragility test for cell wall defects | lack of central pallor on RBC smear
38
hereditary spherocytosis tx (2)
splenectomy, give pnuemococcal vaccine
39
primary presentation of back, rib, limb pain
sickle cell anemia
40
cause of sickle cell pain
vaso-occlusive ischemia
41
complications of sickle cell (4)
osteonecrosis of femoral/humeral heads functional asplenism due to infarcts leg ulcers bilirubin gallstones due to chronic hemolysis
42
1st and 2nd line lab tests for sickle cell
Sickledex (1st line) | Hb electrophoresis
43
sickle cell characteristic finding on peripheral smear
Howell-Jolly bodies: residual nuclear material
44
precipitating factors of sickle cell (4)
dehydration hypoxia altitude intense exercise
45
sickle cell tx (2)
Pain crises: analgesics, fluids, oxygen | Hydroxyurea to decrease occurrence of crises
46
antibodies bind to RBCs, damage cell membrane --> hemolysis --> phagocytized --> destroyed in the spleen
autoimmune hemolytic anemia
47
smear findings for autoimmune hemolytic anemia? (4)
reticulocytosis polychromasia spherocytosis nucleated red cell
48
on smear: reticulocytosis, polychromasia, spherocytosis, nucleated red cells
autoimmune hemolytic anemia
49
autoimmune hemolytic anemia tx (4)
treat underlying autoimmune cause corticosteroids for short term splenectomy folic acid supplementation
50
anemia characterized by an abnormal iron metabolism
sideroblastic anemia
51
normal retic count range
0.5-2.5%
52
normal MCV range
80-100 fl
53
length of iron deficiency tx
at least 6 mo- replenish stores
54
decreased serum ferritin, decreased serum Fe, increased TIBC
iron deficiency
55
normal serum ferritin, normal TIBC
unlikely iron deficiency
56
decreased Fe, decreased TIBC, normal ferritin
anemia of chronic disease
57
increased ferritin, increased serum Fe, normal TIBC
Thalassemia

Clin Med 1 (18 decks)

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