Anemia Flashcards

Question

Differnetiating normocytic anemia

Answer 1

DAT test | - positive in AIHA

Answer 2

Macrocytic megaloblastic oval macrocytes neutrophil nuclear hypersegmentation

Answer 3

Normocytic Howell-Jolly body: blue dot-like RBC inclusion, representing DNA - inclusions normally removed by splenic macrophages (patients with SCA usually are hyposplenic due to childhood splenic infarctions - see peripheral signs of hyposplenism)

Answer 4

``` microcytic usually presents with iron deficiency, therefore see microcytic RBCs Basophilic stippling (punctuate basophilia) ```

Answer 5

Microcytic Poikilocytosis - usually target cells - can see other shapes such as schistocytes, elliptocytes, teardrop cells Basophilic stippling

Answer 6

Macrocytic, non-megaloblastic | Low WBC and platelet counts

Answer 7

Normocytic Bite cells and blister cells - signs of oxidative injury Can also see spherocytes, schistocytes

Answer 8

increase O2 capacity | dilute sickled cells

Answer 9

severely decreased platelet counts + bleeding/bruising prophylaxis before surgery if platelets are low dysfunctional platelets + bleeding/bruising

Answer 10

relative: immune thrombocytopenic purpura, hypersplenism absolute: thrombotic thrombocytopenic purpura, heparin-induced thrombocytopenia and thrombosis (HITT)

Answer 11

Multi-factor deficiency + bruising/bleeding | Pre-op prophylaxis if there is evidence of multifactor deficiency

Answer 12

``` burns erythroblastosis fetalis hyperbilirubinemia hypoproteinemia hypovolemia nephritic syndrome ```

Answer 13

``` Hypersensitivity anemia heart failure hypernatremia hypertension infection pregnancy breastfeeding renal disease viral infection ```

Answer 14

immune: ABO incompatibility, IgG antibody incited, febrile, allergic, anaphlactic Infectious Fluid: overload, hypothermia Electrolytes: hypokalemia, hypocalcemia, increased Fe

Answer 15

Many are asymptomatic | Fatigue, dyspnea, palpitations, particularly following exercise

Answer 16

dizziness, headache, syncope, tinnitus, vertigo, irritable, difficulty sleeping, concentration GI - indigestion, anorexia, nausea males: impotence, loss of libido

Answer 17

``` Pallor Tachycardia wide pulse pressre Hyperdynamic precordium Systolic ejection murmur (esp in pulmonic) ```

Answer 18

``` Iron/B12/folate deficiency EPO deficiency due to renal disease Endocrinopathy Myelodysplastic syndrome Anemia of chronic disease Liver disease Chemotherapy/marrow suppression ```

Answer 19

Hemolytic anemia - intrinsic RBC defects in: membrane (HS), enzyme (G6PD), Hb (thalassemia/sickle cell) - extrinsic: immune-mediated (AIHA), infectious (clostridium), prosthetic valves, microangiopathic hemolytic anemia (HUS, DIC, TTP)

Answer 20

``` Low Hb Low MCV Low RBC Low reticulocytes Increased RDW Low serum Fe Increased transferrin (TIBC) Low transferrin sat Low ferritin Increased erythrocyte protoporphyrin Increased platelet count ```

Answer 21

``` Low hb Very low MCV High RBC N/High Reticulocytes N RDW N/high serum Fe N/low transferrin (TIBC) N/high transferrin sat N ferritin ```

Answer 22

``` Low Hb N/low MCV Low RBC Low reticulocytes N RDW Low serum Fe N/low TIBC N/low transferrin sat High ferritin ```

Answer 23

``` Low Hb N MCV Low RBC High reticulocytes N RDW ```

Answer 24

POSITIVE DAT!!!! ``` Low Hb N/high MCV Low RBC High reticulocytes High RDW High bilirubin Low haptoglobin High LDH ```

Answer 25

``` Low Hb N MCV Low RBC High reticulocytes High RDW High bilirubin ```

Answer 26

``` Target cells Low Hb High MCV Low RBC Low reticulocytes N RDW ```

Answer 27

``` Low Hb High MCV Low RBC Low reticulocytes High RDW ```

Answer 28

``` Low Hb N/High MCV Low RBC High reticulocytes High RDW Low platelets ```

Answer 29

Low Hb High MCV Low RBC Low reticulocytes

Answer 30

``` Low Hb Low MCV Low RBC Low reticulocytes High RDW ```

Answer 31

Fatigue diminished physical activity reduced endurance Secondary organ dysfunction Arrhythmia, heart failure, cardiac ischemia Flow murmurs Growth/mental developmental delay Reduced attention span/alertness B12 anemia could cause irreversible neurological damage Frequent transfusions could cause secondary hemochromatosis

Answer 32

1) oral prednisone - 70-80% patients better in 3 weeks - taper when Hb levels stabilize - complete remission achieved in 15-20% new onset cases of warm AIHA, but half will need low-dose prednisone for several months 2) 10-20% fail steroid therapy. Need splenectomy Splenectomy - 65-70% response rate 3) Cytotoxic drugs - 40-60% response Severe cases - use plasmaphresis as bridging therapy until drugs take effect

Answer 33

Expect it to be high - indicates sufficient marrow function | If low - inadequate stores of Fe, B12, folate, or other marrow abnormalities

Answer 34

MCV < 80 | MCH < 27

Answer 35

``` Hemolytic anemias Anemia of chronic disease (in some cases) After acute blood loss renal disease Mixed deficiencies Bone marrow failure ```

Answer 36

Megaloblastic - B12/folate deficiency | Non-megaloblastic: alcohol, liver disease, myelodysplasia, aplastic anemia, hypothyroidism

Answer 37

abnormal HFE gene - 85% absorb >4mg iron/day Reduction in hepcidin presents at ages 35-40 and up

Answer 38

High serum iron Low serum transferrin (TIBC) High transferrin sat high ferritin - 1000's

Answer 39

100 - almost always inappropriate 80 - consider in post-op or stable CV patient in hospital, transfuse if symptomatic for anemia (distinguish from symptoms of hypovolemia) <70 - adult and pediatric ICU patients

Answer 40

ABO and D (Rh) | test RBC and plasma

Answer 41

for non-ABO antibodies test plasma allo-antibodies 45 min

Answer 42

final compatibility test before transfusion

Answer 43

allergy/anaphylaxis FNHTR, AHTR, TRALI, sepsis TACO, TAD

Answer 44

Group O Rh-

Anemia Flashcards

(70 cards)