Anemia

Question 1

What is a normal hemoglobin value?

Answer 1

12-17 (~15)

Question 2

What does a hematocrit value assess?

Answer 2

The percentage of blood that is red blood cells

Question 3

What is a normal hematocrit level?

Answer 3

36-50%

Question 4

What does an MCV measure?

Answer 4

Mean corpuscular volume (average size of red blood cell)

Question 5

What MCV level is indicative of macrocytic anemia?

Answer 5

> 100 fL

Question 6

What MCV level is indicative of microcytic anemia?

Answer 6

Less than 100

Question 7

What does MCH measure?

Answer 7

Mean cell hemoglobin – average mass of hemoglobin per red blood cell

Question 8

What does MCHC measure?

Answer 8

Mean cell hemoglobin concentration – average concentration of hemoglobin in given volume

Question 9

Which MCHC value is indicative of hypochromic anemia?

Answer 9

Less than 31

Question 10

Which MCHC value is indicative of normochromic anemia?

Answer 10

> 31 g/dL

Question 11

What is a normal RBC count?

Answer 11

4.1-5.6

Question 12

What does a hemoglobin value measure?

Answer 12

The oxygen-carrying capacity of the blood

Question 13

What is a normal reticulocyte count?

Answer 13

Less than 1.5

Question 14

What does a high reticulocyte count indicate?

Answer 14

High number of immature red blood cells indicates bone marrow response to anemia

Question 15

Which types of anemia are macrocytic?

Answer 15

Hemorrhage, B12 deficiency, folate deficiency

Question 16

Which types of anemia are normocytic?

Answer 16

Prior hemorrhage

Question 17

Which types of anemia are microcytic?

Answer 17

Iron deficiency, prior hemorrhage, anemia of chronic disease, thalassemia

Question 18

Where is erythropoietin produced and where is it released?

Answer 18

Produced in kidney, released into bloodstream

Question 19

When does the body release erythropoietin?

Answer 19

In response to hypoxia to increase red blood cell production

Question 20

How long does it take erythropoietin to increase reticulocyte count?

Answer 20

10 days

Question 21

Which patients are advised to receive erythropoietin?

Answer 21

Those with anemia due to CKD, those being treated with chemo, those undergoing elective surgery

Question 22

What do labs show in a hemorrhage patient?

Answer 22

Normocytic, normochromic, elevated reticulocytes

Question 23

What is the treatment for a patient with hemorrhage?

Answer 23

Find source of bleeding, transfuse

Question 24

What does the CBC show in a patient with anemia of chronic disease?

Answer 24

Microcytic, hypochromic anemia with normal ferritin and transferrin

Question 25

What is the suggested treatment for anemia of chronic disease?

Answer 25

Treat underlying condition, can give iron, blood, erythropoietin (though not shown to improve quality of life)

Question 26

What do labs show in aplastic anemia?

Answer 26

Decreased rbc, white blood cell, and platelets (pancytopenia)

Question 27

What is the suggested treatment for aplastic anemia?

Answer 27

Short-term immunosuppression, intermittent transfusions, bone marrow transplant if severe

Question 28

List major causes of folate deficiency

Answer 28

Alcoholism (especially in the US), poor dietary intake, intestinal malabsorption (Chrons), drug interaction

Question 29

What is G6PD deficiency?

Answer 29

X-linked recessive hemolytic anemia causing destruction of red blood cells upon exposure to free radicals

Question 30

List clinical findings of G6PD deficiency

Answer 30

Usually asymptomatic, can have jaundice, weakness, tachycardia, hematuria

Question 31

How is G6PD deficiency treated?

Answer 31

Self limiting condition with spontaneous resolution – provide supportive care and avoid fava beans

Question 32

What is thalassemia?

Answer 32

Hemolytic anemia involving improper production of alpha or beta chains

Question 33

What are the clinical findings of thalassemia?

Answer 33

Anemia, cognitive dysfunction, bone deformities (usually diagnosed in infancy)

Question 34

What do labs show in patients with thalassemia?

Answer 34

Low MCV, low MCHC, anisocytosis, poikilocytosis, low hemoglobin and low hematocrit

Question 35

How is thalassemia treated?

Answer 35

Blood transfusion, splenectomy, bone marrow transplant, no real cure (patients often die in their 20s)

Question 36

Describe the labs of a patient with sickle cell anemia

Answer 36

Shows sickle cells on peripheral smear

Question 37

What symptoms might a patient with sickle cell anemia experience?

Answer 37

Painful crises, splenomegaly, shortness of breath, joint damage, retinopathy, increased infections

Question 38

How is sickle cell anemia treated?

Answer 38

Pain medicines, fluids, oxygen, transfusions

Question 39

What do labs show for patients with B12 deficiency anemia?

Answer 39

High MCV, normal MCHC, low B12

Question 40

What symptoms do patients with B12 deficiency experience?

Answer 40

tingling in extremities, dementia, along with normal signs and symptoms of anemia

Question 41

How is the B12 deficiency best treated?

Answer 41

A monthly B12 injection, proper nutrition

Question 42

What do labs show in a patient with folate deficiency?

Answer 42

High MCV, normal MCHC, low folate level

Question 43

What symptoms with a patient with folate deficiency experience?

Answer 43

Beefy red tongue, usual anemia symptoms

Question 44

How is a folate deficiency best treated?

Answer 44

Folic acid pill, avoid alcohol

Question 45

What symptoms with a patient with aplastic anemia experience?

Answer 45

Bleeding (thrombocytopenia), infections (leukocytopenia)

Question 46

What do labs show in a patient with iron deficiency anemia?

Answer 46

Low MCV, low MCHC, low iron (serum ferritin)

Question 47

What symptoms would you see in a patient with iron deficiency anemia?

Answer 47

Glossitis, angular cheilitis, koilonychia, pica, gastric atrophy

Question 48

How is iron deficiency anemia best treated?

Answer 48

Give iron, stop bleeding, transfuse if necessary

Question 49

What is Fanconi's anemia?

Answer 49

Inherited aplastic anemia