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Flashcards in Anemia Deck (49)
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1
Q

Anemia for men, women, and pregnant women

A

Less than 13, 12, and 11

2
Q

What is anemia as a disease?

A

A symptom of something else, not a disease in and of itself

3
Q

What is the most common type of anemia?

A

Iron deficiency anemia

4
Q

How do you divide the causes of anemia?

A

Deficiencies, Central, and peripheral

5
Q

Normal MCV?

A

80-100

6
Q

Normal MCHC?

A

32-37

7
Q

Normal MCH?

A

26-34

8
Q

Normal reticulocyte count?

A

1-2%

9
Q

Labs for anemia?

A

Ferritin, transferrin saturation, serum iron, TIBC, folate, B12, bone marrow aspiration, electrophoresis

10
Q

Three types of anemia?

A

Microcytic hypochromic, Normocytic normochronic, Macrocytic, normochormic

11
Q

Five types of microcytic hypo chromic anemia?

A
Iron deficiency anemia
Thalassemia
Lead poisoning
G6PD Deficiency
Sideroblastic Anemia
12
Q

Besides menstruating women, what should you look for in IDA in post menopausal and men?

A

GI bleed (cancer), celiac disease, NSAIDs, vegetarian

13
Q

Signs of IDA?

A

Pallor, tachycardia, kioonchia, pale conjunctiva, angular chelitis, atrophic glossitis

14
Q

Labs for IDA?

A

Low serum ferritin

15
Q

Treatment for IDA?

A

ferrous sulfate 300 mg TID, HCT should rise 1 point each weeks, give with vitamin C, can cause constipation, cramping, reflux, N/V

16
Q

How do you test for Thalassemia?

A

Electrophoresis

17
Q

What labs do alpha thalassemia show?

A

No increase in Hg A2 or F. No Hg F. Normal iron

18
Q

What do labs for beta thalassemia show?

A

Elevated A2, sometimes elevated F

19
Q

Treatment for thalassemia?

A

None. May transfuse. May need iron chelation therapy for hemolysis to prevent hemosiderosis, possibly spleenectomy

20
Q

Risk factors for lead poisoning?

A

Old homes especially sills and putty, poor diet increases absorption of lead, origami paper, fumes from stained glass window, burning batteries, dirt that has leaded gas, folk medicines, moonshine bottles, lead fish weights

21
Q

What is G6PD deficiency?

A

Deficiency of G6PD that produces glutathione, which prevents oxidative stress. Without this, lysis can occur.

22
Q

S/S and history for G6PD deficiency?

A

S/S- palor, jaundice, lethargy, dark urine

Hx- new medications, recent infection

23
Q

Labs for G6PD deficiency?

A

Normal labs, elevated direct and indirect bill, high reticulcyte count

24
Q

Treatment for G6PD deficiency?

A

Remove affecting drug, transfuse as needed

25
Q

When do most anemias become symptomatic?

A

When hemoglobin is less than 10

26
Q

What is sideroblastic Anemia?

A

Anemia that is caused by retention of iron in the mitochondria of developing RBC.

27
Q

What causes sideroblastic anemia?

A

ETOH, lead posoning, malignancy

28
Q

Labs for sideroblastic anemia?

A

High serum ferritin, normal or high FE and TIBC, elevated bone marrow stores of iron.

29
Q

How is sideroblastic anemia confirmed?

A

Bone marrow aspirate with prussian blue stain

30
Q

Treatment for sideroblastic anemia?

A

Referral to hematology, trasnfuse, B6

31
Q

Causes of normochoromic normocytic anemia?

A

Anemia of chronic disease

32
Q

Causes of ACD?

A

chronic disease, malignancy, infection, inflammation.

33
Q

S/S?

A

Usually absent. May look like IDA

34
Q

Labs for ACD?

A

Decreased serum Fe and TIBC, ferritin normal or increased. Should also do a smear to look for sickle cell disease

35
Q

Treatment of ACD?

A

Management of underlying disorder

36
Q

Cause of Microcytic normochromic anemia? There are 4

A

B12- Pernicious Anemia
Folate
Antimetabolite drus
Other miscillaneous

37
Q

Risk factors for pernicious anemia?

A

Family history, female, gastric surgery, other autoimmune diseases, H. Pylori, PPIs

38
Q

What do schistocytes suggest?

A

Intravascular hemolysis, indicative of autoimmune disease in normochromic normocytic anemia

39
Q

S/S of pernicious anemia?

A

Red beefy tongue, numbness and itingling in extremities, gingival bleeding, cognitive deficits, lack of coordination, abdominal mass, looks of vibratory sense, positive romberg, CHF, organomegaly

40
Q

Labs for pernicous anemia?

A

High MCV >115, low B12

41
Q

Risks for folic acid deficiency?

A

ETOH, pregnancy, malignancy, severe psoriasis, gastric diseases, anticonvulsants, oral contraceptives, or methotrexate

42
Q

S/S of folic acid deficiency?

A

Like pernicious anemia, except no neuro deficits

43
Q

Labs for folic acid deficiency

A

Low folate

44
Q

Treatment of folic acid deficiency?

A

Correct cause, push foods high in folic acid, d/c ETOH, vitamin C enhances absorption

45
Q

Compensatory mechanisms for anemia?

A

Increase in 2,3 diphosphoglycerate, CV, respiratory, Renal

46
Q

IDA and megaloblastic anemia?

A

IDA occurs in 1/3rd of patients with megaloblastic anemia

47
Q

What is TIBC?

A

Total iron binding capacity. Inversely related to iron stores

48
Q

What does haptoglobin suggest and what are its limitations?

A

Haptoglobin binds to hemoglobin and is decreased with intravascular hemolytic anemia. Can also be decreased with liver disease

49
Q

What is LDH?

A

enzyme abdundent in hemoglobin. Increased suggests hemolysis, but is not specific. Also occurs in many other disease like liver, heart disease, etcetera.