Anemia

Question 1

Anemia for men, women, and pregnant women

Answer 1

Less than 13, 12, and 11

Question 2

What is anemia as a disease?

Answer 2

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

Question 3

What is the most common type of anemia?

Answer 3

Iron deficiency anemia

Question 4

How do you divide the causes of anemia?

Answer 4

Deficiencies, Central, and peripheral

Question 5

Normal MCV?

Answer 5

80-100

Question 6

Normal MCHC?

Answer 6

32-37

Question 7

Normal MCH?

Answer 7

26-34

Question 8

Normal reticulocyte count?

Answer 8

1-2%

Question 9

Labs for anemia?

Answer 9

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

Question 10

Three types of anemia?

Answer 10

Microcytic hypochromic, Normocytic normochronic, Macrocytic, normochormic

Question 11

Five types of microcytic hypo chromic anemia?

Answer 11

Iron deficiency anemia
Thalassemia
Lead poisoning
G6PD Deficiency
Sideroblastic Anemia

Question 12

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

Answer 12

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

Question 13

Signs of IDA?

Answer 13

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

Question 14

Labs for IDA?

Answer 14

Low serum ferritin

Question 15

Treatment for IDA?

Answer 15

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

Question 16

How do you test for Thalassemia?

Answer 16

Electrophoresis

Question 17

What labs do alpha thalassemia show?

Answer 17

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

Question 18

What do labs for beta thalassemia show?

Answer 18

Elevated A2, sometimes elevated F

Question 19

Treatment for thalassemia?

Answer 19

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

Question 20

Risk factors for lead poisoning?

Answer 20

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

Question 21

What is G6PD deficiency?

Answer 21

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

Question 22

S/S and history for G6PD deficiency?

Answer 22

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

Hx- new medications, recent infection

Question 23

Labs for G6PD deficiency?

Answer 23

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

Question 24

Treatment for G6PD deficiency?

Answer 24

Remove affecting drug, transfuse as needed

Question 25

When do most anemias become symptomatic?

Answer 25

When hemoglobin is less than 10

Question 26

What is sideroblastic Anemia?

Answer 26

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

Question 27

What causes sideroblastic anemia?

Answer 27

ETOH, lead posoning, malignancy

Question 28

Labs for sideroblastic anemia?

Answer 28

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

Question 29

How is sideroblastic anemia confirmed?

Answer 29

Bone marrow aspirate with prussian blue stain

Question 30

Treatment for sideroblastic anemia?

Answer 30

Referral to hematology, trasnfuse, B6

Question 31

Causes of normochoromic normocytic anemia?

Answer 31

Anemia of chronic disease

Question 32

Causes of ACD?

Answer 32

chronic disease, malignancy, infection, inflammation.

Question 33

S/S?

Answer 33

Usually absent. May look like IDA

Question 34

Labs for ACD?

Answer 34

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

Question 35

Treatment of ACD?

Answer 35

Management of underlying disorder

Question 36

Cause of Microcytic normochromic anemia? There are 4

Answer 36

B12- Pernicious Anemia Folate Antimetabolite drus Other miscillaneous

Question 37

Risk factors for pernicious anemia?

Answer 37

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

Question 38

What do schistocytes suggest?

Answer 38

Intravascular hemolysis, indicative of autoimmune disease in normochromic normocytic anemia

Question 39

S/S of pernicious anemia?

Answer 39

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

Question 40

Labs for pernicous anemia?

Answer 40

High MCV >115, low B12

Question 41

Risks for folic acid deficiency?

Answer 41

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

Question 42

S/S of folic acid deficiency?

Answer 42

Like pernicious anemia, except no neuro deficits

Question 43

Labs for folic acid deficiency

Answer 43

Low folate

Question 44

Treatment of folic acid deficiency?

Answer 44

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

Question 45

Compensatory mechanisms for anemia?

Answer 45

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

Question 46

IDA and megaloblastic anemia?

Answer 46

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

Question 47

What is TIBC?

Answer 47

Total iron binding capacity. Inversely related to iron stores

Question 48

What does haptoglobin suggest and what are its limitations?

Answer 48

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

Question 49

What is LDH?

Answer 49

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