Anemia

Question 1

Anemia is
dx
causes

Answer 1

reduced oxygen carrying capacity of blood

hgb

Question 2

MCV

Answer 2

cell size

Question 3

MCHC

Answer 3

cell color

Question 4

RDW

Answer 4

variation in size

Question 5

TIBC

Answer 5

iron binding capacity (baskets that carry iron)

Question 6

serum fe is ___

Answer 6

not a great indicator (more about intake)

Question 7

ferritin

specific for

Answer 7

storage protein for iron/bone marrow stores

specific for iron deficiency anemia

Question 8

reticulocytes should be

Answer 8

1% because 1% of RBC turnover every day

Question 9

Sx anemia

Answer 9

vary

sob, fatigue, headache, tachycardia, palpitations, pallor (late), hemic murmur (

Question 10

Iron deficiency anemia common?

Answer 10

No, usually GI bleed, losing blood somewhere

Question 11

Iron deficiency anemia blood findings

Answer 11

low mcv (small size) 
low MCHC (pale in color) 
increased TIBC (lots of empty baskets) 
decreased Fe
increased rdw (variable in size) 
decreased transferrin percentage 
decreased reticulocyte (cant make baby cells without a lot of iron) -- will go up in 3-5 d

Question 12

Iron deficiency anemia tx
how long to fix blood and stores?
what will you see first?
how long do you treat?

Answer 12

6 weeks to fix blood
reticulocyte count will be normal after 5 days
treat for about 3 months

Question 13

SE iron and how to take

Answer 13

belching bloating n/v constipation

take on empty stomach, glass of OJ

Question 14

Thalassemia
most common form
what is it?
most common in what population

Answer 14

beta thalassemia minor
ENOUGH IRON, malformed hgb
mediterranean, middle eastern, african, asian

Question 15

Thalassemia blood findings

Answer 15

dec. MCV (small cell size)
dec. MCHC (pale in color)
normal ferritin and rdw (same sizes)
hgb electrophoresis: inc. hgb A2)

*genetic counselor

Question 16

Sideroblastic

what is it?

Answer 16

think iron overload, enzyme d/o
adequate iron, but not inc. into hgb
iron is a ring, cant develop into mature rbc

Question 17

Sideroblastic causes

Answer 17

hereditary
idopathic
acquired (ETOH, lead, INH, RA, lymphoma, leukemia)
HEMATOLOGY REFERRAL

Question 18

Sideroblastic blood findings

Answer 18

low mcv (small cell size)
increased ferritin and Fe
increased transferrin saturation percentage
think iron overload

Question 19

Microcytic anemia

Answer 19

iron deficiency
thalassemia
sideroblastic

Question 20

Normocytic anemia

hemolytic

Answer 20

hemolytic anemias
sickle cell: pred. hgb s
G6PD: hemolysis with infection or exp to sulfonamides, antimalarials, fava beans, most common in african/mediterranean
drug induced: quinidine, aldomet, high dose pcn
autoimmune: lupus, lymphoma, ulcerative colitis, epstein barr, cmv, mycoplasma pneumonia, post viral

Question 21

Findings hemolytic anemia

Answer 21

hemolytic anemias or normocytic 
nl MCV (size) 
nl MCHC (color) 
increased reticulocyte (lots of babies being made) 
positive coombs 
also: inc. LDH, bili
dec. haptoglobin

Question 22

Macrocytic anemias

Answer 22

B12

folate

Question 23

B12 deficiency causes

Answer 23

Pernicious anemia (AUTOIMMUNE)
gastric bypass 
long term vegetarians vegans

Question 24

B12 sx

Answer 24

atrophic glossitis 
stocking glove neuropathy* 
memory loss/dementia 
depression, irritability 
balance problems 
loss position/vibration sense 
ataxia 
anorexia 
wgt loss

Question 25

B12 blood findings

b12 tx

Answer 25

inc. mcv (cell size)
nl color
low reticulocyte (missing building block)

lifelong replacement IM daily x 1 week
weekly x 1 month
monthly (watch K+)

Question 26

Folate deficiency causes

tx

Answer 26

dilantin, tegretol, phenobarb, azt, etoh, dialysis, malabsorption, celiac sprue

1mg daily

Question 27

Pernicious anemia is a ____ deficiency
occurs in age?
higher risk of?
lab findings

Answer 27

b12 deficiency
50+
higher risk of gastric cancer
lab findings: hypersegmented neutrophils, oval macrocytes