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SYSTEMS 2 > Anemia > Flashcards

Anemia Flashcards

1
Q

define hematopoeisis

A

is RBC production. It is regulated by Epo (made in kidneys when low oxygen). Epo binds to receptors on erythroid progenitors in bone marrow encouraging them to proliferate

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2
Q

define anemia parameters. Define mild/moderate/severe anemia

A 
men <13 g/dl  Hb
women <12 g/dl Hb
mild 10 g/dl
moderate <10-8 g/dl
severe <8 g/dl
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3
Q

what are the most common causes of anemia in the elderly

A
  • VB12/folate/iron deficiency (26%0
  • anemia of chronic disease (17%)
  • renal insufficiency (15%)
  • unexplained 26%
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4
Q

routine lab tests for anemia diagnosis

A
  • hematocrit 45-49% men, 39-47 females
  • mean cell volume 90+/- 8 fl
  • mean cell Hb weight 30+/- 3 pg
  • mean cell Hb concentration 33+/- 2%
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5
Q

treatment of anemia

A

if due to chronic kidney failure, give recombinant Epo.

- if megaloblastic anemia: B12/folate supplements

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6
Q

clinical presentation of anemia

A

fatigue, breathlessness, tachycardia on physical exertion

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7
Q

define macrocytosis

A

anema where MCV .100

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8
Q

define macrocytosis

A

anema where MCV >100

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9
Q

classification of anemia

A
  • normocytic and normochromic
  • macrocytic and normochromic
  • microcytic and hypochromic
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10
Q

what are reticulocytes

A

are RBC recently released from bone marrow. They provide info on RBC production

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11
Q

classification of anemia

A

With normal bone marrow response (increase in reticulocytes) or without (hypoproliferation, this is more common)

  • normocytic and normochromic
  • macrocytic and normochromic
  • microcytic and hypochromic
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12
Q

what are reticulocytes

A

are RBC recently released from bone marrow. They provide info on RBC production

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13
Q

examples of microcytic/macrocytic anemia

A

iron deficiency
B12 folate deficiency
thalassemia
MDS

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14
Q

examples of normocytic and normochromic anemia

A

BM failure, inflammation, Renal disease

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15
Q

what things let you know the iron status of an individual

A

serum iron, transferrin saturation, ferritin, TIBC

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16
Q

what is hepcidin

A

effector of iron hemostasis secreted by liver, it decreases iron release from reticulo endothelial macrophages and duodenal enterocytes. It causes decreased serum iron levels

17
Q

causes of iron deficiency anemia

A

pregnancy
acute/chronic blood loss in GI
malnutrition, or malabsorption

18
Q

megaloblastic anemia is caused by
A cobalamine deficiency can be due to?
A folic acid deficiency can be due to?
Signs and Symptoms?

A

impaired DNA synthesis. Is associated with B12 and folic acid (cobalamine) deficiency. It is a maturation defect

  • gastrectomy (bc parietal cells in stomach make intrinsic factor), celiacs
  • alcoholics, pregnancy, malabsorption, inhibition of DHF reductase from methotrexte (a chemotherapy drug)
  • GI malaise, neurological involvement (demylination, axonal degenration, neuronal death), ataxia, weakness
19
Q

Hemolytic Anemia is defined as

A

diseases that lead to reduced RBC survival in peripheral blood. note that if hemolysis occurs inside the vessels you will have hemosiderin and Hb in urine

20
Q

what causes hemolysis

A

hemoglobinopathy, enzymopathy

  • abnormal membrane structure
  • mechanical destruction (trauma), or autoantibodies
21
Q

hereditary spherocytosis. (IS a RBC membrane disorder)

  • signs
  • diagnosis
A

causes hemolysis, and is AD, defect in ankyrin gene

  • mild splenomegaly, jaundice
  • osmotic fragility of RBC test, or check ankyrin with gene test
  • is microcytic
22
Q

most common red cell enzyme defects

A

G6PDH (defect in hexose monophosphate shunt), and pyruvate kinase (aka glycolytic enzyme defect- is normocytic)

23
Q

patients of G6PD deficiency should be warned against

A

fava beans, anti malarial drugs, sulfamethoxazole, nitrofurantoin, acetanilide

24
Q

treatment for immune hemolytic anemia

A

steroids, immunosuppressive drugs, splenectomy

25
Q

what are the characteristics of bone marrow failure anemia

A

normocytic and normochromic

26
Q

aplastic anemia is

A

when there is peripheral blood cytopenia, bone marrow hypocellularity. It can be called acquired if it is immune mediated. It can be iatrogenic aplasia if bone marrow hypocellularity is due to cancer therapy, or fanconis, dyskeratosis congenita

27
Q

what infection is associated with pure red cell aplasia

A

parvovirus infection

28
Q

paroxysmal nocturnal hemoglobinuria is due to

A

mutation in PIG-A gene which codes for GPI which is where T cells should bind, the GPI defect causes strong activation of platelets so they have thrombosis (increased LDH shows high risk of thrombosis) and thrombocytopenia.
- symptoms: anemia with hemoglobinuria (intravascular hemolysis)

29
Q

treatment of paroxysmal nocturnal hemoglobinuria

A

eculizumab which inhibits the complement cascade

SYSTEMS 2 (16 decks)

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