Anemia and Iron Flashcards
(85 cards)
1
Q
Most common hematologic disorder in the US affecting 3 million people
A
Anemia
2
Q
Is anemia a diagnosis or condition?
A
Condition
3
Q
What is anemia?
A
-A deficiency and/or dysfunction involving RBC
4
Q
Decreased # of RBCs
Decreased Hgb
A
Anemia
5
Q
What is considered to be anemia in females?
A
Hgb <12
6
Q
What is considered to be anemia in males?
A
Hgb <14
7
Q
4 sxs of severe anemia
A
- Fainting
- Chest Pain
- Angina
- Heart Attack
8
Q
Jaundice Tachycardia Splengomegaly SOB Muscle weakness
A
Sxs of anemia
9
Q
Of skin:
Paleness
Coldness
Yellowing
A
Sxs of anemia
10
Q
2 other sxs of anemia
A
Koilonychia (spoon shaped nails)
Pica (eating dirt)
11
Q
3 main causes of anemia
A
- Reduced production of RBCs
- Increased destruction of RBCs
- Loss of RBCs
12
Q
-Deficiencies in B12, Folate, Iron
-Bone marrow failure
-Renal failure (decreased erythropoietin)
All cause what?
A
Reduced production of RBCs
13
Q
-Hemolysis
-drugs
-Hemoglobinpathies
All cause what?
A
Increased destruction of RBCs
14
Q
-Bleeding
Causes what?
A
Loss of RBCs
15
Q
RBC indicies are part of a CBC and do what?
A
Aid in determining etiology of anemia
16
Q
Measure of average RBC size
A
MCV
17
Q
Weight/amount of Hgb per RBC
A
MCH
18
Q
Hgb concentration
A
MCHC
19
Q
Can be hypochromic, normochromic, or hyperchromic
A
MCHC
20
Q
Measure of variation in RBC size
A
RDW
21
Q
Indicated degree of anisocytosis
A
RDW
22
Q
Large MCV/Large RBC
A
Macrocytic anemia
23
Q
Normal MCV/normal RBC
A
Normocytic anemia
24
Q
Small MCV/small RBC
A
Microcytic anemia
25
Bright color
| MCH > 31
Hyperchromic anemia
26
Normal color
| MCH 27-31
Normochromic
27
Pale color
| MCH <27
Hypochromic
28
Usually secondary to chronic blood loss such as a GI bleed/menstrual loss
Microcytic hypochromic
| small MCV, MCH <27
29
Causes a mild microcytic hypochromic anemia w/basophilic stippling on peripheral smear
Lead poisoning
30
Hereditary disorder characterized by reduced synthesis of globin chains
What is low?
```
Thalassemia
Small MCV (microcytic anemia)
```
31
- Small MCV
- Total RBC count normal/elevated
- Peripheral smear showing target cells and basophilic stippling
Thalassemia minor
32
- Detects abnormal forms of Hgb
| - Can be used to diagnose sickle cell anemia
Hemoglobin electrophoresis
33
Hgb from lysed RBCs placed on paper, pattern of bands is created
Hemoglobin electrophoresis
34
Condition associated w/ particular patterns of bands
Thalassemia
35
Anemia of chronic diseases such as:
- autoimmune/malignancy
- renal failure
- acute blood loss
Normocytic anemia
| normal MCV/normal sized RBCs
36
Anemia caused by
- Vit B12 or Folate deficiency
- Regular alcohol consumption
Macrocytic anemia
| Large MCV/large RBCs
37
Can cause macrocytosis with or without anemia
Regular alcohol consumption
38
A type of macrocytic anemia that often results in B12/folate deficiency
Megablastic anemia
39
Deficiency of B12/folate which causes inhibition of DNA synthesis during RBC production.
Leads to cell growth w/o division = big RBCs
Megaloblastic anemia
40
Characterized by many large immature dysfunctional RBCs in the bone marrow and by hypersegmented neutrophils
Megaloblastic anemia
41
- Results from autoimmune destruction of gastric parietal cells.
- Decrease in IF
- Decreased absorption of B12
Pernicious anemia
42
What are the risks associated w/ anemia (3)
Cardiac events:
- MI
- CHF
- CVA (due to increased workload on heart)
43
Hgb <8
Hct <24%
Transfuse?
Consider, but depends on clinical picture
44
Who are we more likely to consider for a transfusion if Hgb is <10?
Why?
Elderly person, bc/ they are at higher risk of MI
45
Hgb <5
| Hct <15%
Critical!! Super low
46
Iron studies ordered in groups or separate?
Either
47
Which iron studies are often ordered together?
Fe and TIBC
48
Which iron study is often ordered separately?
Ferritin
49
70% of the body's iron is found where?
Hemoglobin of RBCs
50
30% of iron is found where?
Stored as ferritin and hemosiderin
51
What % of iron do we get in our diet?
10%
52
What % of iron is secreted?
90%
53
In plasma, iron is bound to what?
Transferrin (a protein)
54
What steps do iron follow after ingested in diet?
- Absorbed in small intestine
- Transported to plasma
- Bound to transferrin
- Carried to bone marrow
- Incorporated into hemoglobin
55
What does a serum iron measure?
(iron level)
| The quantity of iron bound to transferrin
56
Measurement of all proteins available for binding mobile iron (as opposed to stored iron)
TIBC
57
During iron overload, what levels stay the same?
Transferrin (the main iron binding protein)
58
Is increased in 70% of patients with iron deficiency
TIBC
59
- Negative acute phase reactant protein
| - Levels decrease in various acute inflammatory reactions
Transferrin
60
May be decreased with chronic illness and liver disease
Transferrin
61
Where is transferring produced?
Transferrin
62
The BEST test for hemochromatosis
Transferrin saturation
63
Saturation of what are increased with hemolytic, megaloblastic, sideroblastic anemia?
Transferrin sats
64
Serum iron level X 100% divided by TIBC = ?
Transferrin Saturation
65
Excess iron usually deposited in liver, heart, other organs. Causes severe organ dysfunction (cirrhosis) (cardiomyopathy) (diabetes due to pancreatic islet cell failure)
Hemochromatosis (iron overload)
66
Which type of hemochromatosis is genetic (mostly autosomal recessive)
Primary
67
Which type of hemochromatosis can be caused by repeated blood transfusions?
Secondary
68
Elevated LFTs
Finding with hemochromatosis
69
Marker of iron storage
Ferritin
70
Most sensitive test to detect iron deficiency
Ferritin
71
Decreased Ferritin signifies what?
Decreased iron storage (iron deficiency)
72
Increased Ferritin signifies what?
Iron excess (hemochromatosis)
73
Elevated with inflammation and infection
Ferritin (opposite of transferrin)
74
Results from decrease in serum iron
Iron Deficiency Anemia
75
4 causes of Iron Deficiency Anemia
- Blood loss
- Increased requirement of Iron (late pregnancy, growing child)
- Inadequate gut absorption of iron (Celiac disease)
- Insufficient intake of iron (rare in US)
76
A decreased amt of iron causes a decreased production of?
| result?
Hemoglobin, results in small/pale RBCs
| Microcytic/hypchromic
77
With iron deficiency anemia, what values are low?
-Serum Fe
-Transferrin sats
-Ferritin
(all are low)
78
With iron deficiency anemia, what values are high?
TIBC
79
With a "chronic illness" anemia, what values are low?
-Serum Fe
-TIBC
(are low)
80
With a "chronic illness" anemia, what values are normal?
-Transferring sats
| are normal
81
With a "chronic illness" anemia, what values are high?
-Ferritin (acute phase reactant responding to illness)
82
With hemochromatosis, what values are low?
-TIBC
83
With hemochromatosis, what values are high?
-serum Fe
-Transferrin sats
-Ferritin
-LFTs
(are all high)
84
```
29 y/o Female presents with generalized fatigue. Has been healthy and denies specific complaints. VSS, exam is unremarkable.
Labs show:
Low RBC
Low Hgb
Low Hct
Low MCV
Low MCH
Low MCHC
High RDW
```
Patient has microcytic, hypochromic anemia and her blood cells vary greatly in size.
85
```
54 y/o Male presents for routine PE, no recent complaints. 32 yr pack hx. VSS, lungs slightly diminished.
Labs show:
High RBC
High Hgb
High Hct
```
Polycythemia / erythrocytosis
