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Flashcards in Anemia I Deck (42):
1

anemia

decrease in circulating RBC mass

2

volume of packed RBC

Hematocrit

3

usual ratio of Hgb to Hct

Hgb:Hct = 1:3

4

RBC life span 

120

  • old RBCs are removed by the spleen 

5

reticulocyte count

indication of bone marrows production of RBC

  • normal 1-2%

6

polychromasia 

reticulocytosis

  • except to see lots of blue on peripheral smear
    • "lots of blue means lots of new" 

7

nomenclature for RBC size 

  • normocytic: normal size RBC
  • microcytic: small than normal
  • macrocytic: larger than normal 

8

Mean corpuscular volume. List MCV values for Micro, Normo, and Macro

  • calculated value to determine average volume of RBC
  • Microcytic: < 80 fL
  • Normocytic: 80-100 fL
  • Macrocytic: > 100 fL 

9

mean corpuscular hemoglobin concentration

a measure of the concentration of hemoglobin in a given volume of packed red blood cells

  • normochromic vs hypochromic 

10

anisocytosis 

variation in size of RBC

11

red cell distribution width 

measurement of variation in the size of RBC

12

symptoms often occur when Hgb drops below 

7 g/dL

13

What conditions falls under microcytic, hypochromic 

  • iron deficiency
  • thalassemia
  • sideroblastic 

14

What conditions falls under normocytic, normochromic 

  • Hypothyroidism
  • liver disease
  • chronic disease

15

What conditions falls under macrocytic (megaloblastic)

  • folate defiency
  • vitamin B12 deficiency 

16

Presentation

  • MCV low <80
  • Low Fe
  • High TIBC
  • low ferritin 

  • iron deficiency: determine cause

17

Presentation

  • MCV low <80

  • Low Fe

  • Normal or low TIBC

  • normal or high ferritin 

  • anemia of chronic disease
    • infection
    • inflammation
    • malignancy 

18

Presentation

  • MCV low <80

  • normal to high Fe

  • any TIBC

  • normal to high ferritin 

  • sideroblastic anemia

OR

  • alpha or beta thalassemia

19

Which test is most sensitive for iron defiency 

decrased ferritin: depletion of iron stores occurs first 

20

TIBC. High or low in iron deficiency anemia

total iron binding capacity

  • measures transferrin (what serum iron binds to in the body)
  • transferrin will increrase to maximize the low iron available 

21

IS RDW increased or decreased in iron deficiency anemia

increased: variation in RBC size 

22

Clinical presentation

  • glossitis, cheilitis, koilonychia
  • pica
  • dysphagia
  • restless leg syndrome 

iron deficiency anemia

23

treatment of iron deficiency anemia

  • **treat underlying cause
  • replace iron stores
    • oral ferrous sulfate 325 mg BID-TID until anemia corrected + 3-6 months
    • blood transfusions (select patients) 

24

what is considered a low ferritin level 

< 12 ng/mL 

25

Alpha thalassemia is a deletion of 

one or more of the four alpha globin chains

26

normal Hb genetic makeup 

aa/aa + B/B 

27

list number of deletions of a-globin chains and manifestation in alpha thalassemia 

  • 1 deletion: silent carrier (-a/aa + B/B)
  • 2 deletions: alpha-thalassemia trait 
    • mild microcytic anemia
  • 3 deletions: hemolytic anemia
  • 4 deletions: hydrops fetalis 
    • not compatible with life 

28

beta thalassemia 

reduced or absent beta-globulin chains 

29

list number of deletions of b-globin chains and manifestation in beta thalassemia 

  • dysfunction of one B-globin chain -> thalassemia minor
    • asymptomatic
    • microcytic, hypochromic anemia
  • severe dysfunction of both B globin chains -> thalassemia major (cooley anemia)
    • patients die before age 30 

30

poikilocytosis 

abnormal shaped RBC 

31

RDW is normal or elevated in thalassemia 

normal 

32

diagnosis of thalassemia 

Hgb electrophoresis 

33

peripheral smear of thalassemia 

  • target cells
  • teardrop red cells
    • poikilocytosis 

34

treatment of thalassemia 

  • folic acid supplementation
  • regular transfusion schedule (severe cases) 
  • hematopoietic cell transplantation (severe Beta-T) 
  • Avoid iron supplementation**

35

presentation

  • MCV normal to decreased
  • Serum FE normal to decreased
  • TIBC: normal to decreased
  • Ferritin: normal to increased 

anemia of chronic disease/inflammation 

36

What is Myelodysplastic syndromes 

  • acquired disorder to hematopoietic stem cells
  • ineffective blood cell production 

37

Myelodysplastic syndromes can progress to what conditions 

  • marrow failure
  • leukemia

38

What is Sideroblastic anemia 

  • hereditary or acquired RBC disorder
  • abnormal RBC iron metabolism -> diminished heme synthesis
  • bone marrow produces ringed sideroblasts 

39

what are sideroblasts

  • normally found in bone marrow of healthy people
  • nucleated RBC precursors (erythroblasts)
  • contains iron-containing granules in cytoplasm
  • **abnormal form: ringed 

40

sideroblastic anemia is most often a subtype of what condition 

myelodysplastic syndrome 

 

41

Presentation

  • MCV varied
  • moderate anemia (Hct 20-30%)
  • normal or elevated ferritin
  • marked anisocytosis and poikilocytosis 
  • systemic iron overload 

sideroblastic anemia 

42

what are some other causes of sideroblastic anemia

  • chronic alcoholism
  • lead poisoning
  • medications
  • chronic infection or inflammation