Flashcards in Anemia- Module 4 Deck (57)
What hemoglobin concentration (for adult men & women) suggests anemia?
Men: <12 g/dl
What are reticulocytes? What does the reticulocyte count evaluate?
Immature RBCs; The bone marrow production of RBC's
What level indicates a high reticulocyte count? What does this indicate?
>3%; body is compensating for blood loss
What level indicates a low reticulocyte count? What does this indicate?
<1%; RBC production is impaired
What lab value differentiates microcytic, normocytic, and macrocytic anemia?
Mean corpuscular volume (MCV)
What are the three mechanisms that affect blood volume (and therefore anemia)?
1. Blood loss
2. Decrease in RBC production
3. Increase in RBC destruction
What three types of laboratory values are used to discover which mechanism is the cause:
1. CBC (hgb, hct)
2. RBC indices (MCV, reticulocyte count)
3. Iron indices (ferritin, TIBC, serum iron)
90% of anemias fit in what three categories?
3. Anemia of chronic disease
Hemoglobin: normal values (women & men)
Women: 12-16 g/dl
Men: 13.5-17.5 g/dl
MCV: normocytic value
MCV: microcytic value
MCV: macrocytic value
Serum Iron: Normal value (women & men)
Men: 75-175 mg/dl
What is serum iron?
Iron bound to transferrin (plasma carrier protein), that regulates iron transport in the blood.
What is serum ferritin?
Reflects total body iron stores.
Serum ferritin: normal values (women & men)
Women: 12-150 mg/L
Men: 15-300 mg/L
What is the first value to reflect depleted iron stores?
What does the Total Iron-Binding Capacity (TIBC) reflect?
The availability of binding sites on the protein for iron transport.
How is transferrin level measured?
Indirectly through TIBC.
% calculated by serum iron/TIBC x 100
TIBC: normal level
% of transferrin saturation: normal values
Early Iron Deficiency lab values:
All normal (earliest to drop is serum ferritin)
Intermediate Iron Deficiency values:
Hgb: N; MCV: N; MCHC: N; Serum Iron: low/N; Serum Ferritin: low; TIBC: High N; Transferrin Sat: low
Late Iron Deficiency values:
all Low; EXCEPT: TIBC is High
Thalassemia minor lab values:
Hgb: Low N/Low; MCV: Low; MCHC: N/Low; Serum Iron: N; Serum Ferritin: N; TIBC: N; Transferrin Sat: N
Chronic Disease lab values:
Hgb: Low N; MCV: N/low; MCHC: N/low; Serum Iron: Low; Serum Ferritin: High; TIBC: Low; Transferrin Sat: High
Sideroblastic Anemia lab values:
Hgb & RBC indices: LOW; Iron indices: all HIGH except TIBC: N
Causes of microcytic anemia
IDA, thalassemia, anemia of chronic disease, sideroblastic anemia, Hgb E disease
Causes of macrocytic anemia
Megaloblastic anemia (Vitamin B12 or folate deficiency)