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Flashcards in anemia of diminished erythropoiesis Deck (50):
1

causes of anemia

diminished production
accelerated destruction
blood loss

2

causes of diminished production

renal failure
vitamin deficiency
iron deficiency
anemia of chronic disease
aplastic anemia

3

causes of accelerated destruction

hemolysis
RBC structural abnormality

4

causes of acute blood loss

loss of intravascular volume
dilution with fluids

5

treatment of acute blood loss

stop bleeding
transfusion with blood products

6

normocytic/normochromic causes of anemia

acute hemorrhage
anemia of chronic disease

7

microcytic/hypochromic causes of anemia

iron deficiency
thalassemia
anemia of chronic disease
hemoglobin disorders

8

macrocytic/normochromic causes of anemia

B12/folate deficiency
myelodysplastic syndromes
liver/alcohol disease

9

signs of anemia

weakness
fatigue
headache
dizziness
palpitations
dyspnea
pallor
tachycardia
systolic murmur
low PB

10

megaloblastic anemia

impaired DNA synthesis leading to large erythroid precursor cells
cytoplasm replicates but nucleus can't

11

causes of megaloblastic anemia

b12/folate deficiency
impaired absorption
chemo, antiretrovirals
rare inherited

12

signs/symptoms of megaloblastic anemia

low Hb
high MCV, MCH
low reticulocyte count
hyper chromic, microcytic
ovalocytes
hyperhsegmented neutrophils
large erythroid cells in bone marrow

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pancytopenia

neutropenic
thrombopenic
anemic

14

normal B12 metabolism

B12 separated from proteins by pepsin
free b12 binds r binders
pancreatic enzymes separates the complex
B12 binds IF in ileum
released, absorbed, and binds transcobalamin II in plasma

15

B12 use

needed to switch folic acid from active into usable form and transfers a methyl group to homocysteine to make methionine

16

B12 functions

DNA synthesis
fatty acid synthesis for nerve sheaths

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pernicious anemia

IF deficiency impairing B12 absorption

18

morphology of pernicious anemia

atrophic glossitis and gastritis of funds
increased risk gastric cancer
increased acid secretion
myelin degeneration in dorsal and lateral tracts
neuropsychiatric changes

19

Schilling test

radio labeled B12 given with IF to determine if IF is the cause of b12 deficiency

20

treatment of megaloblastic anemia

b12 deficiency responds to folate, but neuro symptoms worsen

21

causes of microcytic anemia

iron deficiency
thalassemia
anemia of chronic disease
sideroblastic anemia
red cell fragments
hereditary spherocytosis
defective porphyrin synthesis

22

hemosiderin

iron binding protein for iron storage
water insoluble- outside cell

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ferritin

iron binding protein for storage
water soluble- inside cell

24

transferrin

glycoprotein that delivers iron to cells

25

causes of iron loss

gut cells
sweat
blood loss

26

ferroportin

iron transporter that moves iron from inside the cell to the plasma

27

hepaestin

oxidizes iron in plasma

28

hepcidin

acute phase reactant
downregulates ferroportin to decrease iron absorption

29

hepcidin synthesis control

IL6 increases synthesis
increased RBC demand decreases synthesis
increased plasma/stores of iron decreases synthesis

30

hemochromatosis

excess iron

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consequences of no hepcidin

hemochromatosis
increased iron absorption
increased TIBC
transferrin saturated
increased ferritin

32

anemic older male

colon adenocarcinoma

33

clinical features of iron deficiency

numbness/tingling
angular stomatitis
atrophy and soreness of tongue
pica
brittle nails
difficulty swallowing

34

TIBC relationship with iron levels

low iron = high TIBC

35

TIBC

total iron biding capacity
measure of affinity of iron for transferrin

36

ferritin is proportional to

cellular iron stores
EXCEPT with inflammation

37

anemia of chronic disease

low plasma iron but normal stores because hepcidin is produced which decreases iferroportin which reduces iron movement

38

markers of anemia of chronic disease

low TIBC- lots of iron present but not used
high ferritin- iron is held inside cells

39

markers of iron deficiency anemia

high TIBC- low iron means transferrin (takes iron to cellS)
low ferritin- iron NOT in cells because it is needed

40

aplastic anemia

chronic primary hematopoietic failure with pancytopenia

41

main cause of aplastic anemia

idiopathic

42

causes of aplastic anemia

idiopathic
acquired- drugs, radiation, chemicals, viruses
inherited- fanconi's anemia

43

pathophysiology of aplastic anemia

immune mediated marrow suppression
damaged stem cells stimulate T cell response which stops stem cell proliferation

44

treatment for aplastic anemia

young- bone marrow transplant
old- immunosuppressants

45

pure red cell apalsia

erythroid hypoplasia with normal other eclls

46

cause of pure red cell aplasia

tyoma
large granular lymphocytic leukemia
drugs
viruses

47

causes of marrow failure syndromes

diffuse liver disease
chronic renal failure
myelophthic anemia

48

diffuse liver disease

linked to alcoholism- toxic effect on erythroid precursors
chronic disease
vitamin deficiency

49

chronic renal failure

decreased EPO --> reduced production dn survival

50

myelophthic anemia

normal marrow replaced by other cells
metastatic cancer
granulomatous disease
spent phase myeloproliferative disorder