Anemia Part 1 Flashcards by Loui Mojica

is a condition in which number
of RBC or Hgb concentration is lower than the normal.

Anemia

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Anemia is a condition in which number
of RBC or Hgb concentration is _______ (lower or higher) than the normal.

Lower

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Etiology of anemia:

Thalassemia major
Iron deficiency anemia
Megaloblastic anemia
Leukemia

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is a manifestation of a certain disease associated with a decrease in the red blood cell, decrease in hematocrit and a decrease in hemoglobin.

Anemia

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Anemia is a manifestation of a certain disease associated with a decrease in the __________, decrease in __________ and
a decrease in ___________.

red blood cell, hematocrit and hemoglobin

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There is a different definition for Anemia we have

Funtional
Operational
Conventional

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Anaimia is a greek word of

Lack of blood

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An means

Lack

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Haima means

Blood

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Functional of anemia:

Decrease oxygen carrying in blood

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Operational anemia:

Reduction of total number of red blood cell

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Conventional of anemia

Decrease in red blood cell, hematocrit and hemoglobin below normal

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Clinical Findings of Anemia:

History
Physical examination
Signs and symptoms
Laboratory procedures

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Sign and symptoms of anemia most common:

Shortness of breath
Fatigue
Weakness

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History of Patient:

Diet
Bleeding history
Drug ingestion
Travel
Previous drugs

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Physical examination

Skin: pallor
Eyes: hemorrhage
Mouth: mucosal bleeding
Cardiac murmurs
Vital signs: temp, blood pressure and heart rate

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General causes of Anemia

Decreased of red blood cells
Increased red blood cell reduction
Blood loss

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Anemia due to decreased production of RBC:

Iron Deficiency Anemia
Megaloblastic anemia
Thalassemia anemia
Sideroblastoc anemia
Aplastic anemia

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Anemia due to increased destruction of RBC

Intracorpuscular abnormalities
Extracorpuscular abnormalities

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Intracorpuscular abnormalities:

Enzyme deficiency
Membrane defect
Globin abnormality
Paroxysmal nocturnal hemoglobinuria

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Extracorpuscular abnormalities:

Mechanical
Infection
Chemical and physical agent
Antibody mediated anemia

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Anemia due to blood loss:

Acute post hemorrhagic anemia
Chronic post hemorrhagic anemia

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Laboratory test for Anemia assessment

Complete blood count
Reticulocyte count
Iron studies
Urinalysis
Fecalysis

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Morphological Classification of Anemia:

Microcytic normochromic anemia ( decrease rbc)
Macrocytic normochromic anemia
Normocytic normochromic anemia (aplastic anemia)

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Morphological under SIGA

Microcytic

Morphological under MNM

Macrocytic

3 stages of Iron Deficiency:

Stage 1: iron depletion Stage 2: exhaustion of storage pool of iron Stage 3: frank anemia

Stage 1: iron depletion result

Normal: Hb, serum iron, total iron binding capacity Low: ferritin

Stage 2: exhaustion of storage pool of iron result

Normal: hb and rbc dev Decrease: serum iron & ferritin Increase: tibc

Stage 3: frank anemia result

Decrease: hb, serum iron, ferritin Increase: tibc

will measure the circulating iron that is bound to transferring

Serum iron

measure the capacity of iron to bind transferrin

Total iron binding capacity

protein that are used for storge of iron

Ferritin

Size of RBC

Anisocytosis

Shape of Rbc

Poikilocytosis

Treatment of iron deficiency anemia:

Ferry sulfate supplements Avoid late sleep Eat nutritious food

CATEGORIES OF LAB DIAGNOSIS FOR ANEMIA: screening

Complete blood count Red blood cells indices

CATEGORIES OF LAB DIAGNOSIS FOR ANEMIA: diagnostic

Backbone of anemia Iron studie

CATEGORIES OF LAB DIAGNOSIS FOR ANEMIA: specialize:

Hemoglobin electrophoresis Underlying causes

SEVERE TYPE OF IRON DEFICIENCY:

Smooth tongue and koilonychia in iron deficiency

a condition also referred to as “spoon-shaped nails,” is associated with iron deficiency in which the fingernails are thin, brittle, and concave with raised edges.

Koilonychia

Koilonychia a condition also referred to as “_____________,” is associated with iron deficiency in which the fingernails are thin, brittle, and concave with raised edges.

spoon-shaped nails

Condition where there’s a craving for uncertain food. Ex: dirt, clay, chalk

PICA

Love eating ice clinical term

Pagophagia

develop when the incorporation of iron into heme is blocked.

Sideroblastic anemia

Sideroblastic primary cause

Genetic

Sideroblastic secondary cause:

Alchohol Food fad Iron in water

2 type of sideroblastic anemia

Hereditary sideroblastic anemia Primary acquired sideroblastic anemia

due to a congenital enzyme defect delta amino-levulinic acid synthetase or heme synthetase

Hereditary Sideroblastic anemia

due to somatic mutation of the erythroid progenitor cells that cause either defects in heme synthesis or defects in DNA synthesis

Primary acquired sideroblastic anemia

Rare disease caused by accumulation of porphyrins in developing RBC’s

Porphyria

Clinical features: poisoning

Skin problem Impaired production of heme Neurologic complication

anemia associated with systemic diseases:

Arthritis Tuberculosis Human immunodeficiency virus Malignancies

second most common type of anemia

Anemia due to chronic disease

inherited disorders caused by genetic alterations that reduce or preclude the synthesis of the globin chains of hemoglobin tetramer.

Thalassemia

Thalassemia predominant in

Mediterranean African and asian ancestry

Thalassemia first describe by

Cooley and lee (1925)

Type of thalassemia

Alpha and beta thalassemia Hemoglobin lepore

Type of thalassemia

Alpha and beta thalassemia Hemoglobin lepore

most severe form and transfusion dependent anemia

Thalassemia major/cooley’s anemia

more severe anemia than minor B-thalassemia but do not require regular transfusion

Intermediate beta thalassemia/ thalassemia intermedia

results when one of the 2 genes that produce beta globin is defective

Thalassemia minor/ cooley’s trait

thalassemia with increased levels of fetal hemoglobin

Hemoglobin persistence Of hemoglobin F

a rare class of thalassemia caused by crossing over of beta and delta genes

Hemoglobin lepore

is a double heterozygous abnormality and the abnormal genes for Hb S and thalassemia are co- inherited

Hemoglobin S- thalassemia

β thalassemia with inherited Hb C

Hemoglobin C- thalassemia

co-inherited of Hemoglobin E and β thalassemia that results to a marked reduction of β chain production.

Hemoglobin E- thalassemia

LABORATORY FINDINGS OF THALASSEMIA

Complete blood count Mass spectrometry Electrophoresis Supravital stain

disorder in the DNA synthesis of RBC

Megaloblastic anemia

Type of megaloblastic:

Pernicious anemia Folic acid deficiency

This test will determine or distinguish whether the problem is impaired absorption or malabsorption of B12 from other causes.

Schilling test

Pernicious vitamin that effects

Vitamin B 12

Treatment of megaloblstic anemia

Vitamin therapy and supplement therapy

Laboratory Findings of Megaloblastic Anemia:

Complete blood count Peripheral smear Decrease reticulocyte count

anemia caused by conditions such as alcoholism and chronic liver disease

Non-Megaloblastic anemia

characterized by premature RBC destruction caused by autoantibodies that bind the RBC surface.

Autoimmune hemolytic anemia

characterized by premature RBC destruction caused by autoantibodies that bind the RBC surface.

Autoimmune hemolytic anemia

Types of Autoimmune Hemolytic Anemia

Warm reactive autoimmune hemolytic anemia Cold reactive autoimmune hemolytic anemia Paroxysmal cold hemoglobinuria

Drug-Induced Immune Hemolytic Anemia: drugs involved in

Penicillin Stibophen Alpha methyldopa

usually occurs in newborns following the transplacental passage of maternal anti-fetal red cells antibody.

Alloimmune hemolytic anemia

Alloimunne hemolytic anemia causes

Erythroblastosis fetalis Isoimmune hemolytic disease of newborn

Alloimunne hemolytic anemia causes

Erythroblastosis fetalis Isoimmune hemolytic disease of newborn

self-limiting, but severe even fatal following the administration of drug that can cause immune hemolytic anemia

Drug induced immune hemolytic anemia