Anemias

Question 1

02 content=

Answer 1

Sa02(bound) + p02(dissolved_

Question 2

Chronic Hypoxia

Answer 2

high erythropoietin production (kidney parenchyma)
increase mito density
angiogenesis (digital clubbing)

Question 3

2 approches to anemia

Answer 3

inadequate production (reticulocytes high in serum)
excessive destruction

Question 4

cyanosis

Answer 4

02 not getting to tissue(deoxyhemoglobin 5g of Hg)

Question 5

Hypo-proliferative bone marrow problem

Answer 5

low reticulocyte count

Question 6

how does Renal failure affect anemia

Answer 6

dec erythropoietin
treat with: Procrit, Epogen, Darbepoetin

Question 7

Hypothyroidism: erythropoietin
can’t work, treat with

Answer 7

levothyroxine

Question 8

mcc is infection: parvo b19, mcc: drugs, chemicals, chemo: chloramphenicol, Benzene, AZT, Vinblastine

Answer 8

aplastic anemia

Question 9

Fanconi anemia

Answer 9

pure RBC aplasia, hereditary or 2nd to thymoma

Question 10

Diamond blackfen syndrome

Answer 10

RBC aplasia + finger abnormalities like triphalangeal thumb

Question 11

high retic count

Answer 11

destruction leading to bone marrow creating more

Question 12

Mcc of high retic count

Answer 12

extravascular hemolytic anemia

Question 13

intravascular hemolytic anemia

Answer 13

vasculitis: schistocytes, Burr cells, Helmet cells, dec haptoglobin (protein that binds free Hb)

Question 14

extravascular hemolytic anemia sign

Answer 14

splenomegaly & jaundice

Question 15

diseases causing extravascular hemolytic anemia

Answer 15

Hereditary spherocytosis
G6PD
sickle cell anemia
hemoglobin c disease (lysine for glutamate)
pyruvate kinase def

Question 16

osmotic fragility test, defective spectrin/ankyrin, AD

Answer 16

hereditary spherocytosis

Question 17

Coombs test

Answer 17

test antibodies that attack RBC: directly on the RBC surface or in the plasma

Question 18

pos direct Coombs test:

Answer 18

autoimmune Hemolytic anemia: IgG warm, IgM cold

Question 19

drugs causing H.Anemia

Answer 19

penicillins
cephalosporins
sulfa drugs
alpha-methyldopa
PTU
antimalarials
Dapsone

Question 20

Lupus causing drugs

Answer 20

Ethusuximide
Isoniazid.
Hydralazine.
Procainamide.
Tumor-necrosis factor (TNF) alpha inhibitors (such as etanercept, infliximab and adalimumab)
Minocycline.
Quinidine
Pennicillamide
Phenytoin

Question 21

Howell jolly bodies.. think

Answer 21

hemolytic anemia and splenectomy

Question 22

schistocytes …think

Answer 22

vasculitis

Question 23

Target cell …think

Answer 23

iron def anemia or thalassemia

Question 24

Hienz body….think

Answer 24

G6PD

Question 25

Basophilic stippling...think

Answer 25

lead poisoning

Question 26

example of non-immune hemolytic anemia

Answer 26

G6PD malaria MAHA: MicroAngiopathic Hemolytic Anemia PNH: paroxysmal Nocturnal Hemoglobin

Question 27

CBC with differential

Answer 27

MCV MCH MCHC=MCH/MCV=concentration of MCH

Question 28

Microcytic Hypochromic

Answer 28

Impaired Hg production low retic count low MCV or low MCH

Question 29

mcc micro. hypochromic

Answer 29

Fe def: Rx: Ferrous iron with Vit C fe &ferritin low, Transferrin(TIBC) high

Question 30

late chronic disease : any dz lasting over 3 weeks affect Bone marrow

Answer 30

low Fe, low TIBC RBC dies 60-90 day instead of 140 days

Question 31

lead poisoning

Answer 31

Blocks Delta ALA dehydrate and Ferrochetolase basophil stippling high free erythrocyte protoporphyrin

Question 32

Hemoglobinopathies

Answer 32

Thalassemia: Alpha Beta Hemoglobin S SCD glu to Val on position 6 beta chain SCD trait

Question 33

Sideroblastic anemia: cells, inheritance,test

Answer 33

hereditary macrophages holding on to iron Prussian blue stain

Question 34

hereditary spherocytoisis

Answer 34

low mcv, high MCHC, high Retic count, hight bill, hyperkalemia

Question 35

high MCV with defective nuclear division

Answer 35

Macrocytic anemia

Question 36

B12 def mcc, enzymes

Answer 36

mcc type A Gastritis(pernicious Anemia) enzymes: Malonyl-CoA mutase Homocysteine Methyl transferase

Question 37

how does anti-convulsive drug cause macrocytic anemia

Answer 37

they block Ca(needed for microtubules) block folate (B9) block sodium

Question 38

Anti-convulsive drugs phenytoin Ethosuximide Valproic acid carbamazepine

Answer 38

Blocks Ca and folate Ca Na, Ca, folate Na and Ca

Question 39

Glycosyl-phosphatidylinositol (GPI) missing on RBC, complement tag for destruction

Answer 39

Paroxysmal nocturnal Hg pt may present with usual clot due to thrombosis may die of MI and stroke

Question 40

Dx. PNH

Answer 40

flow cytometry to detect CD55 and CD59 Block C5 with Eculizumab mepolizumab Reslizumab Benralizumab