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Final Exam > Anemias > Flashcards

Anemias Flashcards

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1
Q

MCV < 82

N or Increased ferritin

N or Increased SI

N or Decreased TIBC

Decreased production of globin chains, but normal structure, that leads to an imbalance

What type of anemia?

A

Hereditary Thalassemia

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2
Q

Microcytic/Hypochromic

Decreased Hgb production

Increased ferritin and SI

Decreased TIBC, Retics, Hgb, RBCs.

Due to a block in the protoporphyrin ring pathway leading to Iron overload.

Mild-Severe anemia

Basophilic Stippling & PHBs

What anemia am I?

A

Sideroblastic Anemia

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3
Q

N or Increased Iron stores

Decreased SI and TIBC

Blood shows mild microcytic or normocytic anemia.

Due to having storage iron, but can’t release it for Hgb or RBC production.

Seen in malignant disease and RA.

What anemia am I?

A

Anemia of Chronic disease (ACD)

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4
Q

Homozygous

Slightly decreased Hgb

N to increased RBCs

No NRBCs

Micro/hypo RBCs

Target cells

Possible ovalocytes

Basophilic Stippling

No PHBs

NORMAL IRON TESTS

Increased A2 on electrophoresis

A

Beta Thala minor

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5
Q

Heterozygous

Slightly decreased Hgb

Mild in most cases

Basophilic stippling

Targets

Normal Hgb electrophoresis

Bart’s blood in cord.

Due to a deletion of 1-2 alpha genes.

What am I?

A

Alpha Thala minor/trait

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6
Q

Homozygous

DECREASED Hgb and RBC

Severe diagnosis

Increased # of NRBCs

Aniso/Poik

Basophilic Stippling, HJBs, Schistos, PHBs.

Increased: ferritin, SI, bilirubin, and Hgb F

Decreased TIBC, OF test, and Hgb A.

BM hypercellular

Hepatosplenomegaly and splenectomy after 4 and transfusion dependence.

What am I?

A

Beta Thala major (Cooley’s)

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7
Q

Which type of SA has increased basophilic stippling?

A

Lead poisoning

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8
Q

How can you differentiate IDA based on cell morph?

A

No basophilic stippling or PHBs.

Normal electrophoresis, maybe a decrease in Hb A2.

Decreased Iron stores, usually the first thing effected.

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9
Q

Tests used in order to differentiate micro/hypo anemias?

A

Iron Studies

Hgb Electrophoresis

Basophilic Stippling

PHBs

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10
Q

Macrocytic RBCs (>98 MCV)

Normochromic

Mild-Severe anemia

Increased SI, bilirubin, and super increased LDH.

Decreased to N: RBCs, Hgb, Hct

Increased MCH

Normal MCHC

Megakaryocytes abnormal resulting in thrombocytopenia.

Oval macrocytes, HJBs, Cabot rings possible, Hyper-seg Neuts, Giant PLTs, Teardrops,

RBCs are fragile, causing increased LDH.

M:E Ratio decreased

A

Megaloblastic anemia

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11
Q

Types of megaloblastic anemia?

A

Vitamin B-12 deficiency

Folate Deficiency

Pernicious Anemia

B-12 & folate deficiency (together).

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12
Q

Tests to differentiate megaloblastic anemias in order?

A

Vitamin B-12 and Folate

Antibody Tests

Retic Count

Liver tests

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13
Q

What is the schilling test and what is it used to determine?

A

A test for vitamin b-12 deficiency.

Establishes the exact cause of the deficiency.

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14
Q

Steps in Schilling test?

A

B-12

MMA test

IF blocking antibody

Parietal Cell Antibody test

Gastrin Test

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15
Q

When to proceed to the next step in diagnosis of pernicious anemia?

A

B-12 ( <300pg/mL)
leads to

Methylmalonic Acid test
(> 0.4 umol/L) leads to

Intrinsic factor blocking antibody
(Positive- PA) Negative leads to

Parietal cell antibody test (Positive=PA) Negative leads to

Gastrin test (< 100 pg/mL not PA) ( > 100 pg/mL PA, indirect confirmation)

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16
Q

Malabsorption causes of B-12 deficiency?

A

Gastrectomy

Blind loop syndrome (bacteria use up)

H. pylori infections

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17
Q

Drugs that cause B-12 deficiency?

A

Alcohol

Nitrous Oxide

Antitubercular drugs

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18
Q

Increase need B-12 deficiency causes?

A

Pregnancy/Lactation

Growth

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19
Q

Malabsorption of folic acid causes?

A

Ileitis/Crohn’s

Blind loop syndrome

Gluten-sensitivity

Childhood celiac disease

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20
Q

Folic acid deficiency due to increased requirement?

A

Pregnancy

Infancy

Hematologic diseases (Sickle cell anemia).

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21
Q

Drugs that cause folate deficiency?

A

Methotrexate (Chemo)

Alcohol

Oral contraceptives

Long-term Anticoagulant drugs (block vitamin K), Antiseizure meds.

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22
Q

Megaloblastic anemia treatment?

A

Vitamin therapy for B-12 and folate deficiency.

Intramuscular injections for pernicious anemia.

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23
Q

No DNA synth impairment

Round macrocytes

No hyper-seg neuts

Leukos and PLTs normal

No jaundice, glossitis, or neuropathy

Due to: Chronic liver disease, Alcoholism, Stim erythropoiesis (newborns).

INCREASED Retics, including stress retics

What am I?

Study These Flashcards
A

Non-megaloblastic Anemia

24
Q

Normocytic RBCs

Intrinsic

Increased retics

Abnormal RBC membrane or Hgb structure.

Deficient enzyme

Abnormal RBC destruction tests

Study These Flashcards
A

Hereditary Hemolytic Anemia

25
Membrane defects?
H Spherocytosis HS post-splenectomy H Ovalocytosis H Stomatocytosis H Acanthocytosis
26
Increased permeability to Na W/ loss of membrane. True macrocytic RBCs MCHC > 36% DAT ( - ) OF Increased
H Spherocytosis
27
Spherocytes MCHC > 36% HJBs, PHBs, Hgb rises Increased PLTs
HS Post-Splenectomy
28
>25% of ovalocytes have polarized cholesterol on the ends. Normal OF test
H Ovalocytosis
29
Altered membrane lipids Abetalipoproteinemia Normal OF test Many spur cells
H Acanthocytosis
30
Hemoglobin Defects?
Hgb SS Disease Hgb SA trait Hgb SC disease Hgb CC disease Hgb CA trait
31
What is the membrane defect in Hgb?
Amino acid substitution of valine
32
Hemoglobin Defect W/: Mild anemia Targets, C-crystals Decreased OF
Hgb CC disease
33
Hemoglobin Double heterozygous defect Mod Anemia Targets, SC crystals, occasional sickles and C crystals. Decreased OF
Hgb SC disease
34
Heterozygous Hgb defect Not anemic Targets, No C crystals
Hgb CA trait
35
Involved in Vaso-occlusive disease SCP ( + ) Severe Anemia NRBCs, targets, sickle cells, HJBs, PHBs, basophilic stippling Decreased OF Hypercellular BM Decreased M:E
Hgb SS disease
36
Heterozygous No anemia Targets, no sickles SCP (+) Hgb defect
Hgb SA trait
37
HMP Pathway defect Decreased NADPH HBs, Schistos, Spheros X-linked
G6PD deficiency
38
EMB pathway defect Decreased ATP Anemia W/ echinocytes
Pk deficiency
39
Extrinsic defects Increased retics Abnormal RBC destruction tests Reduced RBC Lifespan
Acquired Hemolytic Anemia
40
Causes of acquired hemolytic anemia?
Antibodies Trauma (Mechanical, Microangiopathic) Infectious or physical agents
41
Antibody defect Unknown 1st cause CLL or drugs 2nd cause Spheros MCHC > 36% DAT (+) Increased OF test Warm Autoantibodies
Warm Auto-Immune Hemolytic Anemia (WAIHA)
42
Unknown 1st cause 2nd cause due to mycoplasma RBC agglutination Raynaud's Cold Autoantibodies
Cold Auto-Immune Hemolytic Anemia (CAIHA)
43
Severe Anemia INCREASED NRBCs and Bilirubin
HDN-Rh
44
Not anemic Spheros Increased Bilirubin
HDN-ABO
45
Mechanical-Valves Schistocytes MAHAs-DIC/HUS-Schistocytes Marked Hemoglobinuria- Schistocytes
Trauma caused Hemolytic Anemia
46
Schistocytes and Spherocytes Infectious toxin in Hemolytic Anemia
Clostridia toxins
47
Infectious Agent in Hemolytic Anemia Schistocytes Spherocytes Parasitic
Malarial parasites
48
A physical agent, causing schistocytes and spherocytes in hemolytic anemia?
Thermal burns
49
Pancytopenia or imparied cell production anemia Decreased retics Normal RBC destruction test
BM failure Hemolytic Anemia
50
BM failure HA Immature neuts NRBCs Leukoerythroblastic picture
BM transplant
51
Marrow injury 1st cause is idiopathic 2nd cause Benezene, RADs, viral, chloramphenicol, pesticides. Congenital- Fanconi's Blood: Pancytopenia, No polychromasia or NRBCs Normal bilirubin Hypocellular BM Increased Fat and decreased cells
Aplastic Anemia
52
Aplastic anemia has what ratio in the BM?
3:1
53
What is not used in aplastic anemia?
Iron
54
Tests to differentiate Hemolytic Anemias in order?
Retic Count RBC destruction tests (Bilirubin, LD, etc). OF test, Hgb electrophoresis and/or DAT BM Exam
55

Final Exam (27 decks)

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