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Hematology II Winter Snoopy Style > Anemias > Flashcards

Anemias Flashcards

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1
Q

Describe IDA (Iron deficiency Anemia)
common?
types of rbcs?

A

most common world wide 2% of men 5% of women
microcytic/hypochromic rbcs (due to decrease hgb/iron)

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1
Q

Describe causes of IDA

A

Increased demand (childhood/preg)
Excess loss (Menstruation/chronic bleeding)
Decreased absorption (gastrectomy/malabsorption)
Iron poor diet (milk babies/elderly)

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2
Q

Describe stage 1 of IDA
BM
Serum iron
Pt response
hgb/rdw
Ferritin levels

A

iron depletion
iron in bm decreased to absent
NO DECREASE IN SERUM IRON
pt is asymptomatic/hgb norm/RDW slightly increased
ferritin decreased

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3
Q

Describe stage 2 of IDA
Hgb
Hct
Serum Iron
ZPP/FEP

A

iron deficiency EPO
hgb decreases
hgb content of rbcs (CHr) decreased
hct normal
serum iron decreased
FEP/ZPP increased

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4
Q

Describe stage 3 of IDA

A

classic iron deficiency
serum iron/ferritin/% sat/BM Iron/MCHC/hepcidin decreased

STFR TIBC FEP/ZPP increased

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5
Q

Describe ACI (anemia of chronic inflammation)
what can cause it?

A

chronic disease, secondary to other disease/inflamm/supressive effect
ex. chronic infect
AI
infectious mono
malignancies
TRAPPED IN MACROPHAGES

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6
Q

What are some proposed mechanisms of ACI ?
overactivates what

A

Inability of rbc to access iron trapped w/in macrophages (Mediated by HEPCIDIN)
Ineffective EPO
Hemolysis overactivates RES

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7
Q

Briefly describe the mechanism of ACI

A

invasion of malignancy induces cytokines
stimulation of hepcidin/inactivates ferroportin
iron stuck in macrophages
increase DMT1 damage to rbc membrane
inhibit of EPO/no precursors

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8
Q

How do you distinguish between IDA and ACI?

A

looks similar to distinguish via TIBC and ferritin levels

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9
Q

Lab findings of ACI
Serum iron
ferritin
BM
TIBC
Hepcidin
%sat

A

serum iron DECREASED TRAPPED IN MACROS
ferritin increase
BM stores increased
TIBC decreased
HEPCIDIN INCREASED
%sat decreased

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10
Q

Important lab findings of ACI

A

Increased Hepcidin
Serum Iron Low
BM stores high

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11
Q

IDA Review: causes

A

increased demand
increased loss
decreased absorption
iron poor diet

MICRO/HYPO

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12
Q

ACI review:
causes
inactivates
mediated by

A

2nd to disease to inflammation
decreased epo
increased hemolysis
MEDIATED BY HEPCIDIN
Inactivates ferroportin

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13
Q

Describe Sideroblastic anemia
defect in what
Hereditary disorders (2)

A

defect in heme synthesis/inadequate iron utilization
Hereditary defect (rare)
1.) x linked (ALAS2)
2.) recessive Stem cell dysfunction (decreased heme/pancytopenia)

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14
Q

Describe the Aquired defect diseases in Sideroblastic anemia
(2)

A

Primary - myelodysplastic syndromes
Secondary (exposures) toxins/ LEAD poisoning etc

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15
Q

Briefly describe lead poisoning and the pathways it interferes with

A

interferes with 3 paths
5-ALA - prophobiligen
Copro III - Protop III
LEAD INHIBITS FERROCHELATASE

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16
Q

Describe the Lab results of Sideroblastic Anemia
HGB/HCT
RBC population
RBC inclusions

A

low hgb/hct
RBC: dimorphic/micro/hypo
baso stippling
PAPPENHEIMERS
target cells

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17
Q

What does the BM look like in Sideroblastic anemia

A

erythroid hyperplasia (ineffective EPO) (mainly rbcs)
RINGED SIDEROBLASTS (nrbcs)

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18
Q

Sideroblastic anemia
Serum Iron
TIBC
Serum ferritin
STfRs
FEP/ZPP
Hepcidin

A

Serum iron increased (overload)
TIBC norm/low
Serum ferritin Increased
STfRs norm/low
FEP/ZPP high
Hepcidin High

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19
Q

Lab results of lead poisoning

Study These Flashcards
A

COGNATIVE IMPAIRMENT
course baso stippling
increased lead
increased urin ALA/Corpop
accum of iron/rbc proto

20
Q

Describe Porphyrias
what type of diseases
signs/sympt

Study These Flashcards
A

rare diseases (hereditary) that results in errors in heme biosynth
each disorder has specific enzyme defect in porphyrin in tissues
signs/symp vary and may result in anemia

21
Q

T/F: Porphuria is the spill over in urine/deposit in tissues

22
Q

Describe Hemochromatosis
what type of disorder(Hint I)
inappropriate
doesnt cause what

Study These Flashcards
A

disorder in iron storage
inappropriate increase in iron absorb resulting in excess iron depletion
damages organs
doesnt cause anemia

23
Q

Describe Hereditary Hemochromatosis (HH)
What ancestory
excess what
what defect
colored skin?
amount of iron
what type is most common
mutation to what

Study These Flashcards
A

northern europe ancestory
excess iron absorption due to HEPCIDIN DEFECT
Bronze skin
2-3x iron than normal
type 1 most common
MUTATION TO HFE ALL AFFECT HEPCIDIN

24
Describe 2nd Hemochromatosis (hint:aquired..)
aquired to inhereited anemia/treatment repeated transfusions increased Iron storage (no mech for iron secretion)
25
Lab findings of Hereditary Hemochromatosis EPO Heme liver enzymes Iron studies
EPO normal Heme no abnormalities Increased liver enzymes All iron studies increased (EXCEPT TIBC)
26
Describe Megaloblastic anemias what do rbcs look like
Vitamin B12 def, Pernicious anemia, Folate deficiency RBC: macro ovalocytes hypersegmented
27
T/F: folate deficiencies involve drugs that interfere with DNA synth or inibit folate
true (megaloblastoid)
28
Describe Vitamin B 12 deficiency
functions and participates in folate metabolism required for degradation of fatty acids NEUROLOGICAL DAMAGE
29
What is intrinsic factor
secreted by the stomach, needed in order to absorb B12
30
What is Transcobalamin 1
picks up B12 and carries to cells
31
Describe Vit B12 def in terms of diet, disease of what failure of what organ
diet of animal proteins increased requirements Disease of terminal ileum (chrons_ Gastric failure Competing organisms: Bacteria diphylo. latum
32
Describe Pernicious anemia
Anti-IF anti- Pariteal AB
33
Describe Folate diet/diseases(hint c)
required for DNA synth Vit B12 required to convert folate to functional state def due to diet malabsorption syndrom (celiac/tropical)
34
rbc Morphology in megaloblastic anemias (all 3 cell lines)
megaloblastic/asynch Macro/Ovalo Tear drops baso stippling HJ bodies Inc MCV/RDW
35
What does the BM look like in megaloblastic anemia? WBC? PLT?
BM: erythrohyperplasia increased bilirubin WBC: decreased/hypersegmented PLTS: abnormal
36
What are some other presentations of megaloblastic anemia?
Stomatitis (Inflam of mouth) B12/Folate levels rbc folate levels (better than serum) Anti-IF/Anti-Paretial (early MMA/homocystine)
37
Treatment of B12 Folic Acid Pernicious anemia
Treat w folic acid, improves anemia but not neruologic problems IM Folic acid oral Pernicious B12 Im
38
Describe Aplastic Anemia What does the BM look like? Cells? damage to what cell line
failed production of Rbcs/plt/wbc due to hematopoetic Stem cell damage BM hypocellular Relative lymphocytosis
39
T/F: Aplastic anemia is idopathic or aquired: in aquired it can be caused by benzene, epstein barr virus or radiation
true
40
Describe the hereditary aplastic anemias (2) leukemia/sc
fanconis - Sc chromosomes high incidence of leukemia AML most die in 20s Congenital Pure red cell aplasia (diamond-black fan) defective stem cell unable to commit to rbc precursors may have spontaneous remission physically norm/wbc/plt norm
41
Describe congenital dyserythropoetic anemia change in what what type of cells types? increased what? key factors?
change in eryth cell nuclear membrane/chromatin Macrocytes 3 types RBC destroyed in BM increased Bilirubin/ineffec EPO Mulinuclear/nuclear bridges Oval/macro
42
Describe Anemia w marrow infiltration damage to what casues what kind of hematopoesis
BM infiltration abn cells/tumors crowd out normal cells damage to stem cell EXTRAMED HEMATOPOESIS poik/tear drop/schisto megakaryotes
43
Describe anemia of chronic renal disease what kind of proliferation iron?
EPO def Hemolysis blood loss/PLT dysfunction Chronic inflam/Limited iron Dialysis HIGH SERUM CREATININE/BUN burrs/acanthos/uremia HYPOPROLIFERATION
44
Describe anemia of liver disease no megaloblastoid changes increased what? what happens to spleen
hemolysis, acanthocytes blood loss - dec coag factors Hyperspleenism/PLT sequestered chronic bleedimg ROUND MACROCYTES HYPOPROLIFERATION increase cholesterol/lipids
45
Describe endocrine disorder anemia
EPO not only hormone that participates Pituitary - androgen production - hgb Thyroid - hypothyroid disease demand for O2
46
Describe Anemia of Viral infections
measels has increased iron in macrophages Parvovirus /HIV aplastic
47
What are the micro/Hypo anemias?
IDA, MBA, ACI

Hematology II Winter Snoopy Style (12 decks)

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