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Flashcards in Anemias Deck (41)
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1

Iron difficiency

Microcytic, hypochromic
Pregnancy, growth spurts, vegetarian
If over 50 with low iron, think colon CA
Bone marrow Fe stain is gold standard Dx
Chrons and ciliac can cause this

2

alpha thalassemia

Microcytic, hemolytic
Can get hemochromatosis (iron overload)

3

Beta thalassemia

Microcytic, hemolytic
Minor-Dx with a2delta2 band
Major- xray crewcut

4

Sideroblastic anemia

Microcytic
X linked defect in ALAS
Treat with B6

Also ETOH and Pb (basophilic stipling) can cause it

5

Pb poisoning

Can see lead lines, encephelopathy, abd pain, foot/wrist drop, and microcytic anemia

6

Macrocytic with megaloblast

Hypersegmented neutrophil
Folate: low folate, high homocysteine, normal methylmalonic acid
Low RBC, WBC, and platelets

B12: low B12, high homocysteine, high methylmalonic acid

7

Low b12 causes

Poor nutrition/chrons/ileal resection
Pernicious anemia against parietal or intrinsic factor. Higher risk for gastric carcinoma
D. latum fish worm
Has neuro symptoms
Elevated homocysteine and methylmalonic acid

8

What causes Low folate

Alcoholism and malnutrition can cause this and methotrexate

9

Nonmegaloblastic macrocytic anemia

Bleeding disorders, liver disease, alcoholism, reticulocytosis

10

Non-hemolytic normocytic anemia

Anemia of chronic disease
Aplastic anemia
Can also present as microcytic

11

Anemia of chronic disease

Inflamation--increased hepcidin---decreased macrophage and transferrin to release iron

Labs: low iron, low TIBC, High ferritin

If kidney: treat with EPO if low hematopoiesis

12

Aplastic anemia

Pancytopenia---petechiae, bleeding, infection, neutropenia

Causes: radiation, viruses, fanconi, ideopathic following hepatitis

Tx: Eliminate cause, BMT, GM-CSF

13

Intravascular hemolysis

Low haptoglogin, high LDH, hemoglobinuria

14

Extravascular hemolysis

High LDH, high unconjugated bilirubin

15

Spherocytosis

RBC become spherical and weak
Splenomegaly (Howell jolly bodies if no spleen)
+ Osmotic fragility test
Aplastic crisis (Parvo B19)
Increase RDW and MCHC

16

G6PD

More common in African Americans
Low glutathione and NADPH so more oxidative stress
Get heinz bodies with precipitating factors:
Fava beans, sulfonamides, primaquine, anti TB


17

Sickle cell anemia

Can also show up as crew cut
Valine for glutamic acid
Aplastic crisis (Parvo B19), autosplenectomy, pain, renal papillary necrosis, avascular necrosis of hip, Salmonella osteomelitis

Tx: hydroxyurea (increases HbF)

18

HbC defect

Lysine for glutamic acid. Like Sickle cell but not as bad

19

Haptiglobin

Binds hemoglobin in the serum. If RBCs lysed, more binds to RBC and total in serum is decreased.

20

B symptoms-

Worry about cancers
Fever, night sweats, or weight loss

21

Jak2 mutation

Too much RBC, WBC, Platelets
Polycythemia vera

22

Warm antibody

IgG
SLE, Lymphoma, CLL
Drug induced (PCN and Quinidine)
Use prednisone or anti CD20 Ab (rutiximab)
Can do spleenectomy

Confirm with direct coombs test

23

CLL

Relisten to lecture around 40 minutes in

24

Cold antibody

IgM
Mycoplasma infection, viral, CLL, Lymphoma
Tx: stay warm, treat problem, rituximab

25

Coombs test/Direct indirect

Testing Ab against RBCs
Direct: Ab to RBC
Test newborn
Indirect: Ab in serum to R
Test for mother

26

TTP

Negative direct coombs
High LDH
Plasma exchange

Thrombocytopenia, microangiopathic hemolytic anemia, neuro, kidney failure, fever

27

Heinz body

Heinz bodies are formed by damage to the hemoglobin component molecules, usually through oxidant damage, or from an inherited mutation
Liver disease, G6PDH, NADPH, a-thalla

28

Hypersegmented neutophils

B12, Folate, myodisplastic syndrome

29

Other causes of megoloblastic anemias

Drugs that impair DNA metabolism
Metabolic disorders (orotic aciduria, lesch nyhan)
Refractory megaloblastic anemia
Di guglielmos syndrome

30

Causes of folic acid deficiency

Inhibitors of dihydrofolate reductase: methotrexate, pyrimethamine, triamterene, pentamidine, trimethoprim
Alcohol
Rare enzyme deficiencies: dihydrofolate reductase, others