Anemias Flashcards
(26 cards)
storage form of iron
ferritin
iron transport
transferrin
measured by total iron binding capacity
what are the examples of Microcytic anemia
iron deficiency thalassemia anemia of chronic disease sideroblastic anemia lead poisoning
what are some causes of iron deficiency
dietary
decreased absorption
-gastrectomy- due to decreased acid which is needed for ferrous absorption
-chronic blood loss (menses or carcinoma, parasite)
why might ferritin still be elevated in a microcytic anemia
b/c it is an acute phase reactant so it could be elevated if the anemia is microcytic due to anemia of inflammation
whereas it would be lower in a pure iron deficiency
what lab findings are present with iron deficiency anemia
microcytic
decreased ferritin decreased serum iron increased TIBC decreased MCV (microcytic) decreased MCHC (hypochromic) high RDW - b/c with each round of new blood cells, they are smaller and smaller so there will be variation
hepcidin
produced by the liver–> prevents the release of iron stores, trapping it in bone marrow macrophages
anemia of chronic disease lab findings
microcytic anemia
decreased serum iron
decreased TIBC
iron is trapped in bone marrow macrophages
increased serum ferritin
hepcidin is most likely elevated in chronic inflammatory process–> prevents release of iron
alpha thalassemia
decreased alpha globin chains
excess in beta chains
beta thalassemia
excess in alpha chains
decreased beta chains
alpha thalassemia –> silent carrier state
one deletion in alpha
asymptomatic
alpha thalassemia trait
2 deletions of alpha
hemoglobin H disease
3 deletions of alpha (alpha thalassemia)
increased HbH which forms heinz bodies
hydrops fetalis
has 4 alpha deletions (alpha thalassemia)
lethal in utero
HbA
2 alpha
2 gamma
Hb A2
2 alpha
2 delta
HbF
2 alpha
2 gamma
b thalassemia minor
one beta chain is damaged
asymptomatic
increased hemoglobin A2 and increased hemoglobin F
B thalassemia major
normal at birth
symptoms develop at about 6 months as HbF starts to decling
severe hemolytic anemia results from decreased erythrocyte life span
intramedullary destruction –> ineffective erythropoiesis
hemolysis–> jaundice
“Chipmunk face”
Hair on end skull
microcytic/hypochromic anemia
Target cells
increased retic count
sideroblastic anemia
adequate iron stores but cant incoporate the iron into hemoglobin
ring sideroblasts (accumulated iron in mitochondria of erythroblasts) in bone marrow
increased serum iron
increased serum ferritin
decreased TIBC
what are some normocytic anemias
acute blood loss hemolytic anemias sickle cell bone marrow aplasia/hypoplasia renal insufficiency myelofibrosis myelodysplasia anemia of inflammation
what are some macrocytic anemias
Vit B12 deficiency
Folate deficiency
Treatment with drugs that interfere with DNA synthesis and cell division
Cancer chemo
Mylodysplasia
Hypothyroidism
Liver disease - alcoholism
a protein present in blood serum that binds to and removes free hemoglobin from the bloodstream.
haptoglobin
howell jolly bodies
autosplenectomy
due to sickle cell disease
