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Anemias Flashcards

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1
Q

Four things that people with sickle cell trait are at increased risk for

A

VTE
Ckd
Renal medullary carcinoma
Hematuria

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2
Q

When does sickle cell trait start to have the risk of sudden-death with physical activity

A

Without a dehydration rhabdo or heat exposure

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3
Q

Two tests to detect sickle cell disease

A

Hemoglobin electrophoresis and peripheral smear

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4
Q

What deficiency do sickle cell disease patients have and what does expose them to

A

Folate for megaloblastic macrocytic anemia

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5
Q

Nine causes of vaso-occlusive crisis

A 
Nothing 
hypoxia 
dehydration
 acidosis 
Fatigue
 cold-weather 
alcohol 
pregnancy
 emotional stress
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6
Q

Six associated symptoms with vaso-occlusive crisis

A 
Fever 
swelling 
tenderness 
tachypnea  
HTN  
nausea and vomiting
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7
Q

How long do vaso-occlusive crisis last

A

2 to 7 days

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8
Q

How do you diagnose vaso-occlusive crisis

A

Clinically

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9
Q

How do you treat vaso-occlusive crisis

A

NSAIDs the narcotics

always hydrate

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10
Q

For indications to use hydroxyurea

A

More than three episodes a year
history of ACS
history of vaso-occlusive events
history of symptomatic anemia

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11
Q

The side effect of hydroxyurea

A

Suppress all lines

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12
Q

Presentation of ACS

A

Chest pain
fever
cough
low O2 sat

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13
Q

What is ACS

A

New infiltrate with the pulmonary symptoms in a patient with SCD

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14
Q

Three ways to get increased cycling in the pulmonary vascular in ACS

A

Fat embolism
pulmonary infarct
infection by pneumonia or mycoplasma

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15
Q

Four steps of treating ACS

A

Hydrate with caution
oxygen support
antibiotics
transfusion

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16
Q

Three neurologic complications of sickle cell disease

A

Stroke seizures narrow cognitive decline

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17
Q

How do we determine children’s risk for stroke and SCD

A

Transcranial Doppler

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18
Q

Describe aplastic crisis and SCD

A

Parovirus B 19 causes an infection of red blood cell progenitors in the marrow which impairs cellular division for a few days this causes a rapid drop in hemoglobin with the reticulocyte count less than one

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19
Q

How soon do aplastic crisis patients get better

A

7 to 10 days

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20
Q

When does splenic sequestration usually happen in sickle cell disease patients

A

Within the first five years but can occur anytime

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21
Q

What bacteria’s are especially harmful to kids with sickle cell disease

A

strep pneumo

H flu

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22
Q

Which bacteria most dangerous two adults with sickle cell disease

A

E. coli
Samonella
Strep pneumo

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23
Q

What to viruses or more virulent in SCD

A

Parovirus

H1n1

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24
Q

What cardiovascular event are SCD patients more prone to

A

Myocardial infarction because likely secondary increased 02 demand

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25
Deficiency and hereditary spherocytosis
Spectrin
26
Three clinical manifestations of hhereditary spherocytosis
Anemia jaundice splenomegaly
27
Clinical picture of mild hereditary spero-cytosis
No anemia modest reticulocytosis little splenomegaly or Jandus not diagnosed until adulthood
28
When do you need regular transfusions and hereditary spherocytosis
When is severe
29
Seven key diagnostic features of hereditary spirit cytosis
``` Reticulocytosis microcytic anemia hyperchromic cells elevated RDW spherocytes on peripheral smear pseudohyperkalemia osmotic fragility test ```
30
For complications of hereditary spherocytes cytosis
Lego ulcers hypertrophic cardiomyopathy movement disorders gallstones
31
Three treatments for hereditary spherocytosis
Folic acid blood transfusions splenectomy
32
Six causes of autoimmune hemolytic anemia warm
``` Idiopathic viral infection systemic lupus immune deficiency malignancy of the immune system drugs ```
33
Six drugs that cause warm hemolytic anemia
Sulfas cephalosporins rifampin ibuprofen penicillins fluroquinolones
34
Drug to use for a long-term treatment of warm autoimmune hemolytic anemia
Azothioprine(imuran)
35
What drug can't you use and warm hemolytic anemia
Methotrexate
36
Is warm or cold hemolytic anemia more severe
Warm
37
Two most common infections that cause cold hemolytic anemia
Pneumonia | mono
38
Most common neoplasm to cause cold hemolytic anemia
Lymphoma
39
Is hereditary hemachromatosis dominant or recessive
Recessive
40
For places the iron deposits and hereditary hemachromatosis
Heart liver pituitary pancreas
41
Seven manifestations of hereditary hemachromatosis
``` Liver disease Hepatocellular carcinoma diabetes mellitus joint pain dilated cardiomyopathy hypogonadism skin changes ```
42
The only definitive test to diagnose hereditary hemachromatosis
Liver biopsy
43
When don't we treat hereditary hemachromatosis
Ferritin less than 1000 | asymptomatic
44
Best way to treat hereditary hemachromatosis if you have to
Phlebotomy
45
Most common population of sickle cell
Sub-Saharan Africans
46
Three populations most at risk for taco
Young old and surgical ICU settings
47
Best noninvasive test to determine total Iron body stores
Ferritin
48
Two things that affect TIBC
Pregnancy OCP
49
How much elemental iron does one need for supplementation a day
150 to 200 mg
50
How soon should hemoglobin be back to normal with treatment of iron deficiency anemia
6 to 8 weeks
51
What is often mistaken for a vitamin B12 deficiency
Sideriblastic anemia
52
Transferrin level in sideroblastic anemia
Low
53
RDW in sideroblastic anemia
High
54
Treatment for anemia of chronic disease if you must
EPO
55
Seven causes of a plastic anemia
``` Idiopathic cytotoxic radiation drugs viral immune disorder pregnancy Anorexia Dancing anemia ```
56
6 categories of clinical manifestations in aplastic anemia
``` Cardiopulmonary compromise fatigue recurring infection mucosal hemorrhage Pallor and petechiae rash no lymphadenopathy No hepatosplenomegaly ```
57
Four characteristics of sudden onset cute hemolytic anemia
Jaundice Pallor dark urine with or without abdominal or back pain
58
Hemoglobin reaction to a cute hemolytic anemia
Hg fall of 3 to 4
59
Drugs that cause hemolytic Anemia in g6pd
``` Fluoroquinolones antimalarial's nitro sulfa drugs Tylenol aspirin methylene blue INH ```
60
What chains are excess in a thalassemia
Gamma in newborns | Beta on adults
61
Where is a thalassemia the most common
Southeast Asia
62
3 Severe lifelong problems in HbH disease
Microcytic hemolytic anemia infective erythropoeisis splenomegaly
63
What are four beta chains bound together that are soluble and formed from Alpha thalassemia intermedia
Hemoglobin h
64
What are four gamma chains bound together called
Hb Bart's
65
What has a higher affinity for oxygen and then HBA but cannot release it
HB Barts
66
What is the MCV in a thalassemia and why?
Well because hemoglobin makes up 35% of the cell volume
67
What are target cells associated with
A thalassemia
68
Reason behind target sells
The KCL cotransporter is broken in a Palastine yeah and allows fluid to leak out causing dehydration
69
When do you see basophilic stippling
Hemolytic anemia and a and B thalassemia
70
Iron transferrin and ferritin levels in a thalassemia
All higo
71
Treatment for a thalassemia minima and minor
None
72
Treatment for h BH disease
Follow bloodwork support with transfusion avoid oxidative stress but no bone marrow transplant
73
What exacerbates hemolysis in HbH dz
Oxidation (same as g6pd)
74
What percent is hemoglobin H in Alpha thalassemia intermedia
5 to 30%
75
Is Alpha thalassemia intermedia symptomatic at birth
Yes with neonatal jaundice and anemia
76
What population is beta thalassemia common in
Mediterranean descent
77
Presentation of beta thalassemia minor
Asymptomatic mild anemic discovered incidentally
78
Presentation of Beta thalassemia intermedia
Varies
79
Synonym for beta thalassemia major
Cooley's anemia
80
Eight characteristics of beta thalassemia major
``` Abdominal swelling growth retardation irritability Jaundice Pallor skeletal abnormalities splenomegaly life long transfusion dependent ```
81
What anemia gets an altered protein synthesis of spectrum in addition to their problems
Beta thalassemia
82
Which thalassemia has premature a pop ptosis
Beta
83
M HC and MCHC of beta thalassemia
Microcytic hypo chronic but some will be very dense

CMPP (17 decks)

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