Clinical Integration Session Flashcards Preview

Week 23: Anemia > Clinical Integration Session > Flashcards

Flashcards in Clinical Integration Session Deck (18)
Loading flashcards...
1

What are the 2 things that cause jaundice?

Liver disease
Hemolytic anemia

2

What 3 things do you expect to see on a lab report for hemolysis

Reticulocytosis (normocytic)
Increased LDH and unconjugated bilirubin
Decreased haptoglobin

3

2 causes of spherocytes on a smear

Immune mediated hemolytic anemia
Hereditary spherocytosis

4

Treatment for AIHA

Corticosteroids (prednisone)
Suppresses the immune system from making autoantibodies
Decreases reticuloendothelial activity

5

Should retics be low or high with
1. Decreased production
2. Increased loss or destruction

1. Not high
2. High

6

4 most important tests

Retic count
MCV
WBC and platelet count
Blood smear

7

How does anemia of chronic disease work

Patients with inflammatory illnesses
Increased hepcidin so decreased iron absorption from the gut and iron is trapped in macrophages
Also relatively inadequate EPO and slightly shortened red cell survival

8

What is the diagnostic test for iron deficiency

Ferritin

9

What is the most common cause of iron deficiency in
1. Adults
2. Kids

1. Bleeding
2. Nutritional deficiencies

10

Causes of normocytic anemia

Hemorrhage
Hemolysis
Early iron deficiency
CKD
Bone marrow suppression
Bone marrow disorder (infiltration or failure - can also be macrocytic)

11

Bone marrow infiltration vs failure

Infiltration: no room to make blood cells (ex: acute leukemia)
Failure: no cells being made (ex: aplastic anemia)

12

Factors that argue against a bad bone marrow disorder

Acute anemia
Reticulocytosis
Microcytic anemia
Normal WBC and PLT
No worrisome cells on peripheral smear
Obvious other cause for the anemia

13

3 causes of megaloblastic anemia

B12 deficiency
Folate deficiency
Meds that interfere with DNA synthesis

14

These anemias can be in multiple MCV categories. Which ones?
1. Iron deficiency
2. Anemia of chronic disease
3. Bone marrow disorders

1. Microcytic or normocytic
2. Microcytic or normocytic (lower limit of normal)
3. Normocytic or macrocytic

15

3 anemias where the reticulocytes will be high

Thalassemia
Hemorrhage
Hemolysis

16

Are most
1. Intrinsic
2. Extrinsic
red cell defects congenital or acquired

1. Congenital
2. Acquired

17

Intrinsic red cell defects

Hemoglobin (sickle cell, thalassemia)
Membrane (hereditary spherocytosis)
Enzymes (G6PD deficiency, PK deficiency)

18

MAHA

When you see schistocytes on peripheral smear!
Patients are also thrombocytopenic and can have organ ischemia from small vessel occlusion
Always indicates a serious illness (ex: TTP, HUS, DIC)