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Week 23: Anemia > Clinical Integration Session > Flashcards

Flashcards in Clinical Integration Session Deck (18)
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1
Q

What are the 2 things that cause jaundice?

A

Liver disease

Hemolytic anemia

2
Q

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

A

Reticulocytosis (normocytic)
Increased LDH and unconjugated bilirubin
Decreased haptoglobin

3
Q

2 causes of spherocytes on a smear

A

Immune mediated hemolytic anemia

Hereditary spherocytosis

4
Q

Treatment for AIHA

A

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

5
Q

Should retics be low or high with

  1. Decreased production
  2. Increased loss or destruction
A
  1. Not high

2. High

6
Q

4 most important tests

A

Retic count
MCV
WBC and platelet count
Blood smear

7
Q

How does anemia of chronic disease work

A

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
Q

What is the diagnostic test for iron deficiency

A

Ferritin

9
Q

What is the most common cause of iron deficiency in

  1. Adults
  2. Kids
A
  1. Bleeding

2. Nutritional deficiencies

10
Q

Causes of normocytic anemia

A
Hemorrhage
Hemolysis
Early iron deficiency
CKD
Bone marrow suppression
Bone marrow disorder (infiltration or failure - can also be macrocytic)
11
Q

Bone marrow infiltration vs failure

A

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

12
Q

Factors that argue against a bad bone marrow disorder

A
Acute anemia
Reticulocytosis
Microcytic anemia
Normal WBC and PLT
No worrisome cells on peripheral smear
Obvious other cause for the anemia
13
Q

3 causes of megaloblastic anemia

A

B12 deficiency
Folate deficiency
Meds that interfere with DNA synthesis

14
Q

These anemias can be in multiple MCV categories. Which ones?

  1. Iron deficiency
  2. Anemia of chronic disease
  3. Bone marrow disorders
A
  1. Microcytic or normocytic
  2. Microcytic or normocytic (lower limit of normal)
  3. Normocytic or macrocytic
15
Q

3 anemias where the reticulocytes will be high

A

Thalassemia
Hemorrhage
Hemolysis

16
Q

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

A
  1. Congenital

2. Acquired

17
Q

Intrinsic red cell defects

A

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

18
Q

MAHA

A

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)