EXAM #1: ANEMIA 2.0 Flashcards Preview

Hematology and Oncology > EXAM #1: ANEMIA 2.0 > Flashcards

Flashcards in EXAM #1: ANEMIA 2.0 Deck (40):
1

What is polycythemia?

An abnormal increase in Hb concentration in the blood

2

What is the RBC count in thalassemia?

High

3

How do you calculate an absolute retic. count?

(RBC# x %reticulocytes)/ 100

4

What do you know if the absolute retic. count is less than 100,000 microL?

NO retirculocytosis

5

What are the two primary causes of megaloblastic anemia?

- Vitamin B12 deficiency
- Folic acid deficiency

*Drugs can also cause megaloblastic anemia

6

What are the causes of nonmegaloblastic macrocytic anemia?

1) Hypothyroidism
2) Liver disease
3) Alcoholism
4) Myelodysplastic syndromes

7

Outline the BIG FAT RED CELLS mnemonic.

B= B12
I= Inherited
G= GI disease/ surgery

F= Folic acid
A= Alcholism
T= Thiamine response

R= Reticlocyte miscount
E= Endocrine
D= Dietary

C= chemotherapy
E= Erythro
L= Liver
L= Lesch-Nyhan Syndrome
S= Splenectomy

8

What are the signs of anemia?

Pallor
Pica
Koilonychia

9

What are the PBS hallmarks of megaloblastic anemia?

1) MCV greater than 100
2) Hypersegmented neutrophils

10

How do the total body stores of B12 and Folate compare?

B12= 2-5mg
Folate= 5-10mg

11

How does the daily requirement of B12 and Folate compare?

B12= 1-3 micrograms

Folate= 50-100 mircograms

12

What is the source of B12? What is the source of Folate?

B12= animals
Folate= plants

13

Compare the sites of absorption for B12 and Folate.

B12= terminal ileum

Folate= proximal jejunum

14

What is the main difference in symptomatic outcomes of B12 deficiency and Folate deficiency?

B12= neurologic complications

Folate= NTD

15

List the specific causes of B12 deficiency.

1) Vegans--veggie man
2) Pernicious anemia--prune anemone
3) Gastric bypass--stomach stapler
4) Malabsorption--mallet
5) Celiac spure--sprouts
6) Enteritis--enter intestines
7) Diphyllobathrium latum--fish tapeworm
8) Chron's Disease

16

What is the functional role of Vitamin B12?

Vitaminc B12 is an important cofactor for for conversion of:
1) Methylmalonic acid to succinly-CoA (Methylmalonyl-CoA mutase)
2) Methylation of homocysteine to methionine (methionine synthase)

17

How does B12 deficiency lead to neruologic symptoms?

Build-up of methylmalonic acid

18

What is difference between folate and B12 deficiency in regards to methylmalonic acid?

B12= methylmalonic acid increase

Folate= no increase

BOTH will be high in homocysteine

19

What is the presentation of Congenital Transcobalamin II Deficiency?

Infantile anemia in a few weeks of birth

20

What is the presentation of Congenital Methylmalonic Acidemia?

Infants ill from birth

21

What is the presentation of excessive NO inhalation?

*Irreversible oxidation of methylcobalamin*

- Presents like B12 deficiency

22

What is the major difference between the symptoms of B12 deficiency and folate deficiency?

Neurological symptoms

23

What lab values are diagnostic for B12 deficiency?

1) Increased MCV
2) Decresed retic.
3) High methylmalonic acid
4) High homocysteine

24

How is B12 deficiency treated?

1) Find the cause
2) Supplement w/ 1,000 micrograms SC or IM for a month, then monthly

25

What electrolyte needs to be monitored with B12 deficiency?

Potassium

26

What are the complications of B12 deficiency?

1) Demyelination of the posterior spinal column and lateral corticospinal tract
2) Infertility
3) Cervical smear abnormalities

27

What post-op patient populations must be B12 supplemented?

Total gastrectomy

28

What is pernicious anemia?

- Autoimmune disorder directed against gastric parietal cells
- Results in absent gastric acid and IF

29

What test can be done to diagnose Pernicious Anemia?

Schilling Test

30

What lab values are diagnostic for Pernicious Anemia?

1) Parietal cells and IF antibody positive
2) High serum gastrin
3) Low pepsingoen

31

What are the major causes of folate deficiency?

Remember, causes a macrocytic, megaloblastic anemia b/c
1) Malabsorption--mallet
2) Poor dietary intake-- my chart
3) Elderly--tea and toast diet
4) Methotrexate- moth-T-rex ate
5) Trimethoprim--tampon
6) Increased need:
- Hemolytic anemia
- Pregnancy

32

What lab values are diagnostic for Folate Deficiency?

NORMAL Methylmalonic acid

33

How is a Folate Deficiency treated?

1) Consume foods rich in folic acid
2) Supplement

34

What is aplastic anemia?

Bone marrow failure to produce RBCs, WBCs, platelets

i.e. bone marrow failure leading to PANCYTOPENIA

35

What are the major causes of aplastic anemia?

1) SLE
2) Drugs

36

What are the symptoms of aplastic anemia?

Symptoms are related to the three blood cell line defects:
1) Anemia= weakness/fatigue
2) Neurtopenia= bacterial/fungal infection
3) Thrombocytopenia= bleeding

37

What are the signs of aplastic anemia?

- Pallor, petechaie, purpura
- HSM?

38

Is bone pain a normal finding in aplastic anemia?

NO--this is indicative of underlying cancer

39

What lab values are diagnostic for aplastic anemia?

1) PANCYTOPENIA
2) Reticulocytopenia

40

How is aplastic anemia treated?

1) Stop offending agent and supportive care
2) Severe cases are treated with bone marrow transplant