Heme

Question 1

Cryoprecipitate contains:

Indications?

Answer 1

factor VIII and fibrinogen

hemophilia A, decr fibrinogen (DIC) and vWD

Question 2

Intravasc hemolysis:
etiology?
symptoms?
management?

Answer 2

ABO mismatch (IgM, C9)

F, chills, NV, flank pain, CP, dyspnea –> hypovol shock, DIC, RF with hemoglobinuria

fluid, epi, dopamine/NE for BP

Question 3

Extravasc hemolysis:
etiology?
symptoms?

Answer 3

minor RBC antigens (3-4w after transfusion; RBC coated and removed extravasc by macrophages in spleen)

F, jaudice, anemia

Question 4

Causes of normocytic (80-99) anemia?

Answer 4

aplastic, BM fibrosis, tumor, anemia of chr disease, RF

Question 5

Causes of macrocytic (>100) anemia?

Answer 5

abn B12 and folate
liver disease (if B12/folate nml)

Question 6

Causes of microcytic (<80) anemia?

Answer 6

decr Fe/TIBC –> anemia of chr disease

decr Fe + incr TIBC –> Fe def anemia

nml Fe/TIBC –> lead poisoning, Thal

Question 7

Labs in FE def anemia?

Answer 7

decr ferritin***
incr TIBC, incr transferrin
high RDW

Question 8

Acquired sideroblastic anemia etiology?

Answer 8

drugs (chloramphenicol, INH, EtoH)

lead

collagen vasc disease

neoplastic

Question 9

sideroblastic anemia vs Fe def anemia

Answer 9

TIBC nml/incr in sideroblastic

Question 10

Labs in anemia of chr disease?

Answer 10

decr serum Fe
decr TIBC
decr transferrin
incr ferritin