HEME AND ONC Flashcards
hat are the macrocytic anemias? What would we see on a blood smear with these anemias?
B12 and Folate deficiency
Megaloblastic (hypersegmented neutrophils)
What would a pt have with B12 deficiency?
Peripheral neuropathy
What type of anemia may be secondary to alcoholism?
Folate deficiency
What type of anemia is associated with glossitis?
Folate (can also occur in B12)
What are the microcytic anemias? What consititues as microcytic?
*TICS*
Anemia or chronic disease
Iron def anemia
Thalassemia
Sideroblastic
MCV is less than 80What are the differences between Anemia of chronic dz and iron def anemia?
Both have LOW Serum Iron
Ferritin is NORMAL in ACD
Ferritin is LOW in IDA
IDA will also have a high iron binding capacity
What is the max amount of ferrous sulfate a person absorb/day?
Max = 4mg
Males require 1mg
Females require 2mg (more if preggo)
If the iron levels are normal but the MCV is still less than 80, what should you think of?
Thalassemia or sideroblastic
What is thalassemia?
Reduced or absent beta or alpha chain
*Normal hemoglobin is made up of two alpha globin & two beta globin chains
How do you diagnose a thalassemia?
Electrophoresis (Hgb A2 and F)
When would we see Beta thalassemia diagnosed?
Intermediate and Major occur between 4-6months when the switch from fetal hemoglobin to adult occurs
Minor is asymptomatic
How do we treat alpha vs beta thalassemia?
Alpha H – folic acid supplements, avoid iron supplements
Beta = transfusions, iron chelation
What is the MC cause of sideroblastic anemia? Dx?
Lead toxicity
Lead level followed by bone marrow biopsy
What would normocytic anemia be caused from? What are the MCV levels?
Acute blood loss, organ failure, or impaired marrow function.
What is hemolytic anemia?
HIT (hereditary, immune attack, and trauma to the RBCs); characterized by decreased RBC survival and increased cell lysis
What are some of the causes of hemolytic anemias?
spherocytosis, elliptocytosis, G6PD, thalassemias, and sickle cell
How might a patient present with hemolytic anemia?
Jaundice, delayed puberty (from sickle cell), hepatosplenomegaly, and petechiae and purapura
Target cells are associated with what?
Thalassemias
Heinz body or bite cells are associated with what?
G6PD
Howell-Jolly cells are associated with what?
Folate def (can also be seen in a Sickle cell smear)
A pt presents with epistaxis, HA, dizzy. The pt notes extreme pururitis last night after bathing – dx?
Polycythemia vera
What would be seen on labs with polycythemia vera?
Increased number of RBC’s and increased total blood volume
Thrombocytosis, leukocytosis, increased basophils and eosinophils, and increased number of large platelets
How do we treat polycythemia vera?
Phlebotomy and low-dose aspirin
What is the classification system for leukemias?
Acute or Chronic
Myelocytic or Lymphocytic
