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Flashcards in Microcytic anemia Deck (73):
1

Is anemia ever a concludin diganosis?

No--always requires further investigation

2

What are the severe symptoms of anemia?

Confusion
Tachycardia
Hypotenion
Syncope

3

What are the four charateristics to look for to categorize anemia?

Size
Color
Chronicity
Etiology

4

What is the lab that determines between microcytic or macrocytic anemia?

MCV

5

Why are lymphocytes captured in a PBS?

Used as a measuring tool, since they should be about the same size

6

What is the normal Hb levels for males? Females?

Males = 14-18
Females = 12-15

7

What is the hemotocrit?

Percentage of solid RBCs in a spun down test tube

8

What is the normal Hct levels for males? Females?

males = 42-50%
Females = 36-44

9

What is the normal MCHC (hb/hct)?

30-36%

10

What is the RDW?

average width of RBCs

11

What are the three etiologies of Fe deficiency?

Inadequte absorption
Inadequate utilization
Excessive loss

12

How many mg of Fe are absorbed per day?

1-3 mg/day

13

Fe is best absorbed in an acidic or basic environment?

Acidic

14

Why is plant Fe not good?

Fe3+ state
Non-heme

15

What is the enzyme on the brush border of enterocytes that converts Fe3+ to 2+ to allow for absorption?

Duodenal cytochrome B

16

What is the protective protein for Fe in enterocytes?

Ferritin

17

What is the passage that allows for ferritin to enter the blood

Ferroporitin 1

18

What is the protein in the circulation that converts Fe2+ to 3+ in the blood?

Hephasestin

19

What is the role of hepcidin?

Blocks ferroporitin
Reduces Fe release from spleen

20

What is the cytokine that upregulates hepcidin?

IL-6

21

What down regulates hepcidin?

Low ferritin, hypoxia

22

What cells produce EPO?

Renal fibroblasts

23

What anemias is EPO not useful for?

EPO abundant ones (Fe deficiency)

24

What amount of Fe is stored in RBCs?

2500 mg

25

What amount of Fe is stored in Fe containing proteins?

400 mg

26

What amount of Fe is stored in transferrin?

3-7 mg

27

What amount of Fe is stored in storage?

1000 mg

28

True or false: there is no dedicated system to get rid of Fe in the body

True

29

True or false: there is an insensible loss of Fe through sweat

True

30

What bone is particularly vascular?

Hip

31

What happens to TIBC in Fe deficiency anemia?

High

32

What is the most accurate measurement of total body Fe stores?

Ferritin

33

What happens to treansferring in anemia?

High amounts, but low saturation d/t low Fe amounts

34

What is reticulocytosis?

Incrased amounts of reticulocytes in circulation

35

What is the normal range for Serum Fe?

60-150 mcg/dL

36

What is the normal TIBC?

300-360 mcg/dL

37

What is the normal saturation for Fe?

20-50%

38

What is the normal ferritin range?

40-200 mcg/L

39

What malignancies in particular lead to Fe deficiency anemia?

GI malignancies

40

True or false: restless leg syndrome is a symptom of Fe deficiency

True

41

What are the symptoms of Fe deficiency anemia?

Glossitis
Nail changes
Palm creases pale

42

What are the three common Fe supplements?

Fe sulfate
fumarate
Gluconate

43

Why is IM injction of Fe bad?

Causes myolysis

44

Why is hepcidin increase in sepsis?

Decreases Fe circulation, which decreases bacterial growth

45

Anemia of renal disease is usually normo, hyper, or hypochromic?

Normochromic

46

What are EPo levels like in renal disease?

Low

47

What is the composition of Hgb A?

alpha2 beta2

48

What is the composition of Hgb A2?

alpha2 delta2

49

What is the composition of Hgb F?

alpha2 gamma2

50

What is the composition of Hgb H?

beta4

51

What is the composition of Hgb barts?

gamma4

52

What is the composition of Hgb S?

alpha2 B (6glu to val)2

53

What causes Hb H synthesis?

having only one alpha gene

54

What are the histological features of Hb H disease?

Odd shaped RBCs

55

What happen in beta (naught) thalaessemia?

No Hb A

56

What happens to RBC destruction in beta-thalassemia?

Increased

57

What is the treatment for beta thalaessemia?

phlebotomy

58

What is sideroblastic anemia?

Problem with protoporphyrin synthesis

59

What are Fe stores like in siderblastic anemia?

High

60

What are the histological features of sideroblastic anemias?

Ringed siderblasts (concentrated mitochondria around the nucleus)

61

How are the congenital siderblastic anemias pass on, usually? What is the basis for this?

xLR defect in ALA synthase

62

What is the primary cause of siderblastic anemia?

Myelodysplasitc syndrome

63

What are the secondary causes of siderblastic anemia?

Drug induced
EtOH abuse
Pb poisoning

64

Are sideroblastic anemias hyper, hypo, or normocytic?

normocytic

65

What are pappenheimer bodies?

Precipitated Fe granules in RBCs found in siderblastic anemias

66

What is the treatment of sideroblastic anemia?

Pyridoxine

67

What are the following labs like in anemia of thalassemia?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin

Hbg = low
MCV =low
Smear = micro/hypo
Fe = normal
TIBC = Normal
Sat% = 30-80
Ferritin = 50-300

68

What are the following labs like in siderblastic anemia?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin

Hbg = low
MCV = variable
Smear = variable
Fe = normal
TIBC = Normal
Sat% = 30-80
Ferritin = 50-300

69

target/cigar cells on a PBS indicates what?

Siderblastic anemia

70

What is the MOA behind renal failure and anemia?

Fibroblasts in kidneys are damaged, and thus do not produce EPO

71

What are the following labs like in anemia of chronic disease?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin

Hbg = low
MCV =low
Smear = normal/ micro+hypo
Fe = normal/high
TIBC = 10-20
Ferritin = 30-200

72

What are the following labs like in IDA?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin

Hbg = low
MCV = low
Smear = microcytic, hypochromic
Fe = 360
Sat% =

73

What are the following labs like in anemia of renal disease?

Hbg
MCV
Smear
Fe
TIBC
Sat%
Ferritin

Hbg = low
MCV =low
Smear = normal
Fe =