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Hematology > Microcytic anemia > Flashcards

Microcytic anemia Flashcards

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1
Q

Is anemia ever a concludin diganosis?

A

No–always requires further investigation

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2
Q

What are the severe symptoms of anemia?

A

Confusion
Tachycardia
Hypotenion
Syncope

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3
Q

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

A

Size
Color
Chronicity
Etiology

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4
Q

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

A

MCV

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5
Q

Why are lymphocytes captured in a PBS?

A

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

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6
Q

What is the normal Hb levels for males? Females?

A 
Males = 14-18
Females = 12-15
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7
Q

What is the hemotocrit?

A

Percentage of solid RBCs in a spun down test tube

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8
Q

What is the normal Hct levels for males? Females?

A 
males = 42-50%
Females = 36-44
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9
Q

What is the normal MCHC (hb/hct)?

A

30-36%

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10
Q

What is the RDW?

A

average width of RBCs

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11
Q

What are the three etiologies of Fe deficiency?

A

Inadequte absorption
Inadequate utilization
Excessive loss

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12
Q

How many mg of Fe are absorbed per day?

A

1-3 mg/day

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13
Q

Fe is best absorbed in an acidic or basic environment?

A

Acidic

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14
Q

Why is plant Fe not good?

A

Fe3+ state

Non-heme

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15
Q

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

A

Duodenal cytochrome B

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16
Q

What is the protective protein for Fe in enterocytes?

A

Ferritin

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17
Q

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

A

Ferroporitin 1

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18
Q

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

A

Hephasestin

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19
Q

What is the role of hepcidin?

A

Blocks ferroporitin

Reduces Fe release from spleen

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20
Q

What is the cytokine that upregulates hepcidin?

A

IL-6

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21
Q

What down regulates hepcidin?

A

Low ferritin, hypoxia

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22
Q

What cells produce EPO?

A

Renal fibroblasts

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23
Q

What anemias is EPO not useful for?

A

EPO abundant ones (Fe deficiency)

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24
Q

What amount of Fe is stored in RBCs?

A

2500 mg

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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 =

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