Pathophysiology of Anemia

Question 1

A pregnant woman may present with what type of anemia?

Answer 1

Relative anemia due to hemodilution

Question 2

How is Thalassemia treated?

Answer 2

Transfusions with regular RBCs

Question 3

What will the total iron binding capacity be in the case of chronic microcytic anemia?

Answer 3

Decreased due to iron sequestration

Question 4

What are the four major causes of macrocytic anemia?

Answer 4

Chronic alcohol consumption, drug interactions, nutrition deficiency, reticulocytosis

Question 5

How does the body compensate during chronic anemia?

Answer 5

Increases CO, changes blood distribution, greater O2 extraction

Question 6

Microcytic anemia is most associated with what clinical causes?

Answer 6

Disorders of Fe metabolism & disorders or heme/globin synthesis

Question 7

What are the general causes of iron deficiency anemia?

Answer 7

Blood loss, poor intestinal absorption, dietary issues

Question 8

What is the clinical presentation of anemia due to blood loss?

Answer 8

Normocytic, normochromatic

Question 9

Acute hemorrhage is a form of what type of anemia?

Answer 9

Absolute anemia - equal loss of both RBC mass and plasma volume

Question 10

What are the general signs of anemia?

Answer 10

Fatigue, weakness, dizziness, dyspnea, pallor, tachypnea, tachycardia

Question 11

How can sickle cell anemia be treated?

Answer 11

Hydroxyurea to increase HbF production, simple transfusion, exchange transfusion, vaccinations and antibiotics to protect against infections due to autosplenectomy

Question 12

Macrocytic anemia due to (folate/B12) deficiency is more common.

Answer 12

Folate deficiency

Question 13

A patient is diagnosed with microcytic anemia due to iron deficiency. What will be the results of iron studies?

Answer 13

Serum Iron - Decreased
TIBC - Increased
Serum Transferrin - Increased
Bone Marrow Storage - Decreased

Question 14

What do serum iron tests measure?

Answer 14

Measures Fe3+ bound to transferrin in serum

Question 15

True/False. RBC count is generally increased in patients with Thalassemia.

Answer 15

True - the body is trying to compensate for deficient Hb synthesis

Question 16

A patient presents with microcytic anemia. They are started on iron therapy, but see no improvement. What is the likely cause?

Answer 16

Anemia of chronic disease due to iron sequestration in macrophages

Question 17

Vaso-occlusive crises and chronic pain are associated with what anemic disorder?

Answer 17

Sickle cell anemia

Question 18

What are reticulocytes?

Answer 18

Immature RBCs

Question 19

What does transferrin measure?

Answer 19

Total transferrin in plasma

Question 20

What test provides the most accurate measure of total body iron?

Answer 20

Total iron binding capacity - measures percentage of transferrin bound to iron

Question 21

What is the difference between relative and absolute anemia?

Answer 21

Relative anemia is a normal RBC mass, but an increase in plasma volume. Absolute anemia is an actual decrease in RBC mass

Question 22

What cardiac symptoms are associated with severe anemia presentation?

Answer 22

Chest pain, angina, heart attack

Question 23

What causes are associated with microcytic, hypochromatic anemia?

Answer 23

Fe deficiency, Thalassemia, anemia of chronic disease

Question 24

How do sickle cell and thalassemia differ?

Answer 24

Sickle cell results in abnormal Hb. Thalassemia is reduced rate of Hb synthesis

Question 25

What test correlates with iron stores in the body?

Answer 25

Serum ferritin

Question 26

What are the 5 general causes of anemia?

Answer 26

Blood loss, RBC destruction, decreased RBC production, survival defects, sequestration

Question 27

What are the symptoms of iron deficiency anemia?

Answer 27

Fatigue, lethargy, fragile nails, glossitis, cheilitis, pica, tachycardia

Question 28

True/False. A patient with anemia may present with jaundice.

Answer 28

True. Anemia may cause an increase in bilirubin and thus jaundice

Question 29

How can folate and B12 deficiency anemia be differentiated?

Answer 29

In B12 deficiency, only serum methylmalonic acid will be increased. With folate deficiency, homocysteine and MMA will be increased