The Microcytic Anemias

Question 1

Anemia

Answer 1

A condition in which red blood cells are no longer able to supply oxygen to body tissues resulting to decreased oxygen transport

Question 2

If Microcytic/Hypochromic anemia develops, then:

Answer 2

MCV is less than 80 fL
MCHC is less than 32%

Question 3

General symptoms of Anemia are:

Answer 3

Fatigue

Question 4

Factors affecting iron absorption are:

Answer 4

Gastroesophageal reflux disease (GERD)

Question 5

What % of the daily intake of iron is need to maintain RBC’s

Answer 5

5%

Question 6

Iron needs for Infants, Children, Men, and Women are:

Answer 6

Men: 1mg
Women: 2mg
Infants: 1mg
Children: .5mg

Question 7

What % of iron used for RBC production is recycled for infants and adults?

Answer 7

Infants: 70%
Adults: 95%

Question 8

Iron Deficiency Anemia is related to what?

Answer 8

Increased demands
Lack of iron intake
Blood loss

Question 9

How is IDA related to increased demands?

Answer 9

Growth spurts in infants and children and pregnancy and nursing

Question 10

How is IDA related to lack of iron intake?

Answer 10

Nutritional deficiency and conditions that diminish absorption

Question 11

How is IDA related to blood loss?

Answer 11

Gastrointestinal bleeding, excessive menses, and hemolysis

Question 12

How is IDA related to blood loss?

Answer 12

Gastrointestinal bleeding, excessive menses, and hemolysis

Question 13

The IDA clinical symptoms are:

Answer 13

Vertigo-dizziness and Dyspnea (air hunger)

Question 14

Unique symptoms of IDA are:

Answer 14

Cheilitis (chapping around edges of the mouth)

Koilonychia (spooning of the nail beds)

Question 15

Laboratory testing for IDA

Answer 15

if iron deficiency is suspected, analysis to include RBC status and iron status.

Question 16

RBC is assessed by:

Answer 16

CBC

Question 17

Iron status is assessed by:

Answer 17

serum iron, serum ferritin, transferrin, or total iron binding capacity (TIBC)

Question 18

What will happen with the total iron binding capacity with IDA

Answer 18

It will be elevated

Question 19

Sideroblastic Anemias (too much iron)

Answer 19

Accumulation of iron in the mitochondria

Question 20

How does one get Sideroblastic Anemias

Answer 20

either acquired or hereditary

Question 21

Acquired Sideroblastic Anemia occurs with:

Answer 21

High transfusion protocol
Alcoholism
Lead poisoning
Chloramphenicol
(HALC)

Question 22

Hereditary Sideroblastic Anemia occurs with:

Answer 22

Enzyme deficiency

Question 23

Diagnosis of Sideroblastic Anemia happens with:

Answer 23

Ringed sideroblasts

Question 24

Hereditary Hemochromatosis (HH)

Answer 24

Rare disease compared to other blood disorders. It is an autosomal recessive disorder.

Question 25

Hereditary Hemochromatosis is caused by:

Answer 25

An abnormal gene called HFE

Question 26

Clinical Symptoms of Hereditary Hemochromatosis:

Answer 26

Hair loss Chronic fatigue or weakness Tender swollen joints

Question 27

Diagnosis of Hereditary Hemochromatosis

Answer 27

Transferrin saturation, Serum iron, and Serum Ferritin are elevated. Serum ferritin levels are >300 ug/L and transferrin saturation levels are >60%

Question 28

Basic defects in Thalassemia

Answer 28

2 million Americans carry the gene for Thalassemia Defects of hemoglobin synthesis which results in lack of production of alpha or beta globin chains

Question 29

Alpha Thalassemias

Answer 29

Each of the four alpha thalassemia is a result of a deletion of one or more alpha genes.

Question 30

What is critical in the formation of adult hemoglobin?

Answer 30

The alpha chain

Question 31

Barts hydrops fetalis happens when:

Answer 31

There is no Hgb A or Hgb F

Question 32

Barts hydrops fetalis results in:

Answer 32

Spontaneous abortion or stillbirth. If discovered, most pregnancies are terminated

Question 33

Hemoglobin H disease happens when:

Answer 33

3 gene deletion, 1 function gene (a chain)

Question 34

Hemoglobin H inclusions are formed when:

Answer 34

RBC resembles pitted golf ball when stained with supravital

Question 35

Clinical results of Hemoglobin H disease are:

Answer 35

MCV >60fL

Question 36

Alpha thalassemia trait occurs when:

Answer 36

Two functional alpha gene 5-10% hgb barts

Question 37

Silent carrier happens when:

Answer 37

Three functional alpha gene. Hematologically normal

Question 38

Beta Thalassemia Trait (Minor)

Answer 38

One abnormal beta gene inherited. Mimics IDA

Question 39

What will you see of a smear with Beta Thalassemia Trait?

Answer 39

May see basophilic stippling Target cells