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Flashcards in Week 3 HRM Deck (54):
0

What would the MCV value be in microcytic anemias?

<80fL

1

What would the MCV value be in macrocytic anemias?

>100fL

2

What would the MCV value be in normocytic anemias?

80-100fL

3

Name the 4 microcytic anemias

Iron deficiency, thalassemia, anemia of chronic disease and sideroblastic anemia

4

What is TIBC

Total iron binding capacity

5

What laboratory tests would be done for IDA?

Serum iron levels, TIBC, bone marrow iron stain, serum ferritin levels, RDW

6

What laboratory tests would be done for megaloblastic anemia?

Vitamin B12 and folate levels, liver and thyroid function test, bone a,row biopsy

7

What laboratory tests would be done for Hemolytic anemias?

Morphology, reticulocyte count, Coombs test( direct and indirect) Hb electrophoresis

8

What is the most common anemia?

Iron deficiency anemia

9

Name some common(aetiology) causes of IDA?

Bleeding, nutritional problems,worms, cancers, pregnancy, childhood

10

Discuss the pathogens is of IDA

Low Hb because of low iron, normal DNA with increased divisions due to hypoxia stimulating EPO. Iron is needed for cytochrome enzymes so epithelium is affected also. Smaller because there is less Hb

11

Describe the morphology of IDA

Microcytic, hypochromic, decreased central pallor, pencil cells, Anisocytosis and poikilocytosis

12

List some causes (aetiology) of megaloblastic anemia

Vitamin B12/ folate deficiency, gastritis, gastric atrophy(no intrinsic factor), cancer, old age, alcoholism, liver disease, hypothyroidism

13

Describe the pathogenesis of megaloblastic anemia

Abnormal DNA synthesis therefore there are decreased cell divisions
Affects WBCs and RBCs

14

List some clinical features of IDA?

Anemia, koilonychias(brittle spoon nails), esophagitis, glossitis (smooth shiny tongue), stomatitis, pale skin

15

List some clinical features of megaloblastic anemia

Stomatitis, anemia, jaundice, glossitis, chelates, neurological symptoms

16

Describe the morphology of megaloblastic anemia

Hypersegmented neutrophils, oval macrocytes, anisopoikilocytosis, polychromatophils, pancytopenia

17

Why do hyper segmented neutrophils disappear after only 14 days of treatment for megaloblastic anemia?

Because WBCs have a short lifespan and are replaced regularly

18

What is anemia of chronic diseas?

Anemia where iron is blocked from being stored in RBC precursors. The body has enough iron but it is unable to be accessed by the developing erythrocytes

19

What is the role of hepcidin in iron homeostasis?

It is a polypeptide produced by the liver that inhibits the release of iron from macrophages and intestinal epithelial cells via its interaction with the transmembrane iron transporter ferroportin

20

Why does inflammatory stimuli cause anemia in anemia of chronic disease?
(Pathogenesis)

Inflammatory stimuli activates monocytes and T cells, the T cells the Increase hepatic (liver) synthesis of hepcidin and decrease erythropoietin release . As this occurs, hepcidin inhibits iron release and erythropoiesis is also decreased.

21

Name some inflammatory mediators

IFN, TNF, IL-6

22

Describe some causes of anemia of chronic disease?

Rheumatoid arthritis, diabetes, Ct diseases, chronic infections, renal failure, inflammation, renal cell carcinoma

23

Describe clinical features of anemia of chronic disease?

Mild anemia, does not respond to nutritional supplements

24

Describe morphology of anemia of chronic disease?

Normal to microcytic cells, hypochromic

25

What are some lab roster indicators of anemia of chronic disease?

Having a chronic disease, low iron saturation and TIBC , reduced EPO and reticulocytes, increased ferritin

26

What is aplastic anemia?

Substantial reduction in number of haematopoietic stem cells and a fault in the remaining stem cells, that makes them unable to divide and differentiate sufficiently to populate the bone marrow. Replacement of marrow is by fatty yellow marrow

27

List some causes of aplastic snemia

Half cases are idiopathic, chemotherapy, toxic chemicals, radiation, viral infections, drugs

28

Clinical features of aplastic anemia?

Anemia, infections of throat and mouth, bleeding gums, bruising

29

Morphology of aplastic anemia?

Pancytopenia, norpmochromic, normocytic, low reticulocyte count

30

What antibody is responsible for warm type autoimmune Hemolytic anemia?

IgG antibody

31

What are some causes for warm type autoimmune Hemolytic anemia?

Idiopathic , drugs, viral infections, autoimmune disorders

32

What is the pathogenesis for warm autoimmune Hemolytic anemia?

IgG antibody coasts the RBC with receptors and the resident macrophages gradually remove it's membrane . It is destroyed prematurely predominantly in the spleen (extravascular)

33

Why is it called warm autoimmune Hemolytic anemia?

Because he antibodies can function in warm and cooler temperatures

34

Why is it called cold autoimmune Hemolytic anemia?

Because the IgM antibody can only function in regions of cooler blood such as finger tips and earlobes. Best functions at 4 degrees

35

Clinical features for warm autoimmune Hemolytic anemia?

Spleenomegaly, any age, any gender, anemia

36

Morphology for warm autoimmune Hemolytic anemia?

Spherocytes (no central pallor), increased reticulocytes with bluish tinge in blood film,

37

What antibody is responsible for cold type autoimmune Hemolytic anemia?

IgM antibody

38

Causes for cold type autoimmune Hemolytic anemia?

Idiopathic, infections (pneumonia, mononucleosis), lymphoma, autoimmune disorders

39

Pathogenesis of cold type autoimmune Hemolytic anemia?

Anemia, mild jaundice, spleenomegaly, acroyanosis (purplish skin discolouration)

40

Morphology of cold type autoimmune Hemolytic anemia?

Clumping of RBCs , hazy blood film

41

Morphology of glucose 6phosphate deficiency

Heinz bodies and blister cells

42

Morphology of Thalassemia

Microcytic, hypochromic, target cells with central dark stain

43

Which thalassemia anemia is more severe? Minor or major?

Major

44

Clinical features of thalassemia major

Severe anemia, spleenomegaly and liver Englarement, expansion of bones

45

What is sickle crisis

A sudden Severe attack of vascular occlusion, Hemolytic or marrow failure

46

What are folate and vitamin B12 required for

Synthesis for DTMP which is essential for DNA synthesis of thymine

47

Compare iron deficiency lab results to anemia of chronic disease

IDA has low ferris, ACD has high ferritin. Iron deficency has high TIBC , ACD has low TIBC

48

What are thalassemias?

Defects of globin destruction - alpha or beta

49

What happens in G6PD?

Hemolysis of RBC because of oxidative stress. This occurs because without G6P, NADH moron the Pentose phosphate pathway is decreased
And glutathione can no longer be produced. Glutathione assists with alleviating. oxidative stress

50

Causes of G6PD?

Infection, fava beans, anti malarial drugs

51

Clinical features of G6PD

Jaundice, dark urine, SOB, rapid HR

52

How does the direct Coombs test work

Detect antibodies Bound directly to RBC

53

How does the indirect Coombs test work

Detects free floating antibodies in serum