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Hematology > Anemias > Flashcards

Anemias Flashcards

1
Q

Microcytic Anemias

A

Low MCV.

  • Thalassemia
  • Iron Deficiency
  • Chronic Disease
  • Sideroblastic Anemia
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2
Q

Whats the most common cause of iron deficiency anemia in the US?

A

Blood loss: either occult or acute.

- Generally GI

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3
Q

Average iron storage in adult man?

A

10mg/kg

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4
Q

Usual anemia presenting symptoms

A

Weakness, HA, Irritability, fatigue, exercise intolerance.

Many patients are asymptomatic

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5
Q

Pica

A

Cravings for food not fit for consumption. Dirt, paper, ice.

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6
Q

Pagophagia

A

Pica for ice. Considered quite specific for the iron deficiency state.

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7
Q

Gold standard for diagnosing iron deficiency.

A

Low serum ferritin (iron stores).
Serum iron: reduced
Total iron binding capacity: increased
Transferrin sat: low

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8
Q

RDW

A

Measures anesiocytosis

Test measuring the variation of size in red blood cells.

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9
Q

Microcytic anemia with low or normal RDW = ?

A

Chronic disease or thalassemia

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10
Q

Microcytic anemia with high RDW = ?

A

Iron deficiency anemia.

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11
Q

Anemia of chronic disease

A

Occurs in the setting of chronic inflammatory diseases.
EPO is low, serum iron is reduced.
ferritin is high(ddx from IDA)
usually normocytic, can be micro

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12
Q

Diseases than are commonly associated with ACD?

A

RA, SLE
HIV, TB
Carcinomas, lymphomas, leukemias

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13
Q

Megaloblastic Macrocytic Anemias

A

Abnormalities in DNA metabolism.

  • B12 and Folate deficiency
  • Drug side-effects
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14
Q

Absorption of B12 depends on these 5 things.

A 
Adequate dietary intake
Acid-pepsin in stomach
Intrinsic factor
Pancreatic proteases
Functional ileum
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15
Q

Total body stores of cobalamin

A

The average stores of B12 are 2 - 5 milligrams

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16
Q

Pernicious Anemia

A

Autoimmune disease where parietal cells fail to release intrinsic factor in the stomach.

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17
Q

Lab results that ddx B12 from folate deficiency?

A 
Elevated homocysteine (HC) AND Methylmalonic acid (MMA).
Folate is just elevated HC
18
Q

B12 deficiency tx

A

1000 mg B12 daily for a week, weekly for a month, monthly for life.

19
Q

Most common cause of folate deficiency?

A

Nutritional due to poor diet and or alcoholism.

20
Q

Non-megaloblastic macrocytic anemias?

A 
Alcoholism
Liver disease
Aplastic anemia
drug-induced
pregnancy
myeloma
hypothyroidism
21
Q

DDx for normocytic anemia

A

NORMAL SIZE HEM

22
Q

Anemia of chronic renal failure.

A

different from chronic disease anemia. Much more severe.

Give EPO!

23
Q

Mixed anemia

A 
Order peripheral smear because many different cells.
High RDW (many different sized cells), but MCV may be normal because the AVERAGE is in the normal range.
24
Q

Reticulocyte count

A

Usually make up about 1% (stain blue)
Usually reticulocytes circulate in blood for one day before maturing.
Elevated count shows that bone marrow is responding to anemia and producing more cells.

25
Q

3 areas where reticulocyte count is appreciated

A

Acute blood loss
Hemolytic anemia
Response to iron, B12, folate replacement

26
Q

Anemia of acute blood loss

A

Source is usually quite clear
Generally takes 24 hours for Hgb to drop.
Reticulocytosis may result in mild macrocytic anemia.

27
Q

Which test cal determine of a hemolytic anemia is immune?

A

Direct Coomb’s Test. Perform once you know the anemia is hemolytic.

28
Q

Lab tests for hemolysis

A

Decreased Haptoglobin: bound with damages cells
Elevated D.Bili: porphyrin concerted to Bili
Elevated Lactate dehydrogenase (LDH): released from hemolysed RBC’s

29
Q

HUS

A

Hemolytic urea syndrome. Cause by E-coli. Generally happens in kids and causes kidney failure.

30
Q

Heriditary Hemochromatosis

A

Excess Iron.
Harrison’s disease.
Iron is deposited in many tissues and damages them.

31
Q

What cells go with lead?

A

Stippling.

32
Q

What does iron in tissues produce?

A

Hydrogen peroxide is converted to free radical ions. Can cause cancers, cardiac toxicity and many other factors

33
Q

Hemochromatosis liver pathology

A

Usually first organ affected
Hepatomegaly present in 95%
Most common cause of death in treated pt’s.

34
Q

Hemochromatosis Cardiac Pathology

A

Presenting in 15% of patients.

Mostly CHF and arrhythmias.

35
Q

Hemochromatosis Pancreatic Pathology

A

Causes diabetes in 65% of patients

Generally have family hx of diabetes

36
Q

Hemochromatosis Skin Pathology

A

Excessive skin pigmentation present in 90% of symptomatic pt’s.
Metallic hue

37
Q

Hemochromatosis Pituitary pathology

A

Hypogonadism

Decreased libido, no period, manboobs

38
Q

Hemochromatosis Joint pathology

A

Arthritic changes in 25 - 50% of pts
Often starts in hands
Pseudogout can occur

39
Q

Hemochromatosis Lab Dx

A

Transferrin > 50%
Elevated serum ferritin
DNA testing

40
Q

Hemochromatosis Tx

A

Phlebotomy

Take off blood volume, removes iron as well.

Hematology (14 decks)

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