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Flashcards in Anemias Deck (41):
1

What is the MC anemia worldwide?

Iron Deficincy Anemia (microcytic anemia)

2

Chronic blood loss is the MCC of what?

IDA in adults

3

What is the MC source of chronic blood loss?

Menstrual loss

4

What are 2 clinical features of microcytic IDA?

- Pica- ice chips

- Koilonchia (spoon nails)

5

What is the most reliable test to diagnose microcytic IDA?

Serum Ferritin (low)

6

What is the gold standard test to diagnose microcytic IDA but rarely done?

Bone marrow biopsy

7

Tx for microcytic IDA?

Oral iron replacement (ferrous sulfate)
- a trial should be given to menstruating females.

8

Beta-Thalassemia Major predominantly in what population?

Mediterranean population

9

What are 2 clinical manifestations of microcytic Beta-Thalassemia Major?

- Severe anemia (microcytic hypochromic)

- Skull x-ray demonstrates "crew-cut" fuzzy appearance

10

What lab test would you find to be elevated in a pt with microcytic Beta-Thalassemia Major?

Hgb Electrophoresis: Hgb F and Hgb A2

11

What cells would be seen in a peripheral smear in a pt with microcytic Beta-Thalassemia Major?

Target cells

- Dacrocytes (teardrop cells)

12

What is a general characteristic of normocytic Aplastic Anemia?

Massive bone marrow failure - results in pancytopenia

13

What procedure is done to provide a definitive diagnosis of normocytic Aplastic Anemia?

Bone marrow bx

14

Vitamin B12 is bound to what?

An intrinsic factor so it can be absorbed by the terminal ileum

15

MCC of macrocytic Vitamin B12 Deficiency Anemia?

Pernicious anemia
- lack intrinsic factor
- MCC in western hemisphere

16

What disease causes microcytic Vitamin B12 Deficiency Anemia?

Crohn Disease

17

What clinical feature is present in microcytic Vitamin B12 Deficiency Anemia and not in Folate Deficiencies?

Neuropathy

18

What causes hemolytic Sickle Cell Anemia?

- Autosomal recessive disorder (requires 2 genes from 2 carries)

- under hypoxic conditions the hbg molecule polymerize causing RBC to sickle

19

Hemolytic sickle Cell Anemia is MC in what descent?

African descent (1 in 12)

20

A pt with hemolytic Sickle Cell Anemia can experience aplastic crises, how is that provoked?

- Provoked by a viral infection (human parvovirus B19)

21

Normocytic Aplastic crises reduced the ability of what?

- Reduces the ability of bone marrow to compensate

22

What is the MC clinical manifestation secondary to vaso-occlusion in pts with hemolytic Sickle Cell Anemia?

Painful crises involving the bones
- osseous infarction leading to severe pain.
- last up to 1 wk

23

What is the FIRST manifestation secondary to vaso-occlusion in pts with hemolytic Sickle Cell Anemia?

Hand-foot syndrome (dactylitis)

24

Hand-foot syndrome (dactylitis) is what?

Painful swelling of the dorsal aspect of hands and feet, results from avascular necrosis of metacarpal and metatarsal bones.

25

What diagnostic tests are used to dx a pt with hemolytic Sickle Cell Anemia?

- CBC showing anemia (MC finding)

- Peripheral smear showing sickle-shaped RBCs

- Hgb Electrophoresis- required to diagnose

26

What is a tx for hemolytic Sickle Cell Anemia?

- Hydroxyurea

27

What is hemolytic Hereditary Spherocytosis?

Autosomal dominant inheritance, loss of RBC membrane surface area (loss of biconcave) w/o decreased RBC volume which forces the spherical shape.

28

Diagnostic test and tx for hemolytic Hereditary Spherocytosis?

- Splenectomy - tx of choice

- RBC osmotic fragility - test the ability of RBCs to swell

- Direct Coombs test - will be negative

29

What are some general characteristics of hemolytic G6PD Deficiency?

- An X-linked recessive disorder that primarily affects men

- Protects against malaria

30

What is known to precipitant hemolytic G6PD Deficiency?

- Antibiotics: Sulfonamides and Nitrofurantoin

- Fava beans

31

What is some diagnostic test for hemolytic G6PD Deficiency?

- Deficient NADPH formation of G6PD levels

- Measurement of G6PD levels is diagnostic

32

What are some general characteristics of Autoimmune Hemolica Anemia?

RBC destruction

33

What are the clinical features of Autoimmune Hemolica Anemia: WARM AIHA?

- Leads to extravascular hemolysis, the primary site of RBC entrapment is in the spleen

- More common than cold

34

What are the clinical features of Autoimmune Hemolica Anemia: COLD AIHA?

Produces complement activation and intravascular hemolysis, the primary site of RBC sequestration is the liver

35

What diagnostic test is done for Autoimmune Hemolica Anemia: WARM and COLD AIHA?

Direct Coombs test = positive

36

Tx for Autoimmune Hemolica Anemia: WARM AIHA?

Glucocorticoids

37

Tx for Autoimmune Hemolica Anemia: COLD AIHA?

Avoid exposure to the cold - helps prevent attacks of hemolysis and subsequent anemia

38

Hemolytic Sickle cell anemia may cause Priapism what is the tx?

Terbutaline - helps w/ vasocontriction

39

What test do you order if MCV is >100?

B12, folate, and review RDW

40

What test do you order if MCV is <80?

Iron studies and review RDW

41

A lead line along the epicondyle dic seen on an XR is d/t what?

Sideroblastic anemia