Flashcards in Hem & Onc - Pathology (Anemias & Leukopenias) Deck (25):
Define normocytic, microcytic, and macrocytic anemias according to MCV.
(1) Microcytic MCV < 80 fL (2) Normocytic MCV = 80-100 fL (3) Macrocytic MCV > 100 fL
Again, what defines microcytic anemia? What are examples of microcytic anemia?
MCV < 80 fL; (1) Iron deficiency (2) Anemia of Chronic disease (3) Thalassemias (4) Lead poisoning (5) Sideroblastic anemia;
What is unique about Anemia of Chronic Disease? How might ACD first present? What other cause of anemia presents the same way?
It can be either microcytic (and hypochromic) OR normocytic (and normochromic); ACD and iron deficiency may first present as a normocytic anemia & then progress to a microcytic anemia
Again, what defines normocytic anemia? What are the major and minor divisions of normocytic anemia?
MCV 80-100 fL; Nonhemolytic versus Hemolytic; Within Hemolytic, Intrinsic versus Extrinsic
What are examples of nonhemolytic, normocytic anemias?
(1) Anemia of Chronic Disease (2) Aplastic anemia (3) Chronic kidney disease
What are categories/examples of intrinsic hemolytic, normocytic anemias?
(1) RBC membrane defect: hereditary spherocytosis (2) RBC enzyme deficiency: G6PD, PK (3) HbC (4) Sickle Cell Anemia (5) Paroxysmal noctural hemoglobinuria
What are examples of extrinsic hemolytic, normocytic anemias?
(1) Autoimmune (2) Microangiopathic (3) Macroangiopathic (4) Infections
Again, what defines macrocytic anemia? What are the divisions of macrocytic anemia?
MCV > 100 fL; Megaloblastic & Non-megaloblastic
What are examples of megaloblastic macrocytic anemias?
(1) Folate deficiency (2) B12 deficiency (3) Orotic aciduria
What are examples of non-megaloblastic macrocytic anemias?
(1) Liver disease (2) Alcoholism (3) Reticulocytosis
What is ferritin?
Primary iron storage protein of body
What is transferrin's role? How does it relate to TIBC?
Transports iron in the blood; TIBC = indirectly measures transferrin
What are the iron lab trends seen in iron deficiency? Which is the primary effect?
(1) Serum Fe - decreased (Primary) (2) Transferrin or TIBC - increased (3) Ferritin - decreased (4) % Transferrin saturation (serum iron/TIBC) - very decreased
What are the iron lab trends seen in anemia of chronic disease? Which is the primary effect?
(1) Ferritin - increased (Primary) (2) Serum iron - decreased (3) Transferrin or TIBC - decreased (4) % Transferrin saturation - normal
What are the iron lab trends seen in hemochromatosis? Which is the primary effect?
(1) Serum Fe - increased (Primary) (2) Transferrin or TIBC - decreased (3) Ferritin - increased (4) % Transferrin saturation - Very increased
What are the iron lab trends seen in pregnancy/OCP use? Which is the primary effect?
(1) Transferrin or TIBC - Increased (Primary) (2) Serum Fe - normal (3) Ferritin - normal (4) % Transferrin saturation - decreased
What is the evolutionary reasoning behind the decrease of transferrin or TIBC in chronic disease?
Pathogens use circulating iron to thrive, so body has adapted a system in which iron is stored within the cells of the body and prevents pathogens from acquiring circulating iron
What factor impacting iron lab studies is increased in pregnancy and by oral contraceptives?
What kind of anemia can copper deficiency cause?
Copper deficiency can cause a microcytic sideroblastic anemia
Absolute neutrophil count < 1500 cells/mm^3
Name 5 causes of Neutropenia.
(1) Sepsis/postinfection (2) Drugs (including chemotherapy) (3) Aplastic anemia (4) SLE (5) radiation
Define Lymphopenia in adults versus children.
Absolute lymphocyte count < 1500 cells/mm^3 (< 3000 cells/mm^3 in children)
Name 8 causes of Lymphopenia.
(1) HIV (2) DiGeorge syndrome (3) SCID (4) SLE (5) corticosteroids (6) radiation (7) sepsis (8) postoperative
Name 2 causes of Eosinopenia.
(1) Cushing syndrome (2) Corticosteroids