Hem & Onc - Pathology (Anemias & Leukopenias) Flashcards Preview

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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?

Transferrin production


What kind of anemia can copper deficiency cause?

Copper deficiency can cause a microcytic sideroblastic anemia


Define Neutropenia.

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


What changes to immune/blood cells do corticosteroids cause, and why?

Corticosteroids cause neutrophilia, but eosinopenia and lymphopenia. Corticosteroids decrease activation of neutrophil adhesion molecules, impairing migration of the vasculature to sites of inflammation. In contrast, corticosteroids sequester eosinophils in lymph nodes and cause apoptosis of lymphocytes.