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Flashcards in Hematology Deck (272)
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1

Erythrocyte lineage

Stem cell-> proerythroblast->normoblast (nucleus)->reticulocyte (bluish cells)->RBC

2

Inc'd retic count (BM working properly)

etio:
blood loss - GI, vaginal, hemorrhage
inc'd destruction
Extrinsic - DIC, hemolysis
Intrinsic - membrane protein - hereditary spherocytosis
Metabolic enzyme - G6PD
Globinopathies - SS, Hb

3

Dec'd Retic count

Dec'd prodxn
dec EPO - chronic renal dz
Dec Fe - iron def anemia
dec globin - thalassemia
dec DNA - megaloblastic anemia
BM failure - aplastic anemia - DO WELL with bm tx

4

Microcytic (MCV<80)

iron def anemia
anemia of inflamm (MCV 78,79,80)
Thalassemia
Sideroblatic anemia

5

Macrocytic MCV >100

Vit B12/folate (MCV 110)
myelodysplasia
etoh liver dz
liver dz
blood loss
hypothyroid
inc retic hemolysis, blood loss

6

Normocytic MCV 80-100

renal failure
hypothyroid (98-103)
anemia of inflamm (81,82,83)
aplastic anemia

7

Iron study - normal

Iron 50-160, transferrin sat 20-45%, TIC 22-420 Ferritin >20 (station wagon 1/3 full)

8

Iron def anemia -

now school bus very empty
iron <15%, high TIBC (more seats), low ferritin (low iron=low ferritin)

9

Anemia of inflamm

liver secretes hepicidn, inc'd ferroportin in macrophages - internalize feroprtin so that iron can't get out of macrophages
low iron, low to normal transferrin sat, low TIBC cuz high ferrtin just inaccessible

10

Hemochormatosis

screening test - transferrin saturation is most specific - high iron high ferritin low TIBC (occupied)

11

Most sensitive assay for IDA -

ratio soluble transferrin/log ferritin
>2=IDA
<1 anemia of inflammation

12

Chronic alcoholism

inc'd carbohydrate free transferrin level

13

Celiac sprue

oily stools, itch skin lesions (dermatitis herpetiformis - tx with dapsone) - TTG+, IDA

14

R/O IDA

ferritin >100

15

Paroxysmal nocturnal hematuria PNH

C3 dep on RBC, C4 deposits, C6-9 party->hemolysis - pt wakes up with coca cola urine -> also with abd pain -> thrombus in ODD places (splenic thrombosis) - dx with Flow cytometry CD55/59
Tx: BM tx
slso give meningiococcal vaccine

16

Anemia of inflammation (chronic dz)

RBC can't use iron from reticuloendotheial stores (Macrophages etc) due to hepcidin release (traps iron in macrophages) in chronic inflamm states like Rheum arthrtisi, LE, TB etc (iron filled macros in BM)

17

Pagophagia

eating ice in IDA

18

Hg 10, MCV 85, TIBC low, TF sat 22% ferritin low 120 - BM shows?

dec sideroblasts and inc iron filled macrophages

19

70 M or post meno F with Hg9.5, MCV 70, low ferritin - wtd?

GI w/u
Young - EGD
Old - colonoscopy

20

25yo F Hg 9, MCV 63 Ferritin low RDW 17 - hypochromic microcytosis, target cells, pencil/cigar cells dx?

Menstrual loss or preg with inc need
Tx - PO iron (IV only with renal failure)

21

When to check retic count during IDA tx

5 days

22

60yo F DM,RI p.w fatigue, Hg 9, occult neg, EPO 10 (n) started on epo, 4 wks alater Hg only 9.2 wtd?

start iron supp - too low to make cells

23

Hg 10.5, MCV 80, peripheral smear normal - uniform size cells RDW 14

inc plasma volume

24

Hg 10.5m MCV 75, hypochormic microcytic cells RDW 17%

IDA

25

Elderly man p/w n/abd pain diarrhea - slight confusion and gaste distrubance dec biv sense - Hg 9 , MCV78,

check urine for heavy metals (lead)

26

Sideroblastic anemia

INH witout B6, etoh abuse, batt workers, porcellin workers

27

Elderly man works at factor making batteries or lives in old buiding or alcoholic p/w anemai Hg 5, MCV 80

Lead tox

28

Hg A (normal)

2 alpha, 2 beta

29

Hg A2 (small amts ok)

2 alpha, 2 delta

30

HgF

2 alpha, 2 gamma - good prognostic factor - hyroxyurea makes Hg F