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42 Cards in this Set
- Front
- Back
Stimuli for EPO
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hypoxemia
left-shifted OBC high altitude |
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EPO is made
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in the endothelial cells of the peritubular capillaries
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corrected retic count
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effective if > or = 3%
ineffective is < 3% (actual Hct/45 * retic count) |
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fetal-Hb and OBC
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left shit
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lab values in thalassemia
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Hb, Hct are decreased
RBC count increased |
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O2 sat and arterial PO2 in anemia
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both are normal
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increased MCHC
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seen in spherocytes
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RDW
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reflects variation in size of RBCs in the peripheral blood
Fe def. anemia is the only microcytic anemia with increased RDW |
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serum ferritin
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decreased in fe def
increased in ACD, iron overload diseases |
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serum iron levels
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decreased in Fe def, ACD
increased in iron overload diseases |
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TIBC and transferrin
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increased TIBC = increased transferrin and vice versa
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decreased ferritin stores
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cause increased synthesis of transferrin/TIBC
Fe def = increased transferrin |
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increased ferritin stores
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decreased transferrin/TIBC
ACD, iron overload diseases |
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decreased %sat
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Fe def
ACD |
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increased %sat
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iron overload diseases
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HbA
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2alpha/2beta
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HbA2
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2alpha/2delta
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HbF
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2alpha/2gamma
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iron def. most often caused by
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bleeding
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most commona anemia in hospitalized patients
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ACD
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hepcidin
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increased mac iron stores
enters macs and prevents release of iron to transferrin |
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Hb electrophoresis in alpha-thal trait
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is normal
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Beta-Thal minor
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DNA splicing defect
decreased HbA increased RBC count, HbA2, HbF |
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Beta-thal major
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nonsense mutation --> stop codon
no HbA, increased HbA2, HbF |
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sideroblastic anemia
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defect in heme synthesis in the mitochondria
ringed siderblasts due to booze, B6 def, and Pb poisoning |
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most common cause of B6 def
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INH
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Pb poisoning
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paint, batteries
coarse basophilling stippling Pb deposits in epiphyses leading to growth problems |
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phenytoin and folate
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folate is coverted to monoglutamates which are reabsorbed in the jejunum by intestinal conjugase
phenytoin inhibits intestinal conjugase leading to decreased folate absorption |
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alcohol and oral contraceptives
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block reabsorption of folate in the jejunum
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increased homocysteine
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folate and vit B12 def
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most sensitive test for B12 def
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increased methylmalonic acid
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signs of volume depletion
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decreased blood pressure
increased pulse |
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anemia of CRF
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decreased EPO
normocytic burr cells throbocytopenia defect in platelet aggregation that is reversible with dialysis |
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increased RBC osmotic fragility
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hereditary spherocytosis
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PNH
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loss of anchor for DAF which normally neutralizes complement attached to RBCs, platelets, and PMNs
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PNH lab tests
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screen: sucrose hemolysis test --> sucrose enhances complement destruction of RBCs
confirm: acidified serum test --> activates the alternative pw causing hemolysis |
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target cells
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excess RBC membrane
sign of hemoglobinopathy or alcohol excess |
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dactylitis
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painful swelling of the hands and feet in infants with SCA (around 6-9 months) due to bone infarcts
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acute chest syndrome
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vaso-occlusion of pulmonary capillaries
chest pain, lung infiltrates, and hypoxemia most common cause of death in adults with SCA |
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PK def
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normocytic anemia
RBCs with thorny projections increased 2,3-BPG right shifts OBC |
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direct antihuman globulin test (DAT)
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most important marker for immune hemolytic anemia
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malaria and hemolysis
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intravascular hemolysis correlates with fever spikes
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