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35 Cards in this Set
- Front
- Back
what causes microcytic anemias?
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1. MCV <80
2. results from decreased hemoglobin (Hb) production or 3. impaired Hb function |
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name five microcytic anemias
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1. iron deficiency anemia
2. sideroblastic anemia 3. lead posioning 4. thalassemias 5. sickle cell anemia |
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what is the #1 anemia in the world?
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1. iron deficiency anemia
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what is the #1 cause of iron deficiency anemia in the world?
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1. hookworms
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what causes iron defiency anemia in the elderly until proven otherwise?
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1. colon cancer!!!!
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where do you seen iron def. anemia?
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1. increased incidence in women of childbearing age secondary to menses
2. dietary deficiency seen in kids |
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what are si/sx of iron def. anemia?
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1. tachycardia, fatigue
2. pallor all from anemia 3. smooth tongue, brittle nails 4. esophageal webs 5. pica 6. not a dx--must find the CAUSE of iron deficiency!!! |
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what is the dx of iron def. anemia?
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1. decreased serum iron
2. decreased serum ferritin 3. high total iron binding capacity (TIBC) 4. peripheral smear shows target cells |
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what is seen on peripheral smear in iron def. anemia?
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1. target cells!!!!
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what is tx for iron def anemia?
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1. iron sulfate
2. should achieve baseline heamatocrit within 2 months |
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what is sideroblastic anemia?
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1. microcytic anemia
2. ineffective erythropoiesis d/t disorder of porphyrin pathway |
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what are etiologies of sideroblastic anemia?
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1. ineffective erythropoiesis d/t disorder of porphyrin pathway
2. chronic alcoholism 3. drugs (commonly isoniazid) 4. genetic |
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what is seen in labs with sideroblastic anemia?
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1. ineffective erythropoiesis d/t disorder ofo porphyrin pathway
2. high iron 3. N/high TIBC 4. high ferritin |
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what is seen on iron stain of bone marrow with sideroblastic anemia?
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1. ringed sideroblasts on iron stain of bone marrow
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what is a mneumonic for microcytic anemia?
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TAILS:
T= thalassemia A= anemia of chronic dz I= iron def. anemia L= lead toxicity S= sideroblastic anemia |
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what is the pathophys of microcytic anemia?
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1. cell division in bone marrow continues for longer than usual, resulting in smaller cells
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what are ringed sideroblasts?
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1. seen in sideroblastic anemia
2. revealed by Prussian blue stain of the bone marrow 3. cells with iron deposits encircling the red cell nucleus |
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what is tx for sideroblastic anemia?
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1. sometimes responsive to pyridoxine (vit B6) supplements
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what are si/sx of lead poisoning?
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1. microcytic anemia
2. encephalopathy (worse in children) 3. seizures, ataxic gait 4. wrist/foot drops 5. renal tubular acidosis |
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what are classic findings of lead poisoning?
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1. Bruton's lines= blue/gray discoloration at gumlines
2. Basophilic stippling of red cells (blue dots in red cells) 3. high serum lead level |
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what are Bruton's lines?
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1. seen in lead poisioning
2. blue/gray discoloration at gum lines |
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what is tx for lead poisoning?
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1. chelation c/ dimercaprol (BAL) and or EDTA
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what is the pathophys of thalassemias?
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1. hereditary dz of decreased production of globin chains
2. causes decreased production of Hb 3. can differentiate through gel electrophoresis of globin protiens |
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what is pathophys of alpha-thalassemia?
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1. decreased alpha-globin chain synthesis
2. 4 alpha alleles normally 3. seen commonly in Asians, less so in AA and mediterraneans |
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what is pathophys of alpha-thalassemia with 1 allele affected?
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1. carrier state
2. no anemia, aSx 3. no abnlmalities on blood smear |
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what is pathophys of alpha-thalassemia with 2 alleles affected?
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1. alpha-thalassemia minor
2. usually clinically silent 3. mild microcytic anemia |
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what is pathophys of alpha-thalassemia with 3 alleles affected?
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1. HbH disease
2. precipitation of beta-chain tetramers 3. intraerythrocytic inclusions seen on blood smear |
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what is pathophys of alpha-thalassemia with 4 alleles affected?
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1. Hydrops fetalis
2. fetal demise, total body edema 3. Bart's beta-4 Hb precipitations |
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what is pathophys of beta-thalassemia?
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1. decreased beta-globin chain synthesis
2. there are 2 beta alleles normally 3. usually of mediterranean or AA descent |
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what are si/sx of thalassemia major?
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1. B-/B-
2. anemia develops at age 6 mon (d/t switch from fetal gamma Hb to adult beta Hb) 3. splenomegaly 4. frontal bossing d/t extramedullary hematopoiesis 5. iron overload (secondary to transfusions) |
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what is seen in electrophoriesis with thalassemia major?
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(B-/B-)
1. very low HbA (a2B2) 2. high HbA2 (a2d2) 3. high HbF (a2g2) |
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what is tx for thalassemia major?
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(B-/B-)
1. folate supplementation 2. splenectomy for hypersplenism 3. transfuse only for severe anemia |
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what is pathophys of thalassemia minor?
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(B+/B-)
1. typically aSx carriers 2. NO HbF seen!! 3. tx by avoiding oxidative stress |
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what is seen in electrophoriesis with thalassemia minor?
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(B+/B-)
1. low HbA (a2B2) 2. high HbA2 (a2d2) 3. NO HbF (a2g2)!!!!! |
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what is tx for thalassemia minor?
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(B+/B-)
1. avoid oxidative stress!!! |