Term
| Describe peripheral blood & bone marrow morphology characteristic of Iron deficiency anemia |
|
Definition
Decreased: serum Ferritin (storage form of Iron), Hgb & Hct, RBC indices, serum iron
Increased: TIBC (total iron binding capacity->transferrin)
-microcytic, hypochromic |
|
|
Term
| Describe cause of iron deficiency |
|
Definition
-decrease iron intake (iron deficient diets)
-increase iron utilization (postnatal growth spurt/adolescent growth spurt)
-iron loss (physiological)(menstration/pregnancy)
-faulty or incomplete iron absorption (autoimmune gastritis/celiac disease/H. pylori infection)
-iron loss (pathological)(GI bleeding/urogenital bleeding/pulmonary hemosiderosis/intravascular hemolysis/malignancy) |
|
|
Term
Utilize morphology & iron values to distinguish among:
a. iron deficiency anemia
b. sideroblastic anemia & lead poisoning
c.thalassemia |
|
Definition
a. iron deficiency anemia:
-Decreased ferritin, increased transferrin-> decrease erythropoiesis to conserve iron, as hgb decreases->iron decreases->microcytic/hypochromic RBC's -> decreased o2 delivery-> iron def. anemia
b. sideroblastic anemia & lead poisoning:
-in peripheral blood: decreased Hgb/Hct, dimorphic RBC population- poikilocytosis(shape)& basophilic stippling (interruption of heme synthesis), increased ferritin, microcytic/hypochromic RBC, can be acquired or inherited, decreased reticulocytes
In Bone Marrow:
-diagnostic->ringed sideroblast in Prussian blue stain of bone marrow, erythroid hyperplasia, megaloblastic changes (nucleus & cytoplasm don't mature at same rate)
Lead poisoning:
-acquired/defect in heme synthesis (2 building blocks of heme= glycine & ScoA)/considered type of bone marrow toxin->can cause acquired & resolved once removed
c. Thalassemia:
-rate of (globulin) chain production altered, microcytic/hypochromic RBC, decreased RBC, increased pH, cell fragments, looks junky. |
|
|
Term
| Discuss treatment of iron deficiency anemia |
|
Definition
-oral iron supplements, nutritional counseling, correct underlying disorder, avoid blood transfusion
-response to treatment: appearance of reticulocytes; Hgb levels |
|
|
Term
| Describe the defect in sideroblastic anemias |
|
Definition
(is a disorder of iron utilization)
-defective hematopoietic stem cell
-ineffective erythropoiesis
-elevated iron stores (ferritin) |
|
|
Term
| Summarize the peripheral blood and bone marrow morphology in sideroblastic anemias |
|
Definition
-microcytic/hypochromic RBC
-Periph.->dimorphic RBC pop.-poikilocytosis & basophilic stippling
-Bone marrow-> megaloblastic changes, presence of ringed sideroblast seen w/ Prussian blue stain |
|
|
Term
| Explain the relationship b/w lead poisoning & sideroblastic anemia |
|
Definition
| -defective function of stem cells-> defect in heme synthesis |
|
|
