Term
|
Definition
| weakness, fatigue and dyspnea, pal conjunctiva and skin, HA and lightheadedness, angina |
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Term
| causes of microcytic anemia |
|
Definition
| iron deficiency anemia, anemia of chronic disease, sideroblastic anemia nd thalassemia |
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Term
| most common type of anemia |
|
Definition
|
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Term
|
Definition
| absorbed in duodenum vi DMT1 transorters; into blood via ferroportin; transferrin transports iron in blood; stored intracellular iron is bound to ferritin |
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|
Term
| wy iron deficiency anemia in adults 20-50 |
|
Definition
peptic ulcer disease = males
menorrhagia or pregnancy = females |
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|
Term
| iron deficiency anemia in elderly |
|
Definition
wester world = colon polyps/carcinoma
developing = hookworm |
|
|
Term
| stages of iron deficiency |
|
Definition
storage iron depleted = decreased ferritin, increased TIBC
serum iron is depleted = decrease serum iron, decrease %sat
normocytic anemia= fewer but normal sized RBCs
microcytic-hypochromic anemia= smaller and fewer RBCs |
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|
Term
| clinical features of iron deficiency anemia |
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Definition
| anemia, koilonychia (spoon nails) and ica |
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|
Term
| lab findings of iron deficiency |
|
Definition
| increased RDW, decreased ferritin, increased TIBC, decreased serum iron, decreased % sat; increased FEP |
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|
Term
| features of plummer-binson sndrome |
|
Definition
| iron deficiency anemia, esophageal web and atrophic glossitis |
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Term
|
Definition
| sequesters iron in storage sites by limiting iron transfer from macrophages to erythroid precursors and suppression EPO |
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|
Term
|
Definition
| increased ferritin, decreased TIBC, decreased serum iron, decreased %sat; increased FEP |
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|
Term
|
Definition
| address ndelrying cause, exogenous EPO |
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|
Term
|
Definition
| succinyl CoA --ALAS + B6--> ALA --ALAD--> porphobilinogen -->-->--> protoporphyrin + Fe --ferrochelatase--> heme |
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|
Term
|
Definition
| Fe + protoporphyrin --> heme happens in the mitochondria; if no protoporphyrin, then Fe builds up in mitochondria and get a ring around nucleus on prussian blue stain |
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|
Term
| causes of sideroblastic anemia |
|
Definition
alcoholism (mitochondrial poison)
lead poisoning (ALAD and ferrochelatase)
vitamin B6 deficiency (with isoniazid treatment) |
|
|
Term
| lab findings of sideroblastic anemia |
|
Definition
| increased ferritin, decreased TIBC, increased serum iron and increased %sat |
|
|
Term
|
Definition
gene deletion
- one gene= asymp
- two genes = mild anemia (Cis = asians, trans = africans; cis is worse)
- three genes = severe anemia, form HbH (beta chain tetramers)
- four genes = hydrous fettles, Hb Barts (gamma chain tetramers) |
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|
Term
| beta-thalassemia due to gene ________ |
|
Definition
|
|
Term
beta-thalassemia minor
- Hb electrophoresis |
|
Definition
mildest form
- decreased HbA, increase HbA2 and increased HbF |
|
|
Term
beta-thalassemia major
- damage
- clinical features
- treatment
- blood smear
-electrophoresis |
|
Definition
-alpha teramers aggregate and damage RBCs
- massive erythroid hyperplasia (crewcut facies, chipmunk facies, hepatosplenomegaly)
- need chronic transfusions
- microcytic, hypochromic RBCs with target cells andn ulcerated RBCs
- little or no HbA with increased HbA2 and increased HbF |
|
|
Term
folate
- food sources
- where absorbed
- time frame |
|
Definition
-green vegetables and some fruits
- jejnum
- within months |
|
|
Term
| causes of folate deficiency |
|
Definition
| poor diet (alcoholics/elderly), increased demand (pregnancy, cancer and hemolytic anemia) and folate antagonists (methotrexate) |
|
|
Term
| clinical and lab findings of folate deficiency |
|
Definition
| macrocytic RBCs and hyper segmented neutrophils; glossitis; decreased serum folate; increased serum homocystein; normal methylmalonic acid |
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|
Term
|
Definition
complexed to animal derived proteins
salivary gland enzymes liverate B12 then bound to R-binder
pancreatic proteases detach B12 from R-binder
vitaimn B12 binds IF in the small bowel and absorbed |
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Term
|
Definition
| most common type of B12 deficiency; autoimmune destruction of parietal cells |
|
|
Term
|
Definition
| pernicious anamia, pancreatic insufficiency, damage to terminal ileum (Crohn, fish tapeworm) vegans |
|
|
Term
| clinical and lab findings of B12 deficiency |
|
Definition
| macrocytic RBCs with hyper segmented neutrophils, glossitis, subacute combined degeneration of spinal cord, decreased B12, increased homocysteine, increased methylmalonic acid |
|
|
Term
| corrected reticulocyte count |
|
Definition
multiply reticulocyte count by Hct/45
- if >3% then peripheral destruction
- if <3% then underproduction |
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|
Term
|
Definition
| RBC destruction by RES, jaundice with unconjugated bilirubin, increased bilirubin gallstones, and marrow hyperplasia with corrected RC >3% |
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|
Term
|
Definition
| destruction of RBCs within blood vessels, hemoglobinemia, hemoglobinuria, hemosiderinuria and decreased serum haptoglobin |
|
|
Term
| normocytic anemias with predominant extravascular hemolysis |
|
Definition
| hereditary spherocytosis, sickle cell anemia, hemoglobin C |
|
|
Term
| hereditary spherocytosis is a defect in ________, ________ or ________ |
|
Definition
| spectrin, ankyrin or band 3.1 |
|
|
Term
| clincal and lab findings of hereditary spherocytosis |
|
Definition
| spherocytes with loss of central pallor, increased RDW, increased MCHC, splenomegaly, jaundice, increased bilirubin gallstones, increased risk for aplastic crisis with parvovirus B19 |
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|
Term
hereditary spherocytosis
-diagnosis
-treatment |
|
Definition
- osmotic fragility test
- splenectomy |
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|
Term
|
Definition
| glutamic acid (hydrophilic) with valine (hydrophobic) |
|
|
Term
| causes of sickling in sickle cell |
|
Definition
| hypoxemia, dehydration and acidosis |
|
|
Term
|
Definition
| hydroxyurea= increased HbF which is protective |
|
|
Term
|
Definition
| extravascular and intravscular emolysis symptoms, massive erythroid hyperplasia symptoms, dactylics, autospelectomy, acute chest syndrome, pain |
|
|
Term
| sickle cell trait symptoms |
|
Definition
| asymp except in renal medulla= decreased ability to concentrate urine |
|
|
Term
| lab findings of sickle cell |
|
Definition
| sickle cells, target cells, metabisulfite screen (positive in disease and trait), Hb electrophoresis |
|
|
Term
Hb electrophoresis
- sickle cell disease
- sickle cell trait |
|
Definition
- 90% HbS, *% HbF, 2% HbA2
- 55% HbA, 43% HbS, 2% HbA2 |
|
|
Term
|
Definition
| glutamic acid replaced with lysine; characteristic HbC crystals on blood smear |
|
|
Term
| normocytic anemias with predominant intravascular hemolysis |
|
Definition
| PNH, G6PD deficiency, IHA, microangiopathic hemolytic anemia, and malaria |
|
|
Term
|
Definition
| acquired defect --> absent GPI --> can't have DAF on their surface --> complement damage |
|
|
Term
PNH
- screening test
- confirmatory test |
|
Definition
-succrose test
- acidified serum test or flow cytometry to detect lack of CD55 (DAF) |
|
|
Term
|
Definition
| thrombosis of hepatic, portal and cerebral veins |
|
|
Term
|
Definition
| iron deficiency anemia, AML |
|
|
Term
| defect in G6PD deficiency |
|
Definition
| reduced half life of G6PD so susceptible for oxidative stress |
|
|
Term
| variants of G6PD deficiency |
|
Definition
african= milder
mediterranean= markedly reduced half live so marked intravascular hemolysis |
|
|
Term
| clinical and lab findings of G6PD deficiency |
|
Definition
| hemoglobinuria, back pain, heinz bodies, bite cells |
|
|
Term
| cause of oxidative stress in G6PD deficiency |
|
Definition
| fava beans, infections, primaqine, sulfa drugs, dapsone |
|
|
Term
IgG-mediated extravascular hemolysis
- associated with
- treatment |
|
Definition
warm agglutinins
- with SLE, CLL and drugs
- cessation of drugs, steroids, IVIG and splenectomy |
|
|
Term
IgM mediated intravscular hemolysis
- associated with |
|
Definition
cold agglutinins
- mycoplasma pneumonia and infectious mononucleosis |
|
|
Term
coombs test
- direct
- indirect |
|
Definition
- confirms presence of antibody coated RBCs in pt serum
- confirms presence of antibodies in pt serum |
|
|
Term
malaria
- cause
- vector
- which worse |
|
Definition
- plasmodium
- anopheles mosquito
- P falciparum= daily fever vs. P vivax and ovale = every other day |
|
|
Term
| etiologies of anemia due to underproduction |
|
Definition
| causes of microcytic an macrocytic anemia, renal failure, damage to bone marrow precursor cells |
|
|
Term
aplastic anemia
- results in ________ and ________
- etiologies
- bopsy
- treatment |
|
Definition
- pancytopenia and low reticulocyte count
- chemicals, viral infections and autoimmune damage
- empty, fat marrow
- cessation of causative drugs, supportive care, marrow-stimulating factors |
|
|
Term
|
Definition
| pathologic process that replaces bone marrow --> pancytopenia |
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