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20 Cards in this Set
- Front
- Back
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PBRCs should be diluted with ?
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normal saline
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Name four compensatory mechanisms triggered by anemia.
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1. Increased cardiac output
2. Increased extraction ratio 3. Increased 2,3 DPG / right shift of oxyhemoglobin curve 4. Expansion of plasma volume |
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One unit of PBRCs will raise Hb by ?
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one point
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PBRCs are usually delivered in what amount over what time period?
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2 units at a time, over 2 hours
(90 - 120 minutes) |
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What is the normal reticulocyte count?
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1-2%
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What is the pathophysiology of anemia of chronic disease?
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Iron is present but trapped in macrophages, unavailale for Hb synthesis
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What is the pathophysiology of ring sideroblastic anemia?
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Defective synthesis of protoporphyrins, iron accumulates in mitochondria
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If MCV > 100, what besides B12 and folate is in the differential?
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liver disease - MCV up to 115, poor lipoprotein metabolism affects RBC rmembrane and shape
excess erythropoesis - reticulocytes are bigger. (Will have increased retic count) |
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Ddx for normocytic anemia
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HAARM
Hemolytic anemia? Aplastic anemia ACD Renal failure Myelodysplastic / Marrow fibrosis or Malignancy |
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Iron study profile of iron deficiency
anemia iron, TIBC, ferritin, iron saturation (Fe/TIBC) |
iron (Fe) low
TIBC high ferritin low (often under 20) iron sat <18% |
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Iron study profile of thalassemia
iron, TIBC, ferritin, iron saturation (Fe/TIBC) |
everything normal!
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iron study profile of ACD
iron, TIBC, ferritin, iron saturation (Fe/TIBC) |
iron (Fe) low
TIBC high ferritin HIGH (stores are full, just not available) iron sat >18% |
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Iron study profile of sideroblastic anemia
iron, TIBC, ferritin, iron saturation (Fe/TIBC) |
iron (Fe) HIGH
TIBC normal ferritin HIGH iron sat ? basophilic stippling, ringed sideroblasts in bone marrow |
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ACD and ? have high ferritin on iron study
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sideroblastic anemia
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What anemia has high iron values on iron study?
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sideroblastic
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What are the possible etiologies of a pure red cell aplasia?
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thymoma
CLL parvovirus infection |
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Neutrophil hypersegmentation is a sign of ?
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macrocytic anemia
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What are treatments for pure red cell aplasia
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transfusion of PRBCs
then thymectomy (if enlarged) IVIg if parvovirus immunosuppression if CLL |
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Homocysteine and methylmalonic acid: what are their values in B12 and folate deficiency?
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methymALONic acid is elevated in B12 deficiency ALONE
homocysteine is elevated in both B12 and folate deficiency |
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Which has neurologic symptoms, folate or B12 deficiency?
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B12
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