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15 Cards in this Set

  • Front
  • Back
What are the seven elements of the CBC?
Hemoglobin (g/dl)
Hematocrit (%)
What are the physiological responses to anemia?
Increased cardiac output
Vasoconstriction (w/ acute blood loss)
Kidneys retain salt and water
Increased RBC 2,3 DPG
Increased epo synthesis by kidneys
What are the reticulocyte values for hypoproliferative anemias?
Retic index <2%
Absolute retic count <75,000
Differential Dx for Low Retic Count (Hypoproliferative Anemia)
1. Acute blood loss
2. Nutritional anemia (iron, B12, folate)
3. Bone marrow depression
4. Defective RBC production (kidney disease, myelodysplasia)
5. Destruction of marrow erythroid precursors (aplastic anemia, parvovirus)
6. Replacement of normal marrow by tumor or other
What is the defining characteristic of megaloblastic anemias?
A defect in DNA synthesis leading to a characteristic morphology of bone marrow cells
What is the characteristic morphology of bone marrow cells seen in megaloblastic anemias?
Nucleus appears immature
Cytoplasm has mature appearance
Increased cell volume
What is the most common cause of megaloblastic anemia?
B12 and/or folate deficiency
What is the hematoligical clinical presentation of megaloblastic anemia?
MCV and RDW elevated
Peripheral smear shows hypersegmented PMNs
Marrow is hypercellular, with increased nuclear size
What is the non-hematoligical clnical presentation of megaloblastic anemia?
Beefy red tongue
Neuropsych features (B12 only)
What two things are elevated in the blood of a person with B12 deficiency?
Methylmalonic acid
What is elevated in the blood of a person with folate deficiency?
TIBC is a measure of what?
What are the symptoms of iron dificiency?
Glossitis (smooth shiny tender tongue)
Angular cheilitis
Esophageal webs
Koilonychia (spooning of nails)
What are the CBC changes seen with iron deficiency?
Elevated RDW (seen first)
Lowered MCV (seen second)
Lowered Hgb/Hct (seen last)
What are the characteristics of an iron panel in a patient that is iron deficient?
Lowered serum Fe
TIBC increases after storage is depleted
Transferrin sat falls
(Transferrin sat <10% and elevated TIBC = Fe deficiency)