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18 Cards in this Set
- Front
- Back
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iron deficiency anemia
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-commonly caused by chronic blood loss(menstrual/GI)
-increased iron requirements in infants/toddlers/adolescents/pregnancy -microcytic hypochromic -decreased serum ferritin and iron increased TIBC and transferrin -tx with ferrous sulfate(po) or iron dextran(IM/IV) |
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B-Thalassemia major
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-B-chain deficiency--excess alpha chains(homozygous)
-Mediterranean, middle east, indian -microcytic hypochromic -hepatosplenomegaly, distortion of bones(expansion of marrow), growth retardation and FTT -Hb F elevated on electrophoresis -tx with frequent PRBC transfusions |
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B-thalassemia minor
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-B-cahin deficiency-heterozygous
-typically asymptomatic or mild microcytic hypochromic anemia -dx by Hgb electrophoresis -tx not usually necessary |
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A-Thalassemia::
1. silent carriers(one loci dmg) 2. trait(minor) (two loci dmg) 3. HbH Dz(three loci dmg) 4. dmg to all 4 loci |
1. asymptomatic, nl Hgb/Hct, no tx
2. mild microcytic/hypochromic anemia, AA, no tx 3. hemolytic anemia, splenomegaly, microcytic/hypochromic anemia, HbH on electrophoresis, frequent transfusions and splenectomy for tx 4. fatal at birth or soon after |
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sideroblastic anemia
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-abnormality in RBC iron metabolism, hereditary or aquired
-increased serum ferrintin and iron, nl TIBC, ringed sideroblasts in BM -tx is to remove cause, pyridoxine |
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microcytic anemias
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iron deficiency, thalassemias, sideroblastic anemias
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normocytic anemias
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anemia of chronic dz, aplastic anemia
-anemia of chronic dz can show as microcytic hypochromic as well |
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anemia of chronic dz
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--CA, RA, SLE, or trauma
-low serum iron, TIBC, and transferrin -increased serum ferritin -normocytic normochromic, but can be microcytic hypochromic -tx underlying dz/do not give iron |
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aplastic anemia
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-BM failure leading to pancytopenia
-idiopathic, radiation, meds, viral, chemicals -thrombocytopenia, fatigue, dyspnea, increased infection -normochromic normocytic anemia -hypocellular BM is definitive -BM transplant, transfusions, and immunosuppression are tx |
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macrocytic anemias
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vit B12 def, folate deficiency, alcoholism
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vit B 12 deficiency
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-pernicious anemia, gastrectomy, diet, chrons dz, tapeworm, etc
- anemia, stamatitic/chelitis, neuropathy -megaloblastic anemia with hypersegmented neutrophils -decreased b12, increased methylmalonic acid and homocysteine levels -do schilling test with redioactive b12 and intrinsic factor -parenteral b12 q month |
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folate deficiency
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-folic acid stores limited
-diet, alcoholism, Ab, pregnancy, hemolysis, methotrexate(folate antagonist), phenytoin, hemodialysis -similar features to b12 deficiency without neuropathy -tx with oral folic acid qd |
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hemolytic anemias
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sickle cell anemia, hereditary shperocytosis, G6PD deficiency, anutoimmune hemolytic anemia, paroxysmal nocturnal hemoglobinuria
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sickle cell anemia
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-autosomal recessive substitution of valine for glutamic acid
-HbA replaced with HbS-in reduced oxygen conditions cells sickle, polymerize, obstruct--ischemia -hemolytic anemia, jaundice, aplastic crises, acute chest syndrome, AVN, priapism, CVAs, chronic leg ulcers -hydration, avoid high altitudes, prophylactic PCN till age 6, vaccinations, folic acid supplements, transfusions, etc -hydroxyurea enhances HbF levels |
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hereditary spherocytosis
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-autosomal dominant defect in gene for spectrin
-loss of cell membrane surface area without reduction in volume--spherical shaped cells -trapped and destroyed by splenic macrophages -hemolytic anemia, jaundice, splenomegaly, gallstones -dx with osmotic fragility to hypotonic saline, elevated retic and MCHC -direct coombs test negative -splenectomy is tx of choice |
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G6PD deficiency
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-X-linked recessive d/o mostly men
-precipitants::sulfonamides, fava beans, nitrofuritoin, primaquine, and infection -episodic hemolytic anemia, dk urine and jaundice -bite cells on smear and Heinz bodies -hydrate, avoid precipitants, RBC transfusions PRN |
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autoimmune hemolytic anemia
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-autoAb to RBC membrane antigen(IgG or IgM)
-IgG(warm):extravascular hemolysis in spleen/lymphomas/leukemias/malignancies/ drugs/ and collagen vascular dz IgM(cold):intravascular hemolysis in liver/elderly/infection -Coombs test + in warm -steroids and splenectomy, etc |
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paroxysmal nocturnal hemoglobinuria
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-acquired d/o of all blood cell lineage and hematopoietic stem cells
-deficiency of complement inactivating linkage on cell membrane -chronic intravascular hemolysis, normochromic, normocytic anemia, pancytopenia, venous thrombosis -Ham's test, sugar water test, and flow cytometry for dx -glucocorticoids and BM transpplant |
