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26 Cards in this Set
- Front
- Back
Anemia can be a result of 3 pathophysiologic mechanisms.. what are they?
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Proliferation Defect: not enough stem cells, or messed up stem cells
Maturation Defect: Most of anemias are maturation problems Survival Defect: lower survival time of RBC |
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what kind of anemia is associated with
Immune hemolytic anemia Anemia of acute hemorrhage Aplastic anemia End organ failure (endocrinopathy, renal) what is the MCV and MCHC like in this process? *** |
Normochromic Normocytic anemia
(normal MCV, Normal MCHC) |
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what kind of anemia is associated with :
Iron deficiency anemia Thalassemia Anemia of chronic disease (infrequently) Long standing disease what is the MCV and MCHC like in this process? *** |
Hypochromic, microcytic
(low MCV, low MCHC) |
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what kind of anemia is associated with :
Vitamin B12/ Folate Deficiency Refractory Anemias/Myelodysplastic Syndrome (MDS) Liver disease' what is the MCV and MCHC like in this process? *** |
Macrocytic , Normochromic anemia
Increased MCV, Normal MCHC |
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Immature, anuclear red cells containing increased ribosomal RNA for hemoglobin synthesis =
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Reticulocytes
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hemolytic anemia will have a high or low reticulocyte count?
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high
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in anemia, Reticulocytes indicate the degree of effective ______ activity
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Bone Marrow
e.g is the BM compensating for anemia |
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how do you do a corrected reticulocyte count?
*** ON TEST |
(% observed Reticulocytes) X (Patients Hct/45)
example: Anemic individual: RBC 2 X10e9; Hct 19%; Ret 1% absolute Retic No. = .01 X 2 x 10e12 = 20 x 10e9/l Corrected Reticulocyte: 1% X 19/45 = 0.4% (normal 0.8-2.5%) |
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An elevated IRF indicates what in an anemic pt?
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elevated IRF indicates adequate response while normal or subnormal IRF reflects inadequate response
IRF=Immature Reticulocyte fraction |
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B12/Folate deficiency
Chemotherapeutic or retroviral agents Myelodysplastic syndromes Drugs associated with impaired absorption of B12/fotate (contraceptives, anticonvulsants) Toxins (benzene, arsenic) are associated with what type of anemia? |
Megaloblastic Macrocytic Anemia
OVAL |
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Alcoholism and Liver disease should make you think what kind of anemia?
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Round Macrocytosis Non-Megaloblastic
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DNA replication problem where RNA continues to be translated and transcribed with resulting growth of the cytoplasm while nucleus lags behind. One or more cell divisions are skipped leading to larger than normal cells. This describes what?
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Oval Macrocytosis Megaloblastic anemia
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most common cause of oval macrocytosis?
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Folate/B12 deficiency (you will see HYPERSEGMENTED neutrophils)
(remember this was a problem with DNA replication) |
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HYPERSEGMENTED neutrophils is your first tip off that you have what problem?
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Oval Macrocytosis
(remember this was a problem with DNA replication) |
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Folate or B12 deficiency will cause what type of macrocytic anemia?
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OVAL
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MCV>100 should make you think
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Macrocytic anemia
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what must you consider in a child with failure to thrive?
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B12/folate deficiency
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what triad will you see in megaloblastic anemia?
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Triad of oval macrocytes, Howell-jolly bodies and hypersegmented neutrophils
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a defiency in folic acid causes what?
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Folic acid deficiency causes a block in the conversion of dUMP to dTMP resulting in DEFECTIVE DNA SYNTHESIS
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what will be the first sign of anemia associated with a folic acid deficiency?
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Hypersegmented neutrophils
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a deficiency in B12 will cause what two problems
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Necessary for synthesis of methionine, the central reaction in DNA synthesis--Messes up DNA synthesis
Deficient B12 means folate trapped in the n-methyl THF form, meaning B12 deficiency leads to --functional folate deficiency--. |
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a deficiency in Intrinsic factor will lead to what?
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B12 Deficiency
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what will a deficiency in IF and consequentially B12 lead to?
what is this secondary to? associated with? cause? |
PERNICIOUS ANEMIA
secondary to gastric atrophy frequently occurs with other autoimmune diseases due to Auto-antibodies directed against parietal cell |
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What is the Definitive test to distinguish between B12 malabsorption, dietary deficiency or absence of IF?
how does it work? |
Schilling test
give person radioactive B12, see if it is absorbed and then urinated out.. if it is not you need to see if it is malabsorption or IF deficiency Part 2 then gives B12 AND IF, if they then pee it out, you know it was a problem with IF |
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Round rather than oval macrocytes
Hypersegmented PMNs not present Absence of glossitis and neuropathy describes what type of macrocytic anemia? |
Macrocytic Anemia without Megaloblastosis
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Metabolic inhibitors. All rapidly proliferating cells affected, including hematopoietic cells
describes what type of macrocytic anemia? |
Macrocytic Anemia with Megaloblastosis
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