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18 Cards in this Set
- Front
- Back
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What does high levels of LDH indicate. What causes of anemia have high LDH values?
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LDH is released when cells (for example RBCs) are destroyed. High LDH is found in hemolysis and ineffective erythropoiesis anemias.
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What are some causes of Anemia of decreased production? (5)
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1. Fe deficiency
2. Thalassemia minor 3. Anemias of chronic diseases 4. Plumbism/sideroblastic anemias 5. RBC aplasia |
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What are some examples of chronic inflammation/disease?
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infections: TB, osteomyelitis, pulmonary abscess
inflammation-rheumatoid arthritis, systemic lupus |
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What are three causes of pancytopenia?
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-aplastic anemia
-myelophthisic anemia -myelodysplastic syndromes |
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How do proinflammatory cytokines change RBC lifespan?
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cytokines turn on macrophages and this shortens RBC life by 10 to 20 days.
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What releases lactoferrin? What does it do?
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released from cytoplasmic granules of PMNs. It binds iron better than transferrin and deliver the iron to macrophages.
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What synthesizes Hepcidin and what does it do?
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Hepcidin is synth by the liver and causes iron retention in macrophages by up regulation of a metal transporter.
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What are the consequences of iron being in macrophages (as ferritin/hemosiderin) rather than plasma circulation?
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1. serum ferritin increases
2. reduced GI tract absorption which causes fall in serum iron 3. low serum iron causes low delivery to marro erythroblast (iron-restricted erythropoiesis) |
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What is the mechanism for blunted EPO response for anemia of chronic disease?
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IL-1 and TNF-α inhibit EPO by damaging EPO producing cells. Higher levels of EPO are needed when TNF-α and γ-interferon are present.
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Which three cytokines inhibit erythropoiesis?
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1. γ-Inf
2. Il-1 in the presence of T-cells 3. TNF-α associated with decreased stem cell colony growth (and thus erythropoiesis) |
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What are the three similarities of iron deficiency and ACD? What can sometimes (but not always) be different.
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1. microcytosis
2. low serum iron levels 3. low saturation sometimes low serum ferritin like Fe deficiency (but usually high). |
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How do you determine where the anemia is caused by iron deficiency or chronic disease?
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gold standard: bone biopsy and stain. if iron is present, then ACD. ACD should also have high serum ferritin and a reduced total iron binding capacity. Iron deficiency has high EPO and increased erythropoiesis which causes high soluble Tf receptor. ACD has low soluble Tf receptor due to the blunting of EPO.
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When is anemia of chronic renal disease evident? What is the dominant feature?
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evident when renal function is half normal. major factor is underproduction of EPO.
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In anemia of chronic liver disease how does altered lipid metabolism affect rbc shape?
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mild macrocytosis, target cells and then spur cell ending in hemolysis.
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What does anemia correspond to in HIV infection? What virus can cause pure RBC aplasia?
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anemia corresponds to disease severity (CD4 count). Parvovirus B19 can cause RBC aplasia.
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What is the cause of anemia in pregnancy?
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dilution
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What is myelophthisis in malignancy?
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marrow invasion by metastasis.
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What are some traits of plumbism? What other disorder is it like?
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basophilic stippling, ringed sideroblasts accumulation of lead in brain, bones, gum line. microcytic hypochromic anemia (like thalassemia minor)
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