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35 Cards in this Set

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what causes microcytic anemias?
1. MCV <80
2. results from decreased hemoglobin (Hb) production or
3. impaired Hb function
name five microcytic anemias
1. iron deficiency anemia
2. sideroblastic anemia
3. lead posioning
4. thalassemias
5. sickle cell anemia
what is the #1 anemia in the world?
1. iron deficiency anemia
what is the #1 cause of iron deficiency anemia in the world?
1. hookworms
what causes iron defiency anemia in the elderly until proven otherwise?
1. colon cancer!!!!
where do you seen iron def. anemia?
1. increased incidence in women of childbearing age secondary to menses
2. dietary deficiency seen in kids
what are si/sx of iron def. anemia?
1. tachycardia, fatigue
2. pallor all from anemia
3. smooth tongue, brittle nails
4. esophageal webs
5. pica
6. not a dx--must find the CAUSE of iron deficiency!!!
what is the dx of iron def. anemia?
1. decreased serum iron
2. decreased serum ferritin
3. high total iron binding capacity (TIBC)
4. peripheral smear shows target cells
what is seen on peripheral smear in iron def. anemia?
1. target cells!!!!
what is tx for iron def anemia?
1. iron sulfate
2. should achieve baseline heamatocrit within 2 months
what is sideroblastic anemia?
1. microcytic anemia
2. ineffective erythropoiesis d/t disorder of porphyrin pathway
what are etiologies of sideroblastic anemia?
1. ineffective erythropoiesis d/t disorder of porphyrin pathway
2. chronic alcoholism
3. drugs (commonly isoniazid)
4. genetic
what is seen in labs with sideroblastic anemia?
1. ineffective erythropoiesis d/t disorder ofo porphyrin pathway
2. high iron
3. N/high TIBC
4. high ferritin
what is seen on iron stain of bone marrow with sideroblastic anemia?
1. ringed sideroblasts on iron stain of bone marrow
what is a mneumonic for microcytic anemia?
TAILS:
T= thalassemia
A= anemia of chronic dz
I= iron def. anemia
L= lead toxicity
S= sideroblastic anemia
what is the pathophys of microcytic anemia?
1. cell division in bone marrow continues for longer than usual, resulting in smaller cells
what are ringed sideroblasts?
1. seen in sideroblastic anemia
2. revealed by Prussian blue stain of the bone marrow
3. cells with iron deposits encircling the red cell nucleus
what is tx for sideroblastic anemia?
1. sometimes responsive to pyridoxine (vit B6) supplements
what are si/sx of lead poisoning?
1. microcytic anemia
2. encephalopathy (worse in children)
3. seizures, ataxic gait
4. wrist/foot drops
5. renal tubular acidosis
what are classic findings of lead poisoning?
1. Bruton's lines= blue/gray discoloration at gumlines
2. Basophilic stippling of red cells (blue dots in red cells)
3. high serum lead level
what are Bruton's lines?
1. seen in lead poisioning
2. blue/gray discoloration at gum lines
what is tx for lead poisoning?
1. chelation c/ dimercaprol (BAL) and or EDTA
what is the pathophys of thalassemias?
1. hereditary dz of decreased production of globin chains
2. causes decreased production of Hb
3. can differentiate through gel electrophoresis of globin protiens
what is pathophys of alpha-thalassemia?
1. decreased alpha-globin chain synthesis
2. 4 alpha alleles normally
3. seen commonly in Asians, less so in AA and mediterraneans
what is pathophys of alpha-thalassemia with 1 allele affected?
1. carrier state
2. no anemia, aSx
3. no abnlmalities on blood smear
what is pathophys of alpha-thalassemia with 2 alleles affected?
1. alpha-thalassemia minor
2. usually clinically silent
3. mild microcytic anemia
what is pathophys of alpha-thalassemia with 3 alleles affected?
1. HbH disease
2. precipitation of beta-chain tetramers
3. intraerythrocytic inclusions seen on blood smear
what is pathophys of alpha-thalassemia with 4 alleles affected?
1. Hydrops fetalis
2. fetal demise, total body edema
3. Bart's beta-4 Hb precipitations
what is pathophys of beta-thalassemia?
1. decreased beta-globin chain synthesis
2. there are 2 beta alleles normally
3. usually of mediterranean or AA descent
what are si/sx of thalassemia major?
1. B-/B-
2. anemia develops at age 6 mon (d/t switch from fetal gamma Hb to adult beta Hb)
3. splenomegaly
4. frontal bossing d/t extramedullary hematopoiesis
5. iron overload (secondary to transfusions)
what is seen in electrophoriesis with thalassemia major?
(B-/B-)
1. very low HbA (a2B2)
2. high HbA2 (a2d2)
3. high HbF (a2g2)
what is tx for thalassemia major?
(B-/B-)
1. folate supplementation
2. splenectomy for hypersplenism
3. transfuse only for severe anemia
what is pathophys of thalassemia minor?
(B+/B-)
1. typically aSx carriers
2. NO HbF seen!!
3. tx by avoiding oxidative stress
what is seen in electrophoriesis with thalassemia minor?
(B+/B-)
1. low HbA (a2B2)
2. high HbA2 (a2d2)
3. NO HbF (a2g2)!!!!!
what is tx for thalassemia minor?
(B+/B-)
1. avoid oxidative stress!!!