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30 Cards in this Set
- Front
- Back
What is aplastic anemia and its si/sx?
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1) Failure of hematopoiesis --> dec. RBC, neutrophils, platelets
2) Fatigue, pallor, infection, petechiae |
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What are some causes of aplastic anemia?
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1) Usually idiopathic
2) Drugs (chloramphenicol), toxins (benzene), infections (parvovirus B19, HBV, HCV) radiation, paroxysmal nocturnal hemoglobinuria |
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How do you Tx aplastic anemia?
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1) bone marrow transplant
2) anti-thymocyte globulin 3) growth factors (GM-CSF) |
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What is megaloblastic anemia?
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Impaired DNA synthesis with normal RNA & protein synthesis
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What is pathognomonic of megaloblastic anemia on blood smear?
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Hypersegmented neutrophils
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What are some causes of folic acid deficiency?
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1) diet
2) inc. requirements (pregnancy, hemolytic anemia, tumors) 3) drugs (MTX, dilantin) 4) malabsorption |
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What are some causes of B12 deficiency?
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1) Pernicious anemia
2) gastrectomy, ileal resection 3) Diphylloborthrium latum 4) malabsorption |
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How do you determine the cause of B12 deficiency?
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Schilling Test: give labelled B12 orally and collect 24-hr urine; if low give again with Intrinsic Factor; if still low give again with antibiotics; if still low then probably absorption problem in small intestine
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Iron is transported to marrow via _____, used by developing RBCs to make _____ and is stored in _____.
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transferrin; hemoglobin; macrophages
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What is a measure of total body iron stores?
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Ferritin
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In iron deficiency anemia, what do you see on peripheral blood smear?
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Hypochromic microcytosis
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Iron deficiency anemia in the elderly is due to _____ _____ until proven otherwise!
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colon cancer
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What do the labs show in anemia of chronic disease?
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Low iron, LOW TIBC, HIGH ferritin
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What is the problem in sideroblastic anemia?
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Problem is accessing stored iron in mitochrondria in the marrow --> high iron. Look for ringed sideroblasts on iron stain of bone marrow!
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What is lead poisoning anemia? Si/sx?
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Microcytic hypochromic, inhibition of heme synthesis.
L= lead lines in gums, epiphyses of long bones E= encephalopathy, erythrocyte basophilic stippling A= abdominal pain, anemia D= wrist/foot drop |
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How do you treat lead poisoning?
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chelate with EDTA, dimercaprol
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Intravascular hemolysis is characterized by:
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dec. haptoglobin, positive hemosiderin in urine
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Extravascular hemolysis is characterized by:
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spherocytes on blood smear
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Causes of extrinsic hemolysis:
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1) incompatible blood transfusion
2) DIC, TTP, HUS 3) malaria, Clostridium 4) penicillin, a-methyl dopa, quinidine |
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Causes of intrinsic hemolysis:
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1) hereditary spherocytosis, elliptocytosis, from defective cytoskeletal proteins
2) Paroxysmal Nocturnal Hemoglobinuria: loss of GPI CD55 & CD59 so inc. sensitivity to complement lysis 3) G6PD deficiency |
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What is Beta Thalassemia?
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Dec. or absent production of hemoglobin beta chains. Blacks and Mediterraneans.
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What do you see in B-thalassemia Major?
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1) homozygous defect
2) high HbF! high HbA2 3) hypercellular marrow 4) anisocytosis, poikilocytosis 5) high reticulocyte count 6) target cells |
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What do you see in B-thalassemia Minor?
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1) target cells
2) microcytic/hypochromic RBC 3) normal HbF! high HbA2 |
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What is Alpha Thalassemia?
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Dec. or absent production of hemoglobin alpha chains. Africans, Asians, Mediterraneans.
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What is Barts Hb?
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Beta chain tetramers, when have ZERO alpha chains produced. Fetal hydrops.
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When do you see Howell-Jolly bodies?
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asplenia
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When do you see Heinz bodies?
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G6PD deficiency
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When do you see spur cells/acanthocytes?
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Abetalipoproteinemia, cirrhosis (liver diseases)
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When do you see burr cells/echinocytes?
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Uremia (kidney disease)
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When do you see schistocytes/helmet cells?
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DIC, TTP, HUS
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