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30 Cards in this Set

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  • Back
What is aplastic anemia and its si/sx?
1) Failure of hematopoiesis --> dec. RBC, neutrophils, platelets
2) Fatigue, pallor, infection, petechiae
What are some causes of aplastic anemia?
1) Usually idiopathic
2) Drugs (chloramphenicol), toxins (benzene), infections (parvovirus B19, HBV, HCV) radiation, paroxysmal nocturnal hemoglobinuria
How do you Tx aplastic anemia?
1) bone marrow transplant
2) anti-thymocyte globulin
3) growth factors (GM-CSF)
What is megaloblastic anemia?
Impaired DNA synthesis with normal RNA & protein synthesis
What is pathognomonic of megaloblastic anemia on blood smear?
Hypersegmented neutrophils
What are some causes of folic acid deficiency?
1) diet
2) inc. requirements (pregnancy, hemolytic anemia, tumors)
3) drugs (MTX, dilantin)
4) malabsorption
What are some causes of B12 deficiency?
1) Pernicious anemia
2) gastrectomy, ileal resection
3) Diphylloborthrium latum
4) malabsorption
How do you determine the cause of B12 deficiency?
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
Iron is transported to marrow via _____, used by developing RBCs to make _____ and is stored in _____.
transferrin; hemoglobin; macrophages
What is a measure of total body iron stores?
In iron deficiency anemia, what do you see on peripheral blood smear?
Hypochromic microcytosis
Iron deficiency anemia in the elderly is due to _____ _____ until proven otherwise!
colon cancer
What do the labs show in anemia of chronic disease?
Low iron, LOW TIBC, HIGH ferritin
What is the problem in sideroblastic anemia?
Problem is accessing stored iron in mitochrondria in the marrow --> high iron. Look for ringed sideroblasts on iron stain of bone marrow!
What is lead poisoning anemia? Si/sx?
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
How do you treat lead poisoning?
chelate with EDTA, dimercaprol
Intravascular hemolysis is characterized by:
dec. haptoglobin, positive hemosiderin in urine
Extravascular hemolysis is characterized by:
spherocytes on blood smear
Causes of extrinsic hemolysis:
1) incompatible blood transfusion
3) malaria, Clostridium
4) penicillin, a-methyl dopa, quinidine
Causes of intrinsic hemolysis:
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
What is Beta Thalassemia?
Dec. or absent production of hemoglobin beta chains. Blacks and Mediterraneans.
What do you see in B-thalassemia Major?
1) homozygous defect
2) high HbF! high HbA2
3) hypercellular marrow
4) anisocytosis, poikilocytosis
5) high reticulocyte count
6) target cells
What do you see in B-thalassemia Minor?
1) target cells
2) microcytic/hypochromic RBC
3) normal HbF! high HbA2
What is Alpha Thalassemia?
Dec. or absent production of hemoglobin alpha chains. Africans, Asians, Mediterraneans.
What is Barts Hb?
Beta chain tetramers, when have ZERO alpha chains produced. Fetal hydrops.
When do you see Howell-Jolly bodies?
When do you see Heinz bodies?
G6PD deficiency
When do you see spur cells/acanthocytes?
Abetalipoproteinemia, cirrhosis (liver diseases)
When do you see burr cells/echinocytes?
Uremia (kidney disease)
When do you see schistocytes/helmet cells?