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33 Cards in this Set
- Front
- Back
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What is the normal hemoglobin range for an adult?
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12 - 36; 13.5 - 36
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What are the normal values for MCV?
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80 - 100
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What are causes of primary nutritional iron deficiency?
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menstruating females; vegetarianism; children; pregnant females
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What are the common causes of iron-deficiency anemias?
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primary nutritional iron deficiency; chronic blood loss; GI malabsorption
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What are causes of chronic blood loss that can lead to iron-deficiency anemia?
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menometrorrhagia; chronic hemolytic anemia; GI malignancy; PUD; chronic ASA ingestion; intestinal parasitism
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What are GI malabsorption issues that can lead to iron-deficiency anemia?
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celiac disease; chronic gastritis; post subtotal/total gastrectomy
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What are the clinical manifestations of iron-deficiency anemia?
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fatigue and decreased effort tolerance at 10-11 g/dl; pallor; angular cheilitis (aka angular stomatitis); tachycardia often a/w faint murmor
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What are lab findings in iron-deficiency anemia?
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anemia; aniosocytosis (RBC of unequal size) with predominantly small cells; MCV < 80; hypochromasia (decreased MCHC); poikilocytosis; increased RDW; increased TIBC; decreased transferrin saturation
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What does cobalamin (vitamin B12) play an important role in?
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homocysteine metabolism and DNA synthesis
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Why can a B12 deficiency anemai take years to develop?
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because it is highly conserved in the body
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What is the most common cause of B12 deficiency anemia?
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pernicious anemia
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What are some common causes of B12 deficiency anemia beyond pernicious anemia?
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chronic alcoholism; GI malabsorption syndromes (i.e. chronic h. pylori); post-GI surgery; pregnancy; chronic PPI/H2RA use
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What GI surgeries can cause B12 deficiency anemia post-surgery?
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gastrectomy and segmental ileal resection
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What are the clinical manifestations of a patient with B12 deficiency anemia?
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onset of sx is gradual but progressive; anorexia; recurrent fever; generalized weakness (esp of legs); GLOSSITIS; paresthesias (mc in feet and legs); loss of proprioception/vibration sense; hyper-reflexia; ataxia; splenomegaly
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what are the lab findings for B12 deficiency anemia?
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macrocytic anemia; peripheral erythrocyte inclusions (Cabot rings, H-J bodies); leukopenia; hypersegmented neutrophils; thrombocytopenia; decreased serum B12; elevated serum/urine homocysteine; increased serum indirect bilirubin; decreased serum haptoglobin; increased serum LDH
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What are the general clinical course and sequelae for B12 deficiency anemia?
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increased incidence of vascular atherosclerosis; increased incidence of peripheral neuropathy; increased incidence of CHF
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What are risk factors for pernicious anemia?
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family history; blood group A; autoimmune disease -- vitiligo, hashimoto's thyroiditis, addision's disease; hypothyroidism; hypoparathyroidism
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What is the Schilling Test?
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stage 1: oral radiolabeled cobalamin; if radiolabeled cobalamin is not detected then move to stage 2
stage 2: oral radiolabeled cobalamin along with intrinsic factor |
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Patients that are chronic alcoholics commonly suffer from?
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B12 deficiency and folate deficiency
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What are required for methylation of homocysteine to methionine?
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B12 and folate
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Folate depends on the liver for storage which means that
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chronic liver disease leads to folate deficiency
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What is the clinical synopsis for folate deficiency?
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pallor; chronic fatigue; absence of CNS or peripheral neuropathy sx
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What are the lab findings in folate deficiency?
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macrocytic anemia; hypersegmented neutrophils; elevated serum homcysteine level; reduced serum folate levels
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What is the clinical course and sequelae for folate deficiency anemia?
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increased incidence of CAD; increased incidence of restless leg syndrome; without rx leads to progressive anemia culminating in bone marrow failure
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According to Dr. Sims, what is the most common type of normocytic-normochromic anemia?
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anemia of chronic disease
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What are common causes for anemia of chronic disease?
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chronic renal failure; chronic alcoholism; autoimmune disease (i.e. SLE, RA); subacute endocarditis; TB; malignancy; hypothyroidism; addison's disease; HIV
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What does elevated levels of IL-1 do?
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disrupts the normal iron cycle
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What do elevated levels of cytokines do?
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decreased RBC production due to impairment of the transport of iron from iron storage sites
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What are the lab findings of ACD?
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normocytic-normochromic anemia; elevated serum ferritin; usu decreased serum iron; serum transferrin is variable but usu decreased; decreased serum transferrin saturation; elevated serum lactoferrin; elevated ESR; TIBC is variable usu decreased
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What is used to detect autoimmune hemolytic anemia?
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Direct Coombs test
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What are classifications of hemolytic anemias?
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warm antibody type; cold antibody type; paroxysmal cold hemoglobinuria
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What are the general clinical synposis of hemolytic anemias?
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fever; fatigue; weakness; pallor; dyspnea; jaundice; cynosis; tachycardia; darkened urine splenomegaly
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What are the lab findings for hemolytic anemias?
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normocytic-normochromic anemai; poikilocytosis; microspherocytes; polychromasia; reticulocytosis; decreased serum haptoglobin; elevated serum LDH; elevated total serum bilirubin (predominant of indirect); elevated plasma free hemoglobin; hemoglobinuria; elevated urine urobilinogen
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