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44 Cards in this Set
- Front
- Back
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Microcytic, hypochromic anemia types (MCV < 80)
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Iron deficiency
alpha-thalassemia beta-thalassemia Lead poisoning Sideroblastic anemia |
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Iron deficiency anemia
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Decreased iron due to chronic bleeding
Malnutrition/absorption disorders Increased iron demand (pregnancy) Decreased hemesynthesis |
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Iron deficiency findings
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Micocytosis and hypochromia
May manifest as Plummer-vinson syndrome |
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Alpha-thalassemia
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Defect alpha-globin gene mutations
Decreased alpha-globin synthesis Prevalent in Asian and African populations |
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Alpha-thalassemia findings
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4 gene deletions Hb Barts (gamma 4)
Incompatible with life (cause hydropsfetalis) Three gene deletions HbH disease (beta 4) 1-2 gene deletion: no significant anemia |
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Beta-thalassemia
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Point mutations in splice sites + promoter sequences
Decreased beta-globin sythesis Prevalent in Mediterranean populations |
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Beta-thalassemia minor findings
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Heterozygote
Beta chain is underproduced Asymptomatic Increased HbA2 (> 3.5%) |
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Beta-thalassemia major findings
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Homozygote
Beta chain is absent Requires blood transfusion Marrow expansion -->skeletal deformities (chipmonk f) |
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Both major and minor beta-thalassemia
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Increased HbF
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HbS/beta-thalassemia minor
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Mild to moderate sickle cell disease
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Vitamin B12 deficiency
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Macrocytic, megaloblastic anemia
Hypersegmented PMNs Neurologica symptoms due to abnormal mylein Prolonged deficiency = nervous system damage |
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Vitamin B12 found in
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Animal products
Synthesized by microorganisms |
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Vitamin B12 stored in
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Liver for several years
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Vitamin B12 deficiency caused by
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Sprue
Malabsoprtion (Enteritis + Diphyllobothrium latum) Lack of intrinsic factor (pernicous anemia, gastric bp) Absence of terminal ilieum (Crohn's disease) |
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Findings of megalobalstic anemia due to B12 deficiency
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Hypersegmented neutrophils
Glossitis Decreased B12 Increased homocysteine + increased methylmalonic a Neurological symptoms |
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Deficiency in folic acid
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Macrocytic, megaloblastic anemia w/o neuro problems
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Causes of folic acid deficiency
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Alcoholism + pregnancy
Phenytoin, sulfonamides MTX |
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Findings of megalobalstic anemia due to folate deficiency
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Hypersegmented neutrophils
Glossitis Decreased folate Increased homocysteine + normal methylmalonic acid |
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Sideroblastic anemia
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Defect in heme synthesis
Hereditary X-lined defect in delta-aminolevulinic acid syn |
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Causes of Sideroblastic anemia
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Alcohol + lead
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Findings of sideroblastic anemia
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Ringed sideroblasts (Fe in mito)
Increased iron, normal TIBC, increased ferritin |
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Treatment of sideroblastic anemia
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Pyridoxine (B6) therapy
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Macrocytic anemia
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MCY > 100
Impaired DNA synthesis: (Mat of Nuc delayed = big cell) |
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Two types of macrocytic anemia
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Megaloblastic + Nonmegaloblastic
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Megaloblast
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Large Erythroblast
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Erythroblast
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Precursor to erythrocyte
Retains nucleus |
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Nonmegaloblastic macrocytic anemia
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Macrocytic anemia where DNA synthesis is unimpaired
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Causes of Nonmegaloblastic macrocytic anemia
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Liver disease, alcoholism
Reticulocytosis --> Inc MCV Metabolic disorder Congenital deficiencies of purine/pyrmidine syn 5-FU, AZT Hydroxyurea |
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Normocytic, normochromic anemia
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Classified as nonhemolytic or hemolytic
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Intravascular hemolysis anemia findings
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Decreased haptoglobin
Increased LDH Hemoglobin in urine (paroxysmal nocturnal) Hemoglobinuria Mechanical destruction (aortic stenosis + prosth valve) |
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Extravascular hemolysis anemia findings
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Macrophage in spleen clears RBC
Increased LDH + increased UCB causing jaundice |
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Types of nonhemolytic, normocytic anemia
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Anemia of chronic disease
Aplastic anemia Kidney disease |
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Anemia of chronic disease
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Inflammation causes increased hepcidin
Causes decreased release of iron from macrophages |
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Anemia of chronic disease findings
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Decreased iron
Decreased TIBC Increased ferritin Can become microcytic, hypochromic in long disease |
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Aplastic anemia
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Failure/destruction of myleiod stem cells
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Aplastic anemia findings
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Pancytopenia
Hypocellular bone marrow w/fatty infiltration |
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Pancytopenia
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Reduction in red + white blood cells
Reduction in platelets |
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Symptoms of Aplastic anemia
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Fatigue
Malaise Pallor Purpura Mucosal bledding Petechiae |
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Petechiae
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Red/purple spots on skin
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Treatment of aplastic anemia
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Windrawal of offending agent
Immunosuppresive regimens Allogenic bone marrow transplant RBC + platelet transfusion G-CSF or GM-CSF |
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Kidney disease anemia
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Decreased erythropoietin --> decreased hematopoiesis
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Hereditary spherocytosis (E)
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Defect in ankrin, band 3, protein 4.2, or spectrin
Causes small, round RBCs No central pallor Increased MCHC + Increased RDW |
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Findings of hereditary spherocytosis
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Splenomegaly, aplastic crisis
Hwell-Jolly bodies present after splenectomy |
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Treatment of hereditary spherocytosis
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Splenectomy
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