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32 Cards in this Set
- Front
- Back
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MCV lab
type of anemia, causes |
mean corpuscular volume
Nl normocytic anemia microcytic anemia (sm RBC) - iron xu macrocytic anemia (lg RBC) - B12, folate xu. Can't generate full set of chromosomes. |
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MCHC lab
measures? if normal? if low? |
mean corpuscular Hb concentration
Hb by % normochromic, hypochromic (Fe xu) |
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MCH
measures? if normal? if low? |
mean corpuscular Hb
Hb by weight normochromic, hypochromic (Fe xu) |
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TIBC
measures? |
Total Iron Binding Capacity
Maximum Fe that could be bound to transferrin (produced in LV, low in LV dz) |
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Serum Haptoglobin
measures? fxn of haptoglobin? |
Index of Hemolysis
If low, indicates high (intravascular) hemolysis Binds Hb released from RBC destruction to keep Fe from excretion. |
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Direct Coomb's test
indicates? |
autoimmune cause of hemolysis if test is +. Antibodies destroying RBCs.
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Classifications of anemia by etiology:
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Secondary to blood loss
Secondary to increased RBC hemolytic destruction Secondary to decreased RBC production |
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Classifications of anemia secondary to blood loss:
lab results? |
acute - normocytic, normochromic
chronic - looks like iron deficiency (GI bleed) |
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Classifications of anemia secondary to RBC destruction:
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Immune - Hemolytic anemia of newborn due to Rh factor
Hereditary: Enzyme xu - G6P dehydrogenase xu Protein abnormality - spherocytosis (SP sees RBCs as foreign and destroys them) Hemoglobinopathy - defective Hb, SP destroys - sickle cell, thalassemia |
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Classifications of anemia secondary to decreased RBC production causes:
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decreased bone marrow
chronic renal failure dietary B12, iron, folate xu |
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Classification of anemia by RBC size:
causes? |
microcytic - iron xu, thalassemia
macrocytic - B12, folate xu normocytic - acute blood loss |
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Hemolytic anemias?
types? s/sx? causes? |
Intravascular - RBC destruction in vessels. No SPomegaly, sickle cell, G6PD.
Extravascular - RBS destruction by SP. SPomegaly, hereditary spherocytois, thalassemia |
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Aplastic anemia:
etiology? s/sx, labs? |
"No synthesis"
deficient BM = panocytopenia (no blood cells of any kind made) medications, cancer biopsy = hypocellular BM |
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Iron Deficiency Anemia:
labs? common cause? |
microcytic, hypochromic RBCs
low MCV/MCHC, low iron & ferritin, high TIBC GI bleed |
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Megaloblastic Anemia:
etiology? labs? treatment? |
B12 or folate xu - needed for DNA synthesis
pancytopenia (not as low a # as aplastic) oval macrocytosis hypersegmented neutrophil B12 and folate together. W/o B12, peripheral neuropathy is possible due to lack of myelination |
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Causes of B12 deficiency?
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low dietary B12 - strict veg
Intrinsic factor xu - gastrectomy, pernicious anemia (autoimmune attacking parietal cells) Malabsorption - parasites, resection of illeum, Chron's, antibiotic abuse |
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G6PD xu:
cause? factors? s/sx? labs? |
Glucose - 6Phosphate - Dehydrogenase Deficiency
w/o G6PD cells RBCs susceptible to oxidative stress (fava beans, drugs, pollution) and will lyse X-LR (fam. history), race (Med, AfAm) episodic anemia low RBCs, high Blbn, low haptoglobin |
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Sickle Cell Anemia:
cause? labs? s/sx? Tx? |
Hb S - betaglobin is abnormal
high unconjugated Blrb, hemoglobinemia, hemoglobinuria, sickle cells, 85% Hb S high # of infections vaso-occlusive painful crisis aplastic crisis (low Hb concentration) infarcts - SP, KD, bone, retina Tx: hydroxyurea - stimulates Hb F production |
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Sickle Cell Infarcts:
organ? manifestation? |
SP - splenomegaly until @ 2 years, adult = autosplenectomy
Kd - papillary renal necrosis bone - H-shaped fractures, femoral head collapse retina - "sea fans" of vision loss |
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What are the hemolytic anemias?
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G6PD xu
Sickle Cell Anemia Hereditary Spherocytosis Thalassemia |
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What are the clues for G6PD xu?
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1) X-LR
2) intermittent anemia, after exposure to oxidative stressor (fava beans, drugs like anti-malarials) |
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What are the clues for Sickle Cell Anemia?
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1) AR (autosomal recessive)
2) African-American 3) sickle cells 4) HbS |
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What are the clues for Thalassemia?
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1) Mediterranean
2) chipmunk cheeks, crew cut skull 3) requires transfusion --> hemosiderosis --> death from CHF |
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Hereditary Spherocytosis:
cause? population? morphology? labs? s/sx? Tx? |
1) AR spectrin defect --> loss of membrane surface --> loss of biconcave shape
2) small, round shape with no central pallor 3) high MCHC Osmotic fragility (prone to burst) low haptoglobin high indirect bilirubin Coomb's negative 4) anemia splenomegaly jaundice GB stones 5) splenectomy |
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Types of Thalassemia?
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beta thalassemia minor
beta thalassemia major alpha thalassemia |
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Beta-Thalassemia
population types mechanism |
Mediterranean and US
major: Hb F minor: Hb A2 Bad gene leads to bad transcription, leads to deficient hemoglobin production = hypochromic, microcytic anemia. RBC lifespan shortened. |
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Alpha-Thalassemia
population mechanism |
Asia
No gene, no compensation --> fetal death |
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S/sx of Beta-Thalassemia:
Treatment? MCC of death? |
1) Severe anemia requiring transfusions --> hemosiderosis
2) Hepatosplenomegaly - LV/SP increase RBC destruction 3) mild icterus (yellow sclera) 4) chipmunk cheeks & "crew cut," due to BM expansion Tx: Blood transfusion + iron chelation folic acid supplementation BM transplant MCC of death: hemosiderosis |
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Define lymphoma:
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Malignant neoplasm of cells found in lymphoid tissue.
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Types of lymphomas
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Hodgkin's and Non-Hodgkin's
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Define leukemia:
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Abnormal proliferation of one kind of hematopoetic cell, while others are decreased.
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Types of luekemias:
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Acute:
Acute Lymphoblastic Leukemia Acute Myeloblastic Leukemia Chronic: Chronic Lymphocytic Leukemia Chronic Myelocytic Leukemia |
