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13 Cards in this Set
- Front
- Back
Microcytic anemia
means |
Microcytic anemia
means a low mean corpuscular volume (MCV), less than 80. |
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what anemia is a result
of iron deficiency, thalassemia, sideroblastosis, and lead poisoning |
Microcytic anemia
|
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Anemia of chronic disease
can be |
Anemia of chronic disease
can be either microcytic or normocytic. |
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Macrocytic anemia
|
Macrocytic anemia is characterized by an elevated
MCV >100.This is most commonly from vitamin B12 or folic acid deficiency but can also result from the toxic effects of alcohol, liver disease, or chemotherapeutic agents such as methotrexate or medications such as zidovudine (AZT) or phenytoin |
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Normocytic anemia is characterized
by a |
Normocytic anemia is characterized
by a normal MCV:These can be from early forms of all the conditions described above as well as most forms of hemolysis. |
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Clinical Presentation. The predominant symptoms of anemia
|
Clinical Presentation. The predominant symptoms of anemia are based on the severity of the
disease rather than the specific etiology. Early symptoms include fatigue, tiredness, and poor exercise tolerance. As the anemia worsens, the patient develops dyspnea on exertion and lightheadedness. Eventually, confusion and altered mental status may develop as oxygen delivery to the brain decreases. Death from anemia is most often from decreased oxygen delivery to the heart, resulting in the development of myocardial ischemia. The severity of symptoms is profoundly related to the underlying condition of the patient. A healthy young patient may have no symptoms at all with a hematocrit of 27-290/0,whereas an older patient with heart disease may develop dyspnea or anginal symptoms with the same hematocrit. |
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Diagnosis.
1 Once a diagnosis of anemia is determined based on.... 2the first step is |
Diagnosis. Once a diagnosis of anemia is determined based on a low hematocrit or hemoglobin,
the first step is to determine the MCV: Iron studies, reticulocyte count, peripheral smear, red cell distribution of width (RDW), Coombs test, vitamin B12, folate levels, and even occasionally a bone marrow biopsy may be necessary to determine a specific etiology. The tests ordered depend on the specifics of the case presented. |
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Treatment. anemia
|
Treatment. Besides blood transfusion, treatment cannot be generalized.
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Packed red blood cells
are used to maintain a hematocrit greater than |
Packed red blood cells
are used to maintain a hematocrit greater than 25-30% This is based on the underlying condition of the patient. A healthy young patient can have transfusion withheld until the hematocrit is in the low 20% An older patient with coronary artery disease will need to be maintained above a hematocrit of 30%. . Whole blood is rarely, if ever, used. |
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The hematocrit should rise..... every
unit of packed red blood cells given |
The hematocrit should rise approximately three points for every
unit of packed red blood cells given |
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If the question describes
a craving for ice or dirt |
If the question describes
a craving for ice or dirt Ii.e., forms of pica.think anemia. Step3 loves to use pica as a lead in to anemia |
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All forms of anemia lead to
|
All forms of anemia lead to fatigue and a subjective sense of loss of energy. .. such as tired.fatigue, malaise, or loss of energy. You will be
able to recognize more severe anemia when the question says short (~r breath, tightheadedness. or Confusion. Other diseases may also present with fatigue or shortnes.. of breath, similar to anemia |
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Diseases with presentations similar to
those of anemia are the following |
Diseases with presentations similar to
those of anemia are the following: • Hypoxia • Carbon monoxide poisoning Methemoglobinemia • Ischemic heart disease |