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14 Cards in this Set
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3 causes of decreased RBC production:
4 causes of increased RBC destruction: |
Stem cell defects, DNA synthesis (megaloblastic), erythroid precursor defects
enzyme changes, membrane changes, mechanical/chemical, infections, Ab-acquired |
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Classic example of stem cell proliferation defect anemia:
Aplastic anemia is usually secondary to what? Clinical features? What do you see on PS? Treatment? |
aplastic anemia
infection, radiation, drugs (chloramphenicol), immunologic (50%) fatigue, weakness, dyspnea, fever/infection; see pancytopenia (marked decrease in cells) mild/moderate - supportive severe - allogenic bone marrow |
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Erythroid progenitor defect anemia is usually found with what disease process?
What are the effects on RBC's? What type of anemia? What do you see on PS? Treatment? |
chronic renal failure
decreased RBC survival time, decreased RBCproduction due to decreased EPO, and independent of EPO normocytic/normochromic - see acanthocytes on PS transfusions, manage CRF, give EPO/folic acid |
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Increased development time leads to macrocytic anemia, hypersegmented PMN's (>5 in 5%):
Usually due to what 2 dietary deficiencies? A deficiency in B12 can also cause what in the CNS? What do serum folate and RBC folate check for? Main treatments? Why? |
Megaloblastic anemia
B12, folic acid PC degeneration - wide stance, slapping feet serum folate - short term RBC folate - long term Supplemental - usually due to impaired absorption |
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Type of anemia usually seen with myelodysplasia:
Most common cause of anemia worldwide: Dietary recommendations for males/females of iron: Major causes of iron deficiency? |
refractory megaloblastic
Iron deficiency males - 10 mg/d females - 18 mg/d GI bleeding, GU bleeding |
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Any patient with decreased iron should get what kind of workup? Why?
Eponym for iron deficiency anemia due to autophlebotomy: Two examples of malabsorption causes of iron deficiency? |
GI workup for malignancy - cancer until proven otherwise
Lasthenie de Ferjol syndrome intestinal resection, acquired (altered nRAMP II gene, codes for Fe++ transport across brush border) |
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What type of anemia in iron deficiency? Clinical presentation?
What do you see on PS? Treatment? |
microcytic/hypochromic - pt. likes crunchy foods, chewing on ice chips (pagophagia); decreased [Fe], [ferritin], increased TIBC
anisocytosis, poikilocytosis Fe supplement, per IV |
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Characteristics of Anemia of Chronic Disease?
Lab values in ACD? Treatments? What is not effective? |
usually occurs in chronically ill, multiple medical problems; decreased RBC survival time, erythropoiesis, changes in Fe utilization
decreased [Fe], TIBC, normal or elevated ferritin, normocytic/normochromic anemia Fe supplements are not effective, transfusions if needed |
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What are some causes of marrow infiltration?
Classic disorder for enzyme deficiency anemias? Clinical features of G6PD? Lab values? |
malignancies, myelofibrosis, Gaucher's, histiocytosis, sarcoidosis
G-6-PD deficiency - hereditary, non-spherocytic hemolytic anemia food/drug induced (fava beans, Sulfa drugs), need +family hx Heinz bodies - denatured Hgb; "bite cells", normocytic, normochromic |
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Effect of G6PD on retic count, haptoglobin, LDH/bili:
Treatments? Cause and classic presenting symptom of march anemia; who usually gets it? |
increased retic, decreased haptoglobin, increased LDH/bili
splenctomy, avoid food, drugs that cause it repeated mechanical trauma/lysis of RBC's - S/S - pink urine; common in marathon runners, marching soldiers, prosthetic valves |
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Heavy metal classically responsible for chemical-induced anemia:
Other chemically induced causes? Common cause of infection-induced anemia? |
Lead
pure O2, Cu, insect venoms - bee/wasp, spider venoms Malaria |
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Transmitted by the sand flea, "Carrion disease", adheres to RBC membrane:
Transmitted by deer tick, "Maltese cross" appearance on RBC's: |
Bartenellosis
Babesiosis |
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Immune mediated hemolytic anemia:
Warm type mediated by what IG? Does it involve complement? Cold type mediated by what IG? Involve complement? What do a + direct and indirect Coomb's test mean? |
Warm - IGG (Guam, Georgia); no complement
Cold - IGM (Minnesota); +complement +direct = Ab's on RBC surface +indirect = IG's in serum |
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Where do RBC's die in warm Ab hemolysis?
What is the mainstay of therapy for warm hemolysis? Cold agglutination disease is associated with infection by what bacteria? Eponym for anemia caused by tertiary syphilis? |
spleen, liver
steroids; also use immunosuppressives, splenectomy Mycoplasma Donath-Landsteiner |
