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20 Cards in this Set
- Front
- Back
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21. Most accurate diagnostic test for thalassemia?
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a. Hemoglobin electrophoresis
b. Beta: elevated HgA2, HgF c. Alpha: Normal. |
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22. Most accurate diagnostic test for sideroblastic anemia?
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a. Prussian blue stain.
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23. What is the best initial therapy for anemia of chronic disease?
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a. Correct the underlying disease.
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24. Best initial therapy for thalassemia?
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a. No treatment
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25. what is the best initial therapy for MINOR sideroblastic anemia?
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a. Prescribe pyridoxine replacement.
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26. what is the best initial therapy for Major sideroblastic anemia?
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a. Remove the toxin exposure.
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27. A 62-year-old man with a history of anemia from a bleeding peptic ulcer comes for evaluation. He is constipated and has black stool. His medications are omeprazole, oral ferrous sulfate, and occasional liquid antacids. What would you do next?
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a. EGD
b. colonoscopy c. guaiac testing/hemoccult d. discontinue omeprazole e. increase the dose of ferrous sulfate 1. answer: C- oral ferrous sulfate can turn the stool black, but elemental iron, such as this does not make the stool guaiac positive. Only the iron hemoglobin or myoglobin can make the stool guaiac card positive. |
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28. How is alpha- thalassemia, most accurately diagnosed?
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a. DNA sequencing.
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29. Most important diagnostic test for anemia?
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a. Iron studies/profile (FE level, FE, saturation, ferritin, TIBC).
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30. Most accurate test for anemia?
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a. Bone marrow biopsy.
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31. What type of anemia is associated with an elevated RDW (only one type)?!?
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a. Iron deficiency.
b. This is because the newer cells are progressively smaller and smaller; therefore, the red cell with changes over time. |
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32. For what type of anemia is prescient blue diagnostic?
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a. Sideroblastic anemia.
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33. Pathophysiology of sideroblastic anemia?
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a. Associated with iron building up inside the mitochondria of the red cell.
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34. HgH?
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a. Beta-4 tetrades.
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35. A 68-year-old woman is found on routine CBC to have a hematocrit 32% (normal 37-42%) and an mcv OF 70. Her stool is heme negative.what should you do next?
a. Colonoscopy b. sigmoidoscopy c. barium enema d. upper endoscopy e. two more stool tests now f. repeat the stool testing in a year g. capsule endoscopy |
1. answer: colonoscopy is indicated in all patients >50 as routine screening. Hence, in this case, the patient needs colonoscopy anyway, regardless of what the school test show.
2. In other reason to go straight to colonoscopy is the presence of Microsoft anemia. 3. Unexplained microcytic anemia in a patient above 50 is most likely caused by colon cancer. |
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36. What is the only microcytic anemia with a high reticulocyte count?
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a. HgH.
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37. A patient comes with end-stage real disease for evaluation of shortness of breath. After dialysis, he's found to have a hematocrit of 28 with an MCV of 68. Iron studies are performed. What you expect to find?
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a. Iron level
b. TIBC c. Ferritin d. RDW 1. Iron level: Low 2. TIBC: Low 3. Ferritin: Normal 4. RDW: Normal 2. anemia of chronic disease, such as that found in patients with end-stage real disease, is associated with normal or increased amounts of iron in storage ( ferritin/TIBC), but the inability to process the iron into usable cells and hemoglobin. 3. The only form of anemia of chronic disease that reliably responds to epo in is caused by in-state real disease e. can you see extra vascular hemolysis in the peripheral smear? 1. No. “extravascular” hemolysis occurs in spleen and liver, so you cannot see it on the smear. |
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38. Note: all anemia presents with fatigue, including macro sick anemia, which is caused by vitamin B12 of folate deficiency.
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Note: all anemia presents with fatigue, including macro sick anemia, which is caused by vitamin B12 of folate deficiency.
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39. Presentation of B12 deficiency in addition to fatigue?
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a. Neurologic findings- the most common is peripheral neuropathy, but any neurological abnormality can develop at any part of the peripheral or central nervous system.
1. The least common neurological problem is dementia. 2. Neurological problems resolve with treatment if they have been present for a short period of time. 3. B12 deficiency also causes a smooth tongue (glossitis) and diarrhea. |
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40. How does folate deficiency differ from B12 deficiency?
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a. Folate deficiency does not present with neurological problems.
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