Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Q3 Clin Med II Test 1 (Heme) > Anemia 2 > Flashcards

Anemia 2 Flashcards

1
Q

Normochromic/Normocytic Anemias (NNA) causes:

w/ ↑ retic count?

w/ normal retic count?

A

w/ ↑ retic count:
post hemorrhage or recent (not chronic) hemolysis

w/ normal retic count:

+ normal bone marrow = ACD, hypothyroidism, liver dx

+ abnormal bone marrow = myelofibrosis, leukemia, myeloma, metastases, renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Megaloblastic (macrocytic) Anemias caused by?

A

B12 and/or folate deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

B12 and/or folate deficiency result in?

A

defective DNA synth =

disordered RBC maturation ->
cytoplasmic RNA accumulation ->
large RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Difference in Peripheral Smear and Bone Marrow results for B12 and folate deficiency?

A

none, they appear identical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens if tx B12 deficiency as a Folate deficiency?

A

Folate replacement alone will correct blood picture, HOWEVER,
must replace B12 also or will results in neuro damage (degen of spinal cord)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cobalamin (B12) absorption?

Daily requirement?

A

Binds to IF in stomach ->
released from IF and absorbed in ileum

Cobalamin (B12) daily requirement = 1 - 2 µg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pernicious Anemia is?

Results in?

A

Autoimmune disorder causing autoantibodies against gastric parietal cells ->
results in IF deficiency

B12 malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Other causes of B12 malabsorption? (4)

A

gastrectomy
iliac dx
bacteria
parasites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pernicious Anemia clinical findings?

A

anemia sxs
glossitis
jaundice
splenomegaly

neuro findings:
↓ vibratory and position sense
ataxia
paresthesia
confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pernicious Anemia typical Lab Results:

MCV

Peripheral Smear

B12

other findings

A

MCV = ↑ (macro)

Peripheral Smear =
hypersegmented neutrophilis,
Anisocytosis,
Poikilocytosis,
macro-ovalocytes (large, oval RBCs)

B12 = ↓

other findings =
+ Schilling test,
IF antibodies,
↑ methylmalonic acid AND homocystiene levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pernicious Anemia tx?

A

parenteral B12:
daily x 7d ->
weekly x 4w ->
monthly x life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Folic Acid daily requirement?

Half-life?

A

200 µg/day (400 - 800 for preggos)

3 wk half-life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Folic Acid deficiency for how long causes anemia?

A

4-5 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of Folate Deficiency?

A 
alcoholism
end term of pregnancy
anticonvulsant therapy
malabsorption
hemolytic anemias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Folate Deficiency clinical findings?

A

typical anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Folate Deficiency typical Lab Findings?

A

folate = ↓

methylmalonic acid = normal
homocysteine = ↑

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Folate Deficiency tx?

A 
tx underlying cause
folate replacement ( 1 mg PO QD or 5 mg if malabsorb)

r/o co-existing B12 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hemolytic Anemia is?

A

early destruction of RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

↑ bone marrow production can compensate for early RBC destruction down to how may days?

A

20 days
(can sustain 2 - 5 times normal RBC production)

RBCs destroyed in less then 20 days, bone marrow can’t compensate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hemolytic Anemia clinical findings?

A

typical anemia
jaundice
gallstones (U) bilirubin
↑ risk of salmonella or pneumococcus infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hemolysis classifed how? (3)

A

1) duration (acute/chronic)
2) acquired or inherited
3) main site of lysis

22
Q

Intravascular vs Extravascular hemolysis?

A

intra - destruction of RBC in blood stream

extra - destruction of RBC in reticuloendothelial system, (U) spleen

23
Q

Hemolysis typical Lab Results:

Retic count

Peripheral smear

other findings

A

Retic count = ↑

Peripheral Smear =
immature RBC,
nucleated RBC,
fragments RBC (schistocytes)

↑ uncong bilirubin
↑ LDH
↑ plasma Hgb

24
Q

Haptoglobin is?

serum levels of haptoglobin in Hemolysis?

A

mucoprotein from liver ->
binds Hgb from lysed RBC ->
bound haptoglobin catabolized ->
free haptoglobin ↓

Serum Haptoglobin = ↓ in INTRAvascular hemolysis

25
Q

Intravascular Hemolysis caused by? (3)

A

Fragmentation syndromes:
-macro or microangiopathic

Red cell enzyme defects:
-G6PD deficiency

Paroxysmal nocturnal Hgburia

26
Q

Extravascular Hemolysis caused by? (5)

A 
Hereditary Spherocytosis
Sickle Cell
Autoimmune Hemolytic Anemia
Incompatible blood transfusion
Drug-induced
27
Q

Hereditary Spherocytosis is?

Results in?

A

auto-dominant disorder

dense RBCs w/ smaller surface area (normal MCV),
RBCs w/ globular appearance and no central pallor,

RBCs trapped in splenic sinusoids

28
Q

Hereditary Spherocytosis clinical findings?

A

(U) asymp

mild jaundice/scleral icterus,
splenomegaly

29
Q

Hereditary Spherocytosis may cause what 2º anemia?

A

megaloblastic anemia due to inadequate folate:

hemolysis causes need for ↑ folate

30
Q

Hereditary Spherocytosis test?

A

Osmotic fragility test:

Defect in RBC membrane results in ↑ RBC destruction when exposed to hypotonic solution

31
Q

Hereditary Spherocytosis tx?

A

splenectomy:
RBC lifespan returns to normal,
ends risk of bilirubin gallstones

pneumo vaccine to combat splenectomy’s ↑ risk of infections

32
Q

Sickle Cell Anemia (SCA) is?

A

auto-recessive Hgb structure disorder,

RBCs misshaped when deoxygenated

33
Q

Sickle Cell homozygous vs heterozygous forms?

A 
homo = disease (Hb SS)
hetero = trait/carrier (Hb S + Hb A)
34
Q

SCA epidemiology?

A

ºBlacks

M=F

35
Q

SCA signs/sxs?

A

start 4-6 mo (fetal Hgb ∆ to adult Hgb),
delayed development,
↑ infections

36
Q

SCA signs/sxs precipitated by? (4)

A

dehydration
hypoxia
high altitude
intense exercise

37
Q

SCA chronic hemolysis results in? (2)

A 
aplastic crisis (sudden ↑ in Hgb),
bilirubin gallstones
38
Q

SCA vaso-occlusive ischemic tissue injury results in? (5)

A 
pain crisis,
osteonecrosis of femoral/humeral heads,
MI,
splenic infarc,
leg ulcers
39
Q

SCA typical Lab Results:

Hgb

color/size

Retic count

Peripheral smear

other

A

Hgb = 5 - 11 g/dl

color/size = normo/normo

Retic count = ↑

Peripheral smear = 
sickled RBCs,
nucleated RBCs,
target cells,
Howell-Jolly bodies,
thrombocytosis

other: Hgb electrophoresis = Hb S

40
Q

Howell-Jolly Bodies are?

A

nuclear remnants U removed by spleen (black dots)

41
Q

SCA tx? (4)

A

RBC transfusion,
pain management,
hydroxyurea (chemo) to ↓ bone marrow fxn Ѧ pain crisis,
bone marrow transplant

42
Q

Autoimmune Hemolytic Anemia (AIHA) caused by?

A

antibodies to RBC ->
fixes complement ->
causes body to destroy cell

43
Q

RBC w/ antigen/antibody complex destroyed how?

A

phagocytized by macrophages ->
form spherocytes ->
spleen destroys

44
Q

Hemolysis tx?

A

tx cause,
corticosteroids,
splenectomy,
folic acid

45
Q

Most antibodies to RBC directed against?

A

ABO/Rh antigens

46
Q

Coomb’s test detects what?

A

patient antibodies coating transfused RBCs

47
Q

Aplastic Anemia is?

A

acquired bone marrow stem cell abnormality:

total or selective (RBC, WBC, platelets)

48
Q

Aplastic Anemia etiology?

A

> 50% idiopathic
20% drug/chemical
10% viral
(P) ionizing radiation

49
Q

Aplastic Anemia clinical findings?

A

weakness, infections, bleeding

Pancytopenia (hallmark): anemia, leukopenia, thrombocytopenia

bone marrow = absent precursors

50
Q

Aplastic Anemia tx?

A 
tx cause,
r/o DDx,
blood component replacement,
bone marrow transplant,
immunosuppressant

Q3 Clin Med II Test 1 (Heme) (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions