Lecture 8: Anemia Case Studies Flashcards Preview

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Flashcards in Lecture 8: Anemia Case Studies Deck (18)
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What are 3 common symptoms and 4 common signs of anemia?

Symptoms: fatigue, exercise intolerance, rapid heartbeat

Signs: pallor (conjunctiva or muscosa), tachycardia, systolic murmur, edema


What is the earliest and most sensitive sign of Iron Deficiency Anemia?

increased RDW (Red Cell Distribution Width)

- also called Anisocytosis


What are three indications of low iron? What are 2 indications that the body is WAITING for iron?

- low serum iron, low serum ferritin (reflects iron stores), and low transferrin/TIBC (total iron binding capacity)

- increased TIBC and transferrin receptor (TFR)


What do the terms "onychoschizia" and "koilonychia" mean?

O - split nails

K - spooned nails


What are common signs of Iron Deficiency Anemia?

tired, weight loss (cancer/inadequate nutrition), nail problems

- also: conjunctival pallor and cheilosis (angular stomatitis --> around mouth)

PICA --> compulsion to eat substances such as ice, chalk, soil, paper


What should you look for in postmenopausal females or males suspected of iron deficiency anemia?

sources of gastrointestinal blood loss

- do a stool guaiac test (positive for fecal occult blood)


How does anemia of blood loss present? What are 3 common results of anemia from acute blood loss?

- presentation is ACUTE (hypovolemia/heart attack)


results --> hypovolemia, myocardial ischemia (supply vs demand), renal failure


How much should a single unit of RBC increase Hgb by?

1 g/dL


What blood type is the universal donor and what type is the universal acceptor? How does Rh +/- factor into blood transfusions?

UD: type O blood (has no antigens on it)
- RBCs can be given to anyone
- can receive all types of plasma (no Ags on it)

UR: type AB (produces no antibodies)
- plasma can be given to anyone

- only give Rh+ blood to blood types that are positive, Rh- can give blood to their own type and AB- (O- can be given to anyone regardless of +/-)


What is Sickle Cell Disease?

- autosomal recessive causing predominately HbS hemoglobin (rather than HbA) due to Glutamic Acid --> Valine mutation

- particularly prominent in West Africans (survival against endemic malaria)

African Americans have an 8% prevalence


What is the confirmatory test for Sickle Cell Anemia?

gel electrophoresis


How does sickle cell anemia cause stroke, acute chest pain, and renal manifestations?

S - vaso-occulsion (affects 15% of children)

ACP - common cause of death in adults with SCA
- vaso-occlusion by marrow emboli of necrotic bone
- pulmonary vaso-occlusion dec. oxygen count

RM - urine cannot be concentrated due to damage
- hematuria (even in heterozygous peeps)


What bone manifestation can occur in Sickle Cell Anemia?

Avascular Necrosis

- can lead to long-term disability


What are common therapies for Sickle Cell Anemia?

- start oxygen, give NSAIDS (hydrocodone) for pain

- avoid high altitudes and intense exercise

- Hydroxyurea (dec. HbS, more HbF) and transfusions

- possible stem cell transplant


Who would be the best person to receive a blood transfusion from and why?

- we can potentially generate alloantibodies against transfusions unless we possess that antigen

- chronic transfusions should be received from a donor pool as genetically identical to you as possible


What is Aplastic Anemia? Who does it affect?

- a pancytopenia with bone marrow HYPOcellularity

- typically presents in adolescents and young adults

- bleeding is usually first indication something is wrong


What 6 common drugs can lead to Aplastic Anemia? (CCNAHS)

Chloramphenicol, Chloroquines, NSAIDS, anticonvulsants, heavy metals, sulfonamides


How can Aplastic Anemia be treated?

- transfusion or growth factor support

- if no spontaneous resolution, try stem cell transplant