Anemias and Thalasemias
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| Reticulocyte range | show 🗑
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| Corrected retic count calculation | show 🗑
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| show | Red cell Distribution Width; indication of size (anisocytosis)
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| show | 11.5-13.5% - greater than this indicates anisocytosis
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| Serum Iron range | show 🗑
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| show | 250-450 mcg/dl
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| show | iron transport protein; transfers in the 2+ state (ferrous)
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| show | 20-50%
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| show | Iron/TIBC X 100 = %
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| Top three procedures to measure iron | show 🗑
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| show | increased transferrin
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| Reasons for decreased serum Iron | show 🗑
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| Reasons for normal serum iron (in an anemic state) | show 🗑
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| show | hemachromatosis; acute hepatitis; hemolytic anemias; sideroblastic anemia; thalassemia major
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| Reasons for normal changes in serum iron | show 🗑
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| Reasons for increased TIBC | show 🗑
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| show | Anemia of chronic disease; hemolytic anemia; chronic liver disease; hemochromatosis; nephrosis
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| show | Apoferritin (the protein) + iron
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| show | any condition that leads to increased protein: hepatic necrosis; acute-phase reaction; sideroblastic anemia; hemochromatosis
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| Ferritin decreased in . . . | show 🗑
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| show | zinc protoporphyrin; used as a screening test for lead poisoning; elevated in iron deficient conditions (most porphyrin chelates with zincion and makes ZPP)
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| show | pretty much the same thing as ZPP, except instead of measuring porphyrin attached to zinc, you extract the free porphyrins from erythrocytes
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| Ferrous iron | show 🗑
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| show | 3+ state
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| Iron is eaten mostly as . . . | show 🗑
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| show | Ferric (3+)
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| Infant IDA can result from . . . | show 🗑
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| show | GI bleeds
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| Women IDA can result from . . . | show 🗑
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| show | impaired absorption
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| First stage of IDA (first of three) | show 🗑
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| show | Iron-deficient ertythropoiesis - increased TIBC
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| show | Full on IDA - microcytic, hypochromic RBCs; increased ZPP and FEP
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| IDA MCV and MCHC | show 🗑
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| show | decreased; increased; decreased (less than 15%)
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| IDA ferritin, ZPP, TfR (transferrin receptor) | show 🗑
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| show | can be normocytic/normochromic (or micro/hypo); normal to increased hemosiderin in bone marrow (it's there, just isn't released); normal to decreased TIBC; % saturation is >15% (this is key); normal to increased serum ferritin
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| Anemia of Chronic Disease same as IDA | show 🗑
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| show | Vit B12 deficiency; folic acid deficiency
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| MCV of macrocytic anemia | show 🗑
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| show | cobalamine
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| Needed to absorb Vit. B12 | show 🗑
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| Vit B12 absorbed where? | show 🗑
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| Common causes of Vit B12 Pernicious anemia | show 🗑
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| Features of a macrocytic anemia blood smear | show 🗑
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| Macrocytic bone marrow | show 🗑
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| show | increased (they look yellow); decreased; increased (can't carry iron)
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| show | Drink radioactive B12 and measure what percentage is recovered in the urine in 24hrs; if <5 or 7% than repeat with intrinsic factor
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| Clinical features of B12 macrocytic anemia | show 🗑
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| show | jejunum
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| show | weeks; years
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| Sideoblastic anemia aka | show 🗑
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| show | both are micro/hypo; sidero usually has a dimorphic blood picture and papenheimer bodies; sidero has ringed sideroblasts in bone marrow (stained with prussian blue);
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| Bone marrow in sideroblastic anemia has . . . | show 🗑
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| show | increased serum Fe; normal to decreased TIBC; increased %; increased serum ferritin (very important)
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| Hemochromatosis aka | show 🗑
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| show | lead poisoning; congenital dyserythropoetic anemia; thalassemia alpha and beta (among others)
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| Ham's test aka . . . | show 🗑
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| Ham's test tests for what and how does it do it? | show 🗑
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| show | Paroxysmal nocturanl hemoglobinuria (PNH); also can be postive for HEMPAS
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| show | Ham's Test; sugar water test
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| show | HbS
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| show | Beta chain, 6th position, Glu --> Val
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| show | Shows the presence of spherocytes; hereditary spherocytosis, and hemolytic anemias are more fragile (also increased in old blood)
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| show | set up a serial dilution of distilled water and NaCl buffer; first tubes have all 1% NaCl, last tubes have no NaCl; spherocytes will lyse at a higher concentration (in about tube 4) while normally they lyse at about tube 5 or 6
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| What are some associated signs of hemolytic anemias? | show 🗑
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| show | PNH; MAHA; DIC; Drug reaction in G6PD; transfusion reaction; Hereditary spherocytosis; H. eliptocytosis; H. pyropoikilocytosis; H. stomatocytosis
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| Horizontal defects of RBCs | show 🗑
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| Vertical defects of RBCs | show 🗑
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| show | They aren't as flexible- get caught in spleen where there is too much Na; they run out of engery to pump out excess Na and they are destroyed by macrophages
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| show | hgb is decreased; MCV is sligthly decreased; MCHC is increased
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| Problems associated with hreditary elliptocytosis | show 🗑
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| show | Hereditary Pyropoikilocytosis; inherited; horizontal defect; PB shows budding, torn, strange shapes of RBCs
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| Clinical problems associated with HPP | show 🗑
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| show | Often splenectomy is best course; may need exchange transfusions
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| Rh Null disease is associated with . . . | show 🗑
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| What is a thalassemia? | show 🗑
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| What is a hemoglobinopathy? | show 🗑
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| show | increased RBC (erythroid hyperplasia); micro/hypo; target cells, basophilic stippling
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| show | Sideroblastic anemia; there is a disturbed or missing enzyme in the heme synthesis pathway; this leads to iron accumulation within mitochondria, which eventually rupture and deposit the iron into the cell
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| show | Malabsorption
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| show | hypercellular with an increase in erythroid precursors and a decreased M:E ratio; cells show nuclear lagging (megaloblastic changes) "nuclear-cytoplasmic asyncrhony" - metamyelocytes and bands with loose chromatin; increased intercellular destruction
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| show | IDA is <15%, Chronic Disease is >%15
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| What does a longterm hookworm infection do to the blood? | show 🗑
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| What is myelophthisic anemia? | show 🗑
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| What does the blood smear of a burn victim look like? | show 🗑
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| show | decreased M:E ratio, increased cellularity
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| show | decreased M:E ratio; increased cellularity; macrocytic changes (lagging nucleus)
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| What does the bone marrow of hereditary elliptocytosis look like? | show 🗑
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| What condition causes increased Heinz bodies? | show 🗑
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| show | denatured hemoglobin
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| show | RNA and ribosomes
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| show | Iron deposits
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| What is anemia in sickle cell caused by? | show 🗑
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| show | sickled cells stick in narrow capillaries and can cause a vaso-oclusive crisis
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| What causes a vaso-oclusive crisis? | show 🗑
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| What happens to the blood in chronic renal failure? | show 🗑
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| show | can cause stomatocytes and/or ecchinocytes
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| show | typically causes macrocytic anemia; can cause codocytes and/or ecchinocytes
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| What are four states that can lead to target cells? | show 🗑
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| What drugs and chemicals can cause aplastic anemia? | show 🗑
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| Congenital red cell aplasia is called . . . | show 🗑
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| Congenital aplastic anemia is called . . . | show 🗑
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| What does bone marrow in aplastic anemia look like? | show 🗑
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| show | penicillin, quinidine, aldomet,
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| What is the hemolytic mechanism of penicillin | show 🗑
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| show | unknown, but it causes Abs to attack RBCs
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| show | glucose 6 phosphate dehydrogenase deficiencty; the most common erythorcyte enzyme disorder
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| show | helps reduce oxidized glutathione; when it can't the cells burst due to oxidative stress
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| What are some drugs that increase the hemolytic activity in G6PD deficiency? | show 🗑
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| Hemolytic uremia syndrome can cause what complication? | show 🗑
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| show | bacterial infection releases toxins into blood stream; toxins cause release of PLTs which attach to glomeruli and tear up passing RBCs
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| show | children
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| show | adults
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Created by:
redavis2
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