Iron Deficiency Anemia(Microcytic) & Macrocytic Anemia (B12, folate def) Flashcards
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| 5213546592 | LOW | If RBCs are overhydrated the hematocrit is ______ | 0 | |
| 5213548189 | HIGH | If RBCs are dehydrated the hematocrit is _____ | 1 | |
| 5213551319 | MCV | If you have clumping of RBCs then CBC may show elevated _____ | 2 | |
| 5213556533 | RDW | If RBCs have a HIGH _____ value, it means the cells are NOT homogenous (some very large, some very low) | 3 | |
| 5213561514 | MCH | How much Hb in the cell compared to surface volume of RBC; average concentration of Hb in cell | 4 | |
| 5213568232 | Reticulocytes = immature RBCs | -immature, non-nucleated RBCs that contain mRNA and are increased when the marrow responds to stress -Elevation of this count indicates that RBCs are being destroyed or you're losing a lot of blood (causing increased production) -depressed count if marrow is not able to compensate with the anemia -normally 0.5-1.5% in adults | 5 | |
| 5213571268 | nucleus of lymphocytes | RBCs should average the size of the _____ | 6 | |
| 5213578873 | fatigue | Most common symptom of iron deficiency anemia is | 7 | |
| 5213598281 | REMEMBER: | Iron deficiency anemia is NOT a diagnosis itself... must identify underlying problem: -GI tract blood loss: H.pylori, peptic ulcer disease -colon polyps -small intestine, tiny BVs that bleed -cancer -GU bleeding (stool, urine) | 8 | |
| 5213609674 | -iron deficiency -anemia of chronic disease/ACD (some) -thalassemias (dysfunction in globin synthesis) -lead poisoning -sideroblastic anemia (dysfunction in heme synthesis) | Microcytic Anemias | 9 | |
| 5213626216 | ferritin (indicative of iron storage) | With iron deficiency anemia, you continue iron therapy until the ______ is normal | 10 | |
| 5219501323 | anemia | insufficient RBC mass to deliver oxygen to peripheral tissues | 11 | |
| 5219549969 | males = 13 females = 12 | lower limit of Hb in adult males is ____ g/dl and for females it is ____ g/dl | 12 | |
| 5219553557 | 120 days | average RBC lifespan | 13 | |
| 5219553558 | 80-100 fl | average RBC volume (MCV) | 14 | |
| 5219585138 | family history diet travel medications blood loss weight loss, fever | relevant anemia history | 15 | |
| 5219591004 | Microcytosis / Microcytic anemia | ________ = RBC MCV of <80 fl | 16 | |
| 5219596632 | -iron deficiency -anemia of chronic disease (ACD) -alpha/beta thalassemia trait is important to consider esp in African Americans | Most likely causes of microcytic anemia | 17 | |
| 5219609829 | GI tract = source of blood loss GI malignancy Menstrual blood loss | Common causes of iron deficiency | 18 | |
| 5219621740 | -decreased iron intake (inadequate diet or malabsorption - gastric surgery, celiac disease, increased gastric pH, tannins in tea) -increased loss: GI/GU loss (gastritis, peptic ulcer disease, menstrual loss) -increased requirements: pregnancy, childhood | Iron Deficiency Anemia: etiology | 19 | |
| 5219648353 | -symptoms of anemia -pica craving for peculiar food or non-food substances e.g. ices, dirt, chalk -restless legs -Koilonychia-spooning of nails -Dysphagia (difficulty swallowing), esophageal web (plummer- vinson or patterson-kelly Sx)- very rare | Clinical manifestations of Iron deficiency | 20 | |
| 5219708459 | decrease serum iron & decrease in ferritin (storage iron) | Earliest signs of iron deficiency | 21 | |
| 5219552599 | 120 days | average RBC lifespan | 22 | |
| 5219738472 | iron deficiency anemia | CBC findings of ______ -increase in RDW and platelets -decrease MCV, MCH, MCHC, RBC, Hb, Hct -retic count not increased -serum: low iron, low ferritin high TIBC | 23 | |
| 5219818296 | total iron binding capacity (TIBC) | maximum amount of iron needed to saturate plasma or serum transferrin, transferrin receptor | 24 | |
| 5219825400 | Hb and MCV | ___ and ____ decreased levels can be seen in Stage 3 of iron deficiency anemia | 25 | |
| 5219860731 | hypochromic & microcytic | Profound central pallor is found in _____ & ____ RBCs | 26 | |
| 5219868323 | 1. Treat UNDERLYING CAUSE 2. Oral Ferrous sulfate 200 mg of elemental iron gives maximal Hb regeneration; absorption impaired by milk, tea, cereals side effects- nausea, constipation/diarrhea, abdominal pain; dark stool | Treatment for Iron deficiency anemia | 27 | |
| 5219889683 | parenteral iron if still fail to respond to therapy: question diagnosis, compliance, associated illness, ongoing blood loss and malabsorption | If intolerant to PO iron, non-compliant, or iron therapy is malabsorbed give ___ for iron deficiency anemia | 28 | |
| 5219906994 | Hb (usually returns to normal after 2 months) retic | Symptomatic response to iron therapy treatment precedes increase in _____; ____ count increased after 5-10 days of Rx | 29 | |
| 5219939357 | Macrocytic anemias | encompasses both megaloblastic and non-megaloblastic anemias MCV > 100 fl | 30 | |
| 5219956038 | megaloblast | -refers to characteristic bone marrow RBC precursors with specific chromatin changes; impaired DNA synthesis -in macrocytic anemia | 31 | |
| 5219963068 | Non-megaloblastic anemias | _______ anemias do NOT have impaired DNA synthesis and RBC precursors are normal -common causes: ETOH, liver disease, alcoholism, | 32 | |
| 5219970207 | Megaloblastic anemia | Anemias caused by -folate deficiency OR -B12 deficiency characteristics: -pancytopenia (may be seen with B12 def.) | 33 | |
| 5219984905 | Pancytopenia | When anemia, leukopenia and thrombocytopenia occur together | 34 | |
| 5220004223 | folate def = occurs rapidly B12 def = takes years to develop | In megaloblastic anemia, _____ deficiency occurs rapidly; _____ deficiency takes years to develop | 35 | |
| 5220022042 | Neurological changes Ineffective erythropoeisis | _______ changes in B12 deficiency may occur without anemia; reversal of changes with treatment is variable Ineffective _____ (destruction of red cells within the marrow may be seen in B12 def) = labs may be suggestive of hemolytic anemia... but....LOW retic count, because hemolysis is occuring within the bone barrow .. | 36 | |
| 5220046986 | 3-4 lobes | Neutrophils normally have _____ lobes | 37 | |
| 5220053476 | megaloblastic anemia; typically B12 deficiency | Hypersegmented neutrophils (ex. 8 lobes) & macro-ovalocytes are characteristic of ... | 38 | |
| 5220058594 | 1- pernicious anemia 2- surgical (several years after total gastrectomy or resection of terminal ileum - site of B12 absorption - acid blocking drugs in the stomach) 3- Zollinger-Ellison syndrome (gastric acid inactivates pancreatic proteases which impairs B12 binding to IF in the ileum) 4-pancreatic exocrine deficiency 5- blind loop syndrome (stasis, colonizing bacteria bind cobalamin-B12) 6- Diphyllobothrium latum infestation (bind B12 and prevent absorption) 7-Dietary deficiency (very rare, vegans) | Causes of B12 (Cobalamin) Deficiency | 39 | |
| 5220119116 | pernicious anemia | autoimmune disorder -associated with vitiligo, hypotheyroidism -failure of secretion of intrinsic factor (IF) - Antibody directed against IF or parietal cells) leading to B12 deficiency | 40 | |
| 5220167218 | B12 deficiency | If see macrocytic anemia with MYELOPATHY & the following symptoms (neuropsychiatric features - subacute combined degeneration-affects posterior and lateral parts of spinal cord) think..... -->Posterior columns (ascending fibers) -sensory disturbances -incoordination (legs)/ ataxia -diminished vibration, position sense -->Lateral columns (descending fibers) -weakness, spasticity | 41 | |
| 5220189233 | Blood test B12 deficient if .... elevated levels of homocysteine AND methyl-malonic acid (MMA) And possibly Anti-IF antibodies in cases of pernicious anemia | If B12 = <200 deficient >400 NOT deficient between 200-400.. do not know so order ___? | 42 | |
| 5220197647 | Folate | ____ deficiency will show elevated levels of homocysteine but NOT MMA | 43 | |
| 5220226217 | B12 | Prophylactic _____ therapy is given in patients with gastric bypass or ileal resection | 44 | |
| 5220236374 | hypokalemia | _____ may occur early on in B12 deficiency Treatment in severe cases bc potassium is an intracellular ion - taken out as maturation proceeds- can occur when you're replacing cells | 45 | |
| 5220254393 | FOLATE/ folic acid (only 3-4 month supply) main food source = plant & animal cooking = easily destroyed | Test results characteristic of ______ deficiency 1- low serum folate concentration (<2ng; reflects recent intake)- cheaper screening test 2- low serum RBC folate concentration (less sensitive to dietary effects) 3-elevated serum homocysteine level (ONLY) | 46 | |
| 5220265139 | 1- inadequate diet (MAJOR cause) - elderly, poverty, alcoholism 2- impaired absorption - non-/tropical sprue, other diseases of small intestine 3- increased requirements - pregnancy, chronic hemolytic anemias, exofiliative dermatitis (ex. psoriasis) | Folate deficiency causes | 47 | |
| 5220281743 | folate prophylactic folate oral treatment given during pregnancy, prematurity, severe hemolytic anemia, dialysis | ____ deficiency can lead to neural tube defects of fetus in pregnant women; but a lot of food is fortified with folate to avoid this (ex. cereals) | 48 |