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Adult Medicine

Hematology-Thalassemia, megaloblastic

1. What are the thalassemia types? Alpha, beta thalassemia
2. What are the characteristics of alpha thalassemia? Deletion of alpha chain, heterozygote, homozygote, double heterozygote (Hgb H dx)
3. What are the characteristics of beta thalassemia? Deletion of beta chain, heterozygote, homozygote, double heterozygote
4. What are the characteristics of beta thalassemia minor (trait)? Heterozygote, asymptomatic, rarely associated with clinical manifestations
5. What is another name for beta thalassemia major? Cooley’s anemia
6. what is the most severe form of congenital hemolytic anemia? Beta thalassemia major
7. What is beta thalassemia major associated with in childhood? Severe anemia in infancy with hepatosplenomegaly
8. What are the labs for Beta thalassemia major? Peripheral blood smear, aniocytosis and poikilocytosis, target cells, teardrop and cigar shaped cells, stippled cells are seen
9. Basophilic red blood cells are seen in which condition? Beta Thalassemia major
10. What are the labs for beta thalassemia major? Hgb electorphoresis, normoblasts
11. What are the treatments of beta thalassemia major? Mostly supportive, transfusions, folic acid, genetic counseling/antenatal dx, prevention and Tx of Fe overload
1. what does megaloblastic mean? It indicates that bone marrow erythropoeisis has specific morphologicfal abnormally called megalobalstosis
2. What does megaloblastic anemia indicate for those patients on cytotoxic drugs? Indicates a Vitamin B12 or Fe deficiency anemia
3. Presence of oval macrocytes and hypersegmented neutrophils on the blood film suggest which anemia? Megaloblastic anemia
4. What are two types of macrocytosis anemias? B12, Folic
5. what are the causes of Folic acid deficiency? Increased demand, inadequate intake, malabsorption, certain drugs
6. Anorexics and alcoholics are pre disposed to what anemia? Folic acid
7. What is affected in megaloblastic anemia? Cells
1. what is the most common cause of pernicious anemia? B12 deficiency
2. What is pernicious? a severe hyperchromic anemia marked by a progressive decrease in number and increase in size and hemoglobin content of the red blood cells and by pallor, weakness, and gastrointestinal and nervous disturbances and associated with reduced ability to absorb
3. what are the causes of B12 deficiency? Malabsorption, certain drugs, neurologic abnormalities
4. Is B12 deficiency an autoimmune disease? Yes
5. What are the functions of B12? Antibody to gastric parietal cells and intrinsic factors
6. What are the causes of malabsorption of B12? Complications of GI surgery, disorders that cause malabsorption, overgrowth of bacteria in the intestine, tropical spruce, some drugs impair absorption
7. What is a similarity of vitamin B12 and folic acid deficiency? Hematologic manifestations are identical in both
8. What differentiate B12 and folic acid deficiency symptom wise? Neurologic abnormalities
9. What are the clinical manifestations of B12 deficiency? Blood, GI tract, and nervous system problems
10. what should the physical exam include for B12 deficiency? vital signs, skin, eyes, mouth/tongue, cardiac, abdominal, neurological
11. What are the labs for B12? CBC, peripheral blood smear, serum levels of B12/folate (differentiate between folate or B12 deficiency), bone marrow, Schilling test, gastric analysis, intrinsic factor,
12. What is Schilling test? Radioactive B12 ingestion to check absorption rate
13. MCV >96 fL suggests what type of anemia? Megaloblastic anemia
14. B12 deficiency shows what type of neutrophils? Hypersegmentation of neutrophils
15. What is clinical manifestation of B12? Mild thrombocytopenia
16. Treatment for B12? B12, folate, and transfusion occasionally
Created by: sap_213