Save
Busy. Please wait.
Log in using Clever
or

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
focusNode
Didn't know it?
click below
 
Knew it?
click below
Don't know
Remaining cards (0)
Know
0:00
share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Acquired Anemia

Hematology

QuestionAnswer
Microcytic anemia: DDx TICS: thalassemia, iron deficiency, chronic inflammation, sideroblastic
Macrocytic anemia suggests: folate or B12 deficiency
Anemia: RBC production problem (vs destruction problem) distinguished by: Retic count; hypoproliferative = retic low (<2); hyper = retic high (>3)
Causes of Fe deficiency anemia Poor diet/intake; decreased absorption (atrophic gastritis, GI surg, sprue, achlorhydria); increased loss (GI bleed, menorrhagia, neoplasm); increased requirements (PG, lactation)
Anemia of chronic dz: lab pattern Likely microcytic. Low Fe, low ferritin, high TIBC. Low erythropoietin
Glossitis, peripheral neuropathy (stocking-glove paresthesias); MCV 110-140; low retic, hyperseg PMNs, high methylmalonic acid = B12 def
Triad: anemia, splenomegaly and jaundice = Hereditary spherocytosis
Fe deficiency anemia tx ferrous sulfate 325mg tid
pernicious anemia tx lifelong B12 supplementation
Hx HTN, nephrotic syndrome, CRF or Renal insufficiency; do CBC: Anemia
PICA, Pregnant & fatigue, Menstruation; cheilosis: Fe Deficiency Anemia
Anemia after colectomy, partial gastrectomy; glossitis, decreased vibratory sensation = B12 or Pernicious anemia
G6PD + Quinidine, Nitrofurantoin, Sulfa, fava beans => Hemolytic anemia
Fatigue, weakness, low fever, purpura, pallor, gingival bleeding; low retic; no HSM = Aplastic anemia
folate def is ______ anemia; erythropoeisis is due to lack of: megaloblastic anemia; lack of methylation
sideroblastic anemia tx: pts do not respond to: EPO; tx underlying cause, poss txn/ chelation
sideroblastic anemia causes myelodysplasia, chronic EtOH, Pb tox
N/N anemia pathophysiology hepcidin upregulation in response to inflammatory mediators
N/N anemia etiology organ fail d/t systemic dz (renal, endo, thy, liver), or impaired marrow fn (2/2 chronic infxn, aplastic anemia, PRCA)
macro anemia 2/2 folate def: S/S glossitis, no neuro sx
macrocytic anemia 2/2 B12 def S/S glossitis, pale icterus, GI sxs; neuro sxs (posn, vib sense, stocking-glove paresthesia, ataxia)
B12 def causes No. 1 pernicious anemia; veganism, blind loop syndrome, gastric surg, panc insuff, Crohn dz
Most common cause of anemia worldwide Fe def anemia
HYPOproliferative anemia due to: Marrow damage, Fe def, dec'd stimulation
HYPERproliferative anemia due to: BM failure to compensate for blood loss or RBC destruction
Enzyme disorder: adequate Fe but can't get it into Hgb; Fe accumulates in ? Sideroblastic anemia; in RBC mitochondria
Causes of B12 def Diet (vegans); malabsorption: inadequate intrinsic factor prodn (70%), terminal ileum dz (sprue, Crohns), tapeworm, drugs
B12 def vs folic acid def B12: meat/dairy; to 5000 mcg in liver (3 yrs); Folic acid: fruit/veg; 5-20 mg stored (few mos)
Acquired stem cell disorder making RBC membrane prone to lysis by complement PNH
In PNH, there is increased risk of: leukemia/myelofibrosis
Acquired hemolytic anemia due to IgM autoantibody Cold agglutinin dz
Evans syndrome (immune thrombocytopenia) AIHA
Anemia: morphology relative to MCV <80 = microcytic; 80-100 = normo; >100 = macro
Anemia: RBC production problem (vs destruction prob) distinguished by: Retic count; hypoproliferative = retic low (<2); hyper = retic high (>3)
Hypoproliferative anemia due to: Marrow damage, Fe deficiency, decreased stimulation
Hyperproliferative anemia due to: BM failure to compensate for blood loss or RBC destruction
Most common cause of anemia worldwide Fe deficiency anemia
Macrocytic anemias Folic acid def; B12 def
Tx B12 def Replacement tx: IV B12; frontload dose
B12 def vs folic acid def B12: meat/dairy; to 5000 mcg in liver (3 yrs); Folic acid: fruit/veg; 5-20 mg stored (few mos)
Causes folic acid def Inadeq intake (ETOH, teens, elder); inc’d req: PG, malignancy, anemias, hemodialysis; Malabsorption [sprue, drugs (phenytoin, barbituates)]; Impaired metabolism (ETOH, methotrexate)
Folic acid def findings Malnourished; glossitis, cheilitis; NO neuro S/S; RBC folate <150 ng/mL
PRCA is contracted: Acquired or idiopathic
Autoimmune dx mediated by T lymphocytes or (rarely) IgG antibody against erythroid precursors PRCA (pure red cell aplasia)
Poss causes include thymoma, solid tumors, SLE, RA, HIV/hep, phenytoin PRCA
PRCA findings Normal lab except low retic; severe anemia S/S
PRCA Tx Stop all meds; poss thymoma resection; IV Ig
Due to BM failure (injury or suppression); pancytopenia Aplastic anemia
Causes of aplastic anemia Idiopathic (50-65% ; likely autoimmune); Phenytoin, sulfonamides; chemotherapy, radiotherapy; benzene, solvents, insecticides; hep, HIV, EBV; PG, SLE, GVHD; Hereditary (rare): Fanconi’s anemia
Aplastic anemia findings NO hepatosplenomegaly; pancytopenia (purpura, pallor, petechiae); low retic; hypocellular BM
Aplastic anemia: diff dx from: 1-MDS; 2-hairy cell; 3-normo 1=abn cells; 2=splenomegaly & abn lymph cells; 3=SLE, hypersplenism, dissem'd infxn
Aplastic anemia tx Family HLA typing; supportive tx (txn/infxn); immunosuppn; GF; BM txplant
Aplastic anemia prognosis Untx'd = fatal; HLA matched txplant: 60-90% cure; ATG tx: partial remission 60-80% (1/3 relapse & 20-50% MDS)
Hemolytic anemias: intrinsic vs extrinsic Intrinsic = prob w/membrane, z defects, hgb (usu hereditary); Extrinstic = autoimmune, drugs or mechanical trauma (often acquired)
Hemolytic anemia lab findings Low haptoglobin; high LDH, indirect bili (not >4-5mg/dL unless underlying liver dz), retic; hemoglobinuria; stable or falling hgb
Workup to distinguish etiology of Hemolysis Clinical & FH; Direct Coombs; Peripheral blood smear; morpho (Heinz bodies, sickle cells, parasites); Hgb electrophoresis
Acquired stem cell disorder making RBC membrane prone to lysis by complement PNH
PNH findings Episodic hemolytic anemia; Venous thrombosis; Deficient hematopoiesis -> pancytopenia; reddish-brown urine; Hemoglobinuria, esp. first morning urine
Episodic hemolytic anemia; Venous thrombosis; Deficient hematopoiesis -> pancytopenia ... indicate: PNH
In PNH, increased risk of: leukemia/myelofibrosis
PNH tx Tx Fe def; prednisone for hemolysis; BM txp if severe
Acquired disorder which IgG autoantibody formed that binds to RBC membrane AIHA (autoimmune hemo anemia)
AIHA: ___% are idiopathic; seen in ___ 50% ; lupus, NHL, CLL
AIHA findings Pos coombs test; severe anemia (6-10); high retic & ind bili; spherocytes & NRBC; Evans syndrome (immune thrombocytopenia)
AIHA tx Prednisone 1 mg/kg/d; splenectomy if fail; Rituximab, Danazol, IVIG if fail; avoid txn
Acquired hemolytic anemia due to IgM autoantibody Cold agglutinin dz
Cold agglutinin dz causes Idiopathic or neoplasm or post-infxn (Monoclonal gammopathy, mono, mycoplasma)
Cold agglutinin dz findings Mottled/numb fingers/toes; anemia is rarely severe; mild reticulocytosis; spherocytes; Pos Coombs for complement; Pos cold agglutinin test; Chilled blood will look clumped on slide
Cold agglutinin dz tx Symptomatic, avoid cold; poss Rituximab or immunosupp or plasmapheresis; no splenectomy/steroid
Evans syndrome (immune thrombocytopenia) AIHA
Neutropenia findings Stomatitis; fever; poss septicemia, pneumonia and cellulitis
Neutropenia tx DC potl causative agents; tx infxns; poss GF (G-CSF) for severe
Anemia: no hepatosplenomegaly aplastic anemia
Anemia without neuro Sx/Sx suggest: Folic acid def
Aplastic anemia sx/sx do not include: hepatosplenomegaly
Dark blue-gray line along gingival border may be sx of: lead poisoning
most common anemia of hospitalized patients = anemia of chronic disease
Anemia of chronic disease etiologies Chronic inflammatory conditions: infection, IBD, RA, malignancy. CKD
Macrocytic anemia etiologies (PALER) Pernicious anemia. Lung (COPD). EtOH (AST > ALT 2x, increased GGT). Rx (antiseizure meds, methotrexate)
Elevated retic count may be due to: Hemolytic anemia; acute blood loss; response to therapy (within 5-7days)
Low or Normal retic count may be due to: All other forms of anemia (other than hemolytic or acute blood loss)
Created by: Abarnard
 

 



Voices

Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards