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Heme Onc 4 (nonhemolytic anemias)
Heme Onc First Aid 2012
21
Medical
Professional
05/31/2013

Additional Medical Flashcards

 


 

Cards

Term
Give 5 causes of microcytic (MCV<80) anemia
Definition

Iron deficiency

Anemia of chronic disease (if it progresses that far)

Thalassemias

Lead poisoning

Sideroblastic anemia

Term
What kind of anemia is Anemia of chronic disease?
Definition
Starts as normocytic (normal mcv) and can progress to microcytic (mcv<80) anemia
Term

Iron deficiency anemia

- MCV size

- Describe the RBC look

- 3 lab findings

Definition

- Microcytic (Mcv<80)

- Hypochromatic

- Increased TIBC, decreased Serum iron and serum ferritin

Term
Name 2 causes of macrocytic megaloblastic anemia
Definition

Folate deficiency

B12 (cobalamin) deficiency

Term

α-thalassemia

- MCV size and RBC look

- 3 types

Definition

- Microcytic (Mcv<80) anemia due to α-globin gene mutation)

- Hypochromatic

 

4 gene deletion/mutation: Hb Barts (γ4) Incompatable with life

3 gene deletion/mutation: HbH disease (β4) major anemia

1-2 gene deletion/mutation: minor to no anemia

Term

β-thalassemia

- MCV size and RBC look

- 1 lab finding

- 2 types

Definition

- Microcytic (Mcv<80) anemia

- Hypochromatic with target cells

- Increased HbF (α2γ2)

 

β-thalassemia minor (heterozygote)

β-thalassemia major (homozygote)

Term
What is the cause of β-thalassemia?
Definition
Point mutations in splice sites and promoter sequences decreases β-globin synthesis
Term
Describe the presentation of β-thalassemia minor
Definition

Heterzygotes underproduce the beta chain, but mostly aymptomatic

Increased HbA2 on electrophoresis

Term
Describe the presentation of β-thalassemia major
Definition

Homozygotes have no beta chain, so severe anemia requiring transfusions

See marrow expansion causing skeletal deformities and chipmunk facies

Term

Lead poisoning

- MCV size and RBC look

- 2 lab findings

Definition

- Microcytic (Mcv<80) anemia

- Hypochromatic and RBCs with basophilic stippling

 

- Increased serum iron, decreased TIBC (or transferrin)

Term
How does lead poisoning cause anemia?
Definition
Lead inhibits ferrochelatase and ALA dehydratase which decreases heme synthesis
Term
How does lead poisoning present?
Definition

Lead lines on gingiva and epiphyses of long bones

Neuro problems

Abdominal colic

Term
What is used to treat lead poisoning in kids?
Definition
Succimer
Term
What creates the ringed sideroblasts in sideroblastic anemia, and how do you treat it?
Definition

There's iron laden mitochondria that can't be added to heme

Treat with pyridoxine (B6)

Term

What kind of anemia does folate deficiency cause?

- histo findings

- gross findings

- lab findings

Definition

Macrocytic (mcv>100) megaloblastic anemia

Histo: hypersegmented neutrophils and macroovalocytes

Gross: glossitis

Lab: increased homocysteine but normal methylmalonic acid

Term

What kind of anemia does cobalamin (vit B12) deficiency cause?

- histo findings

- gross findings

- lab findings

Definition

Macrocytic (mcv>100) megaloblastic anemia

Histo: hypersegmented neutrophils and macroovalocytes

Gross: glossitis, neuro problems (subacute combine degeneration)

Labs: increased homocysteine and increased methylmalonic acid

Term
What's the difference between megaloblastic and nonmegaloblastic macrocytic anemias?
Definition

Megaloblastic= there's impaired DNA synthesis due to delayed nuclear maturation relative to the cytoplasm

Nonmegaloblastic= no impairment in DNA synthesis (liver disease and alcoholism)

Term

What kind of anemia does Anemia of chronic disease cause?

- 3 lab findings

Definition

Normocytic anemia which can become microcytic

Labs: increased hepcidin (marker for cell injury), increased ferritin, and decreased TIBC

Term
What is the pathology behind Anemia of chronic disease?
Definition
Increased hepcidin binds ferroportin on instestinal mucosal cells and macrophages inhibiting iron transport and trapping it inside the cells.
Term

What kind of anemia does aplastic anemia cause?

- histo findings

Definition

Normocytic anemia with pancytopenia

Histo: Hypocellular bone marrow with fatty infiltration

Term

What kind of anemia does kidney disease cause? How?

 

Definition
Normocytic anemia due to decreased erythropoietin
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