Term
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Definition
| Fissures at corner of mouth |
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Term
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Definition
| Bald fissured tongue (no papillae) |
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Term
| What are the 4 most common causes of Microcytic Anemia? (12) |
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Definition
| 1) Iron Deficiency, 2) Acute/Chronic inflammation, 3) Disorders of Globin Chain Synthesis, 4) Sideroblastic Anemias |
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Term
| What is Microcytosis defined as, what does it often represent, and when is it seen (early/late) if due to Iron Deficiency? (13) |
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Definition
| MCV < 80 fl.; It often represents impaired hemoglobin synthesis; Microcytosis does NOT appear in early Fe deficiency stages |
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Term
| What is Hypochromia defined as, how is it judged on peripheral smear, and when is it seen (early/late) if due to Iron Deficiency? (14) |
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Definition
| Refers to decreased MCHC, Judged on Peripheral smear as an increased central pallor; Hypochromia is NOT seen in early Fe deficiency |
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Term
| Normal vs Hypochromia and Microcytosis (15-16) |
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Definition
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Term
| Definition of Anisocytosis and how is it determined? (17) |
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Definition
| Variability in size, determined by the RDW (Red Cell Distribution Width) |
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Term
| Define Poikilocytosis (18) |
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Definition
| Variability in Cell Shape |
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Term
| Image of severe Anisocytosis and Poikilocytosis (19) |
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Definition
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Term
| What is the most common form of Anemia, and what are the morphological features? (20) |
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Definition
| Iron Deficiency Anemia; Seen as Microcytosis, Hypochromia, and Absent Iron Stores |
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Term
| What are some of the common signs and symptoms of Iron Deficiency Anemia? (21) |
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Definition
| Craving for Ice, Pica, and Fatigue |
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Term
| What is Plummer-Vinson Syndrome and what does it result in? (22) |
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Definition
| Esophageal Web that forms in Iron Deficiency anemia; results in Dysphagia |
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Term
| *Iron Requirements for Men, Women/Adolescents, and Pregnant women (23) |
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Definition
| Men: 1mg/day - Women/Adolescents: 3mg/day - Pregnant Women: 5mg/day |
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Term
| *What are the two main forms of Iron obtained from the diet, where is Fe normally absorbed, via what receptors, what environment is Fe best absorbed, and what hormone regulates Fe absorption? (26) |
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Definition
| Heme rings (meat) and Ferric Hydroxide are taken in from the diet, The Fe is absorbed at the Brush Border of the Duodenum and Proximal Jejunum via DMT-1 Receptors; Best absorbed in an Acid environment as Fe++; Hepcidin is the hormone that regulates Fe absorption |
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Term
| How does Hepcidin levels change when there is high Fe? Low Fe? Inflammatory states? |
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Definition
| Low Hepcidin when Low Fe, High Hepcidin when High Fe, High Hepcidin in Inflammatory states |
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Term
| Transferrin and what cells take it up and what happens to it |
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Definition
| Iron Carrier protein that is absorbed by RBC precursors for incorporation into hemoglobin, myoglobin or cytochrome oxidases within mitochondria |
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Term
| Ferritin and what forms it |
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Definition
| Storage form of Fe formed by ferric ion and apoferritin |
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Term
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Definition
| Water insoluble Fe-protein complex (intracellular) |
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Term
| When is it best to obtain blood specimens for serum Fe, and why? (30) |
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Definition
| When patient is fasting because dietary/medicinal Fe can cause transient rises |
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Term
| What are some common causes of Fe Deficiency, and how much daily blood loss must occur to lead to negative Fe balance? (31) |
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Definition
| Blood loss from GI tract or Urinary loss due to Intravascular Hemolysis; 5ml daily blood loss must occur for negative iron balance |
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Term
| Detection of Hemosiderinuria with Prussian Blue (34) |
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Definition
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Term
| What are 3 other major causes of Iron Deficiency that should be considered? (35) |
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Definition
| Pregnancy, Prior Gastric Surgery, or Malabsorption States |
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Term
| What is the Best form of Fe to administer, under what conditions is it best absorbed, and what forms should be avoided? (37) |
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Definition
| Fe should be given orally (as a ferrous salt); It is best absorbed on an empty stomach, and you should avoid slow release forms due to poor absorption |
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Term
| Why is it important not to give Fe if not necessary? (39) |
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Definition
| To avoid inappropriate treatment and side effects |
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Term
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Definition
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Term
| What type of Anemia is Anemia of Chronic Inflamation and what are some causes (43) |
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Definition
| Mild/Moderate Anemia due to chronic infections, trauma, or other chronic inflammatory disorders |
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Term
| Describe the clinical Characteristics of Anemia of Chronic Inflammation (44) |
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Definition
| Low Serum Iron and Transferrin (TIBC), Increased Serum Ferritin, and Increased Hepcidin levels BOUND TO FERROPORTIN to impair Fe absorption/transport |
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Term
| Why should you evaluate Renal function under Anemia of Chronic Inflammation? (46) |
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Definition
| Renal disease can lead to decreased Erythropoietin levels which will make RBC production slow |
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Term
| What is the standard treatment procedure for Anemia of Chronic Inflammation? (47) |
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Definition
| Treat the Underlying Disorder, only give Iron if Iron deficiency present, and Only give Erythropoietin if Renal failure is present |
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Term
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Definition
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Term
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Definition
| Tetramer of 2 alpha and 2 beta chains |
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Term
| What is the most common single gene disorder, what is it caused by, and what are heterozygous forms characterized by? (55) |
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Definition
| Thalassemias; Caused by defect in rate of polypeptide globin chain synthesis and an Imbalance of alpha and beta chain production; Heterozygous forms have only mild asymptomatic microcytic-hypochromic anemia |
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Term
| What are the clinical characterisitcs of Thalassemias? (56) |
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Definition
| Target cells, Basophilic Stippling, Increased Hb A2 (beta thalassemia minor) with normal to increased serum Fe and Ferritin |
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Term
| What is the cause of Beta-Thalassemia Minor, what are the two forms, and what is the typical treatment? (58) |
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Definition
| Point mutations in beta-globin synthesis; Can be 1) absence of production (B0-thalassemia) or 2) Decreased synthesis (B+Thalassemia); No treatment necessary b/c it is mild |
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Term
| Beta-Thalassemia Major (a severe microcytic anemia) will show what on peripheral smears and what are the transfusion dependent patients prone to develop? (59) |
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Definition
| Heinz Bodies; Transfusion dependent patients prone to develop Iron Overload |
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Term
| Appearance of child with Beta-Thalassemia Major (62) |
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Definition
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|
Term
| What causes alpha-Thalassemias? |
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Definition
| Deletions from Chromosome 16 of entire alpha-genes |
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Term
| In Newborns, what can be detected in blood if they have alpha-Thalassemia? |
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Definition
| Hemoglobin Barts (gamma-4) or Hemoglobin H (beta4, unstable) |
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Term
| Unlike beta-thalassemias, alpha-globin genes are duplicated. How many deletions must occur before clinical symptoms of anemia are noticed, what is the disorder called, and what is seen on peripheral smear? |
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Definition
| 3 deletions, known as Hemoglobin H disease; Heinz bodies on peripherl smear |
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Term
| What happens if there are 4 alpha-globin gene deletions? |
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Definition
| Hydrops Fetalis (edema of fetus) with death in utero |
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Term
| Sideroblastic Anemias (the fourth type of microcytic anemia) is a result of... |
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Definition
| Abnormalities of Mitochondrial metabolism |
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|
Term
| What are 1/3 of Sideroblastic anemias responsive to? |
|
Definition
| Pyridoxine in large doses |
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Term
| What are the 4 causes of Acquired forms of Sideroblastic anemias? |
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Definition
| Alcohol, Drugs/Toxins, Inflammatory conditions, or Neoplastic disorders |
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