Hematology

Front 1

what causes microcytic anemias?

Back 1

1. MCV <80
2. results from decreased hemoglobin (Hb) production or
3. impaired Hb function

Front 2

name five microcytic anemias

Back 2

1. iron deficiency anemia
2. sideroblastic anemia
3. lead posioning
4. thalassemias
5. sickle cell anemia

Front 3

what is the #1 anemia in the world?

Back 3

1. iron deficiency anemia

Front 4

what is the #1 cause of iron deficiency anemia in the world?

Back 4

1. hookworms

Front 5

what causes iron defiency anemia in the elderly until proven otherwise?

Back 5

1. colon cancer!!!!

Front 6

where do you seen iron def. anemia?

Back 6

1. increased incidence in women of childbearing age secondary to menses
2. dietary deficiency seen in kids

Front 7

what are si/sx of iron def. anemia?

Back 7

1. tachycardia, fatigue
2. pallor all from anemia
3. smooth tongue, brittle nails
4. esophageal webs
5. pica
6. not a dx--must find the CAUSE of iron deficiency!!!

Front 8

what is the dx of iron def. anemia?

Back 8

1. decreased serum iron
2. decreased serum ferritin
3. high total iron binding capacity (TIBC)
4. peripheral smear shows target cells

Front 9

what is seen on peripheral smear in iron def. anemia?

Back 9

1. target cells!!!!

Front 10

what is tx for iron def anemia?

Back 10

1. iron sulfate
2. should achieve baseline heamatocrit within 2 months

Front 11

what is sideroblastic anemia?

Back 11

1. microcytic anemia
2. ineffective erythropoiesis d/t disorder of porphyrin pathway

Front 12

what are etiologies of sideroblastic anemia?

Back 12

1. ineffective erythropoiesis d/t disorder of porphyrin pathway
2. chronic alcoholism
3. drugs (commonly isoniazid)
4. genetic

Front 13

what is seen in labs with sideroblastic anemia?

Back 13

1. ineffective erythropoiesis d/t disorder ofo porphyrin pathway
2. high iron
3. N/high TIBC
4. high ferritin

Front 14

what is seen on iron stain of bone marrow with sideroblastic anemia?

Back 14

1. ringed sideroblasts on iron stain of bone marrow

Front 15

what is a mneumonic for microcytic anemia?

Back 15

TAILS:
T= thalassemia
A= anemia of chronic dz
I= iron def. anemia
L= lead toxicity
S= sideroblastic anemia

Front 16

what is the pathophys of microcytic anemia?

Back 16

1. cell division in bone marrow continues for longer than usual, resulting in smaller cells

Front 17

what are ringed sideroblasts?

Back 17

1. seen in sideroblastic anemia
2. revealed by Prussian blue stain of the bone marrow
3. cells with iron deposits encircling the red cell nucleus

Front 18

what is tx for sideroblastic anemia?

Back 18

1. sometimes responsive to pyridoxine (vit B6) supplements

Front 19

what are si/sx of lead poisoning?

Back 19

1. microcytic anemia
2. encephalopathy (worse in children)
3. seizures, ataxic gait
4. wrist/foot drops
5. renal tubular acidosis

Front 20

what are classic findings of lead poisoning?

Back 20

1. Bruton's lines= blue/gray discoloration at gumlines
2. Basophilic stippling of red cells (blue dots in red cells)
3. high serum lead level

Front 21

what are Bruton's lines?

Back 21

1. seen in lead poisioning
2. blue/gray discoloration at gum lines

Front 22

what is tx for lead poisoning?

Back 22

1. chelation c/ dimercaprol (BAL) and or EDTA

Front 23

what is the pathophys of thalassemias?

Back 23

1. hereditary dz of decreased production of globin chains
2. causes decreased production of Hb
3. can differentiate through gel electrophoresis of globin protiens

Front 24

what is pathophys of alpha-thalassemia?

Back 24

1. decreased alpha-globin chain synthesis
2. 4 alpha alleles normally
3. seen commonly in Asians, less so in AA and mediterraneans

Front 25

what is pathophys of alpha-thalassemia with 1 allele affected?

Back 25

1. carrier state
2. no anemia, aSx
3. no abnlmalities on blood smear

Front 26

what is pathophys of alpha-thalassemia with 2 alleles affected?

Back 26

1. alpha-thalassemia minor
2. usually clinically silent
3. mild microcytic anemia

Front 27

what is pathophys of alpha-thalassemia with 3 alleles affected?

Back 27

1. HbH disease
2. precipitation of beta-chain tetramers
3. intraerythrocytic inclusions seen on blood smear

Front 28

what is pathophys of alpha-thalassemia with 4 alleles affected?

Back 28

1. Hydrops fetalis
2. fetal demise, total body edema
3. Bart's beta-4 Hb precipitations

Front 29

what is pathophys of beta-thalassemia?

Back 29

1. decreased beta-globin chain synthesis
2. there are 2 beta alleles normally
3. usually of mediterranean or AA descent

Front 30

what are si/sx of thalassemia major?

Back 30

1. B-/B-
2. anemia develops at age 6 mon (d/t switch from fetal gamma Hb to adult beta Hb)
3. splenomegaly
4. frontal bossing d/t extramedullary hematopoiesis
5. iron overload (secondary to transfusions)

Front 31

what is seen in electrophoriesis with thalassemia major?

Back 31

(B-/B-)
1. very low HbA (a2B2)
2. high HbA2 (a2d2)
3. high HbF (a2g2)

Front 32

what is tx for thalassemia major?

Back 32

(B-/B-)
1. folate supplementation
2. splenectomy for hypersplenism
3. transfuse only for severe anemia

Front 33

what is pathophys of thalassemia minor?

Back 33

(B+/B-)
1. typically aSx carriers
2. NO HbF seen!!
3. tx by avoiding oxidative stress

Front 34

what is seen in electrophoriesis with thalassemia minor?

Back 34

(B+/B-)
1. low HbA (a2B2)
2. high HbA2 (a2d2)
3. NO HbF (a2g2)!!!!!

Front 35

what is tx for thalassemia minor?

Back 35

(B+/B-)
1. avoid oxidative stress!!!