Term
| Give 5 causes of microcytic (MCV<80) anemia |
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Definition
Iron deficiency
Anemia of chronic disease (if it progresses that far)
Thalassemias
Lead poisoning
Sideroblastic anemia |
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Term
| What kind of anemia is Anemia of chronic disease? |
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Definition
| Starts as normocytic (normal mcv) and can progress to microcytic (mcv<80) anemia |
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Term
Iron deficiency anemia
- MCV size
- Describe the RBC look
- 3 lab findings |
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Definition
- Microcytic (Mcv<80)
- Hypochromatic
- Increased TIBC, decreased Serum iron and serum ferritin |
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Term
| Name 2 causes of macrocytic megaloblastic anemia |
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Definition
Folate deficiency
B12 (cobalamin) deficiency |
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Term
α-thalassemia
- MCV size and RBC look
- 3 types |
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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 |
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Term
β-thalassemia
- MCV size and RBC look
- 1 lab finding
- 2 types |
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Definition
- Microcytic (Mcv<80) anemia
- Hypochromatic with target cells
- Increased HbF (α2γ2)
β-thalassemia minor (heterozygote)
β-thalassemia major (homozygote) |
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Term
| What is the cause of β-thalassemia? |
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Definition
| Point mutations in splice sites and promoter sequences decreases β-globin synthesis |
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Term
| Describe the presentation of β-thalassemia minor |
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Definition
Heterzygotes underproduce the beta chain, but mostly aymptomatic
Increased HbA2 on electrophoresis |
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Term
| Describe the presentation of β-thalassemia major |
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Definition
Homozygotes have no beta chain, so severe anemia requiring transfusions
See marrow expansion causing skeletal deformities and chipmunk facies |
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Term
Lead poisoning
- MCV size and RBC look
- 2 lab findings |
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Definition
- Microcytic (Mcv<80) anemia
- Hypochromatic and RBCs with basophilic stippling
- Increased serum iron, decreased TIBC (or transferrin) |
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Term
| How does lead poisoning cause anemia? |
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Definition
| Lead inhibits ferrochelatase and ALA dehydratase which decreases heme synthesis |
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Term
| How does lead poisoning present? |
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Definition
Lead lines on gingiva and epiphyses of long bones
Neuro problems
Abdominal colic |
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Term
| What is used to treat lead poisoning in kids? |
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Definition
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Term
| What creates the ringed sideroblasts in sideroblastic anemia, and how do you treat it? |
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Definition
There's iron laden mitochondria that can't be added to heme
Treat with pyridoxine (B6) |
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Term
What kind of anemia does folate deficiency cause?
- histo findings
- gross findings
- lab findings |
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Definition
Macrocytic (mcv>100) megaloblastic anemia
Histo: hypersegmented neutrophils and macroovalocytes
Gross: glossitis
Lab: increased homocysteine but normal methylmalonic acid |
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Term
What kind of anemia does cobalamin (vit B12) deficiency cause?
- histo findings
- gross findings
- lab findings |
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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 |
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Term
| What's the difference between megaloblastic and nonmegaloblastic macrocytic anemias? |
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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) |
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Term
What kind of anemia does Anemia of chronic disease cause?
- 3 lab findings |
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Definition
Normocytic anemia which can become microcytic
Labs: increased hepcidin (marker for cell injury), increased ferritin, and decreased TIBC |
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Term
| What is the pathology behind Anemia of chronic disease? |
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Definition
| Increased hepcidin binds ferroportin on instestinal mucosal cells and macrophages inhibiting iron transport and trapping it inside the cells. |
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Term
What kind of anemia does aplastic anemia cause?
- histo findings |
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Definition
Normocytic anemia with pancytopenia
Histo: Hypocellular bone marrow with fatty infiltration |
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Term
What kind of anemia does kidney disease cause? How?
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Definition
| Normocytic anemia due to decreased erythropoietin |
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