Iron Deficiency
Inflammatory Anemia
B12/Folate Deficiency
Thalassemia/Hemolysis
Oh my Hemolytic Anemias
100
This is the most natural way patient's can obtain their iron supplements
What is Red Meats/Poultry/fish and Green leafy vegetables
100
This protein causes decreased iron absorption from the enterocyte through internalization and proteolysis of ferroportin in response to inflammatory mediators like IL6
What is hepcidin
100
This most likely occurs due to malabsorption with presenting symptoms of weight loss, glossitis, pallor and jaundice resulting from ineffective erythropoiesis, loss of vibratory sense, proprioception, spastic ataxia, and other dorsal column symptoms, dementia, hallucinations, and frank psychosis
What is cobalamin deficiency
Note: peripheral blood smear shows oval macrocytes and hypersegmented neutrophils, intramedullary hemolysis including decreased haptoglobin, elevated LDH, and elevated indirect bilirubin levels.
100
characterized by an MCV 60-70 fL with a hemoglobin level of 10 to 12 g/dL, produces an increase in hemoglobin A2(α2δ2) because of a substitution of δ globin for β globin
Beta Thalassemia
100
These are the recommendations and guidelines for managment of patient's with sickle cell disease
What is rapid initiation of opioids for vaso-occlusive crisis, Use of incentive spirometry in hospitalized patients, Use of analgesics and physical therapy for treatment of avascular necrosis, Use of ACE inhibitors in patients with microalbuminuria, Regular ophthalmologic examinations, echocardiography to evaluate signs of pulmonary hypertension, and Hydroxyurea for patients with more than 3 vaso-occlusive crises per year, for those with pain or chronic anemia interfering with daily activities, or those with recurrent acute chest syndrome
Preoperative transfusion to serum hemoglobin level of 10 g/dL (100 g/L) for surgeries requiring general anesthesia
Assess for iron overload and begin oral iron chelation if necessary
200
This infection is associated with iron deficiency because of impaired iron uptake and increased iron loss from gastritis or peptic ulcer disease.
What is Helicobacter pylori
200
These values are expected to be seen on CBC in a patient with inflammatory anemia (ACD)? MCV, iron level, TIBC, transferrin sat, ferritin, peripheral smear
What is MCV normal, iron low, TIBC low, transferrin sat low, ferritin high, normocytic normochronic , hemoglobin 8-10g/dL
200
Dietary cobalamin is more available for absorption in an acidic environment but requires binding with this to enhance absorption in the terminal ileum.
What is intrinsic factor
200
Patients with this trait have inadequate production of two copies of the α gene on chromosome 16 (α−/α− or −−/αα). Such patients have a chronic microcytic anemia with hemoglobin levels of approximately 10 g/dL.
alpha-thalassemia
note: Patients with this condition should receive supplemental folate and avoid iron supplementation because they may develop iron overload requiring chelation therapy
200
These are two newly approved drugs for management of sickle cell anemia
What is 1.) oral L-glutamine, a precursor of nicotinamide adenine dinucleotide (NAD), is necessary to form the antioxidant NADH. It is believed that sickle cell crises are partially related to oxidant stress. 2.) P-selectin inhibitor, crizanlizumab, has been shown to reduce painful crises by preventing cellular adhesion.
300
These values are expected to be seen on CBC in a patient with true iron deficiency? MCV, RDW, iron level, TIBC, transferrin sat, ferritin, peripheral smear
MCV <80, RDW elevated, iron low, TIBC high, transferrin sat low, ferritin low <14ug/L, microcytosis
300
Erythropoietin is made here in response to anemia and hypoxia hence patients with kidney disease can have anemia that is typically normochromic and normocytic with a low reticulocyte count
renal cortex
300
A chronic condition caused by lack of cobalamin (B12) due to lack of intrinsic factor either from antibodies against intrinsic factor (70%) or parietal cells (90%) . It is also sometimes associated with grave's disease, hashimoto's thyroiditis, addison's disease and vitiligo
What is pernicious anemia
300
Includes mutations causing reduced surface-to-volume ratio, osmotic fragility, and splenic sequestration. Usually patients are normal until a single infection in adulthood leads to splenomegaly, splenic infarction or rupture, and calcium bilirubinate gallstones
What is hereditary spherocytosis
MCHC elevated, erythrocytes have increased osmotic fragility
300
The hallmark of this type of anemia includes IgM antibodies binding to erythrocytes, positive Coombs test, C3 positive, erythrocyte agluttination on peripheral smear, symptoms of anemia, fatigue, dyspnea, jaundice, acrocyanosis, splenomegaly , association with Mycoplasma and EBV, IgM MGUS, Waldenström macroglobulinemia, B-cell non-Hodgkin lymphomas
What is cold agluttin disease (<37 degrees)
tx: Cold avoidance, rituximab, plasmapheresis, treatment of underlying condition
400
This is an acute phase reactant that increases with inflammation and once >100ug/L virtually excludes iron deficiency
What is Ferritin
400
Guidelines recommend that CKD patients undergoing diaylsis should initiate erythropoesis stimulating agents (ESA) at this hemoglobin level .
What is hemoglobin level less than 10 g/dL
but hemoglobin concentrations should not exceed 11.5 g/dL (115 g/L) to avoid adverse effects, including worsening hypertension, volume overload, and thrombotic complications
400
Although serum cobalamin levels may be low, serum cobalamin, may not adequately represent tissue cobalamin levels. As such, an elevated concentration of this is a more sensitive indicator of cobalamin deficiency.
Methymalonic acid
400
Patient's with hemolytic causes of anemia who are undergoing splenectomy should be vaccinated against what organisms?
What is streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitides
400
this type of anemia is accompanied by thrombocytopenia and is characterized by the presence of fragmented erythrocytes (shistocytes) resulting from shearing as erythrocytes circulate through fibrin strands. Seen in TTP, HUS, eclampsia, malignancy, DIC, hypertensive crisis, or caused by drugs such as cyclosporine, mitomycin, or gemcitabine
What is Microangiopathic hemolytic anemia (MAHA)
500
This is appropriate method to treating IDA in patients with IBD
What is parental iron due to difficulty absorbing oral iron...iron sucrose, ferric gluconate, ferumoxytol, and iron carboxymaltose.
500
What is a burr cell (echinocyte)
500
This is how folate deficiency is distinguished from cobalamin deficiency
folate deficiency: high homocysteine, normal MMA cobalamin deficiency: high homocysteine and MMA
note: if folate level is normal but suspicion is high, check homocysteine level
500
What are bite cells and heinz bodies associated with G6PD deficiency.
Note: important enzymes in reducing NADP to NADPH for oxidative stress pathway. Triggered by fava beans (mediterranean) or sulfa drugs and dapsone
500
This type of anemia develops after physical erythrocyte destruction in the soles of the feet in response to long-distance running or marching. It has also been described in hand drummers and karate enthusiasts.
What is march hemoglobinuria