Anemia

Question 1

What are the main components of blood?

Answer 1

RBCs, WBCs, Platelets

Question 2

What are common blood disorders?

Answer 2

Leukocytosis, leukopenia, polycythemia, anemia, thrombocytopenia, thrombocytosis

Question 3

What hormone stimulates RBC production?

Answer 3

Erythropoietin (EPO)

Question 4

What is the normal hematocrit range for males vs females ?

Answer 4

Males: 40–54%/ Females: 37-47%

Question 5

What conditions increase hematocrit?

Answer 5

Polycythemia, dehydration, shock, high altitudes

Question 6

What conditions decrease hematocrit?

Answer 6

Anemia, cirrhosis, leukemia, acute blood loss, hemolysis

Question 7

What is the normal hemoglobin range for males vs females?

Answer 7

Males: 13.5–17.5 g/dL/ Females: 12–16 g/dL

Question 8

Why is hemoglobin more important than hematocrit in anemia?

Answer 8

It directly reflects oxygen-carrying capacity

Question 9

What is the best index to classify anemia?

Answer 9

Mean Corpuscular Volume (MCV)

Question 10

What peripheral smear finding is seen in lead poisoning?

Answer 10

Basophilic stippling

Question 11

What peripheral smear finding is seen after splenectomy?

Answer 11

Howell–Jolly bodies, Target cells

Question 12

What condition shows sickle cells on smear?

Answer 12

Sickle cell trait or disease

Question 13

What does an increased reticulocyte index indicate?

Answer 13

Hemolysis, recovery from bleed, post-anemia treatment

Question 14

What does a decreased reticulocyte index indicate?

Answer 14

Fe deficiency, aplastic anemia, untreated pernicious anemia, chronic infection, marrow tumor

Question 15

What lab tests confirm B12 deficiency?

Answer 15

B12, MMA, homocysteine

Question 16

What causes folate deficiency?

Answer 16

Low intake, alcoholism, dialysis, anticonvulsants, methotrexate, pregnancy, cancer

Question 17

What ferritin level rules out iron deficiency anemia?

Answer 17

> 100 ng/mL

Question 18

What transferrin saturation suggests iron deficiency?

Answer 18

<20%

Question 19

What is the normal TIBC range?

Answer 19

240–450 mcg/dL

Question 20

What is anemia of chronic disease (ACD)?

Answer 20

Hypoproliferative anemia due to chronic illness with impaired iron release and low EPO response

Question 21

What are typical lab findings in ACD?

Answer 21

Normal MCV, Hgb ≤10, low EPO, normal marrow iron but impaired release (MOST LIKELY TEST ?)

Question 22

What is the treatment for ACD?

Answer 22

Epoetin alfa injections + supplemental iron, goal Hct ~36%

Question 23

When should IV iron NOT be given?

Answer 23

With an active infection (concern for turning into sepsis)

Question 24

What is sideroblastic anemia?

Answer 24

Hereditary/acquired RBC disorder characterized by abnormal iron metabolism and the presence of ring sideroblasts

Question 25

Why should EPO NOT be given to HD patients with a HGB above 11?

Answer 25

Risk for cardiovascular events, stroke, venous thromboembolism

Question 26

Microcytic anemia Causes & labs

Answer 26

MCV < 80 Causes: Iron deficiency anemia (most common), Thalassemias, Anemia of chronic disease, Sideroblastic anemia Key Labs/Clues: ↓ MCV, ↓ MCH ↑ RDW (in iron deficiency) ↓ Ferritin, ↑ TIBC (iron deficiency)

Question 27

Macrocytic anemia Subtypes & key labs

Answer 27

MCV >100 Subtypes: Megaloblastic (DNA synthesis problem) Vitamin B12 deficiency, Folate deficiency, Drugs (methotrexate, hydroxyurea, antiretrovirals) Findings: hypersegmented neutrophils Non-megaloblastic Alcohol use, Liver disease, Hypothyroidism, Reticulocytosis (e.g., hemolysis) Key Labs/Clues: ↑ MCV Oval macrocytes Hypersegmented neutrophils (if megaloblastic)

Question 28

Normocytic anemia Causes & labs

Answer 28

MCV 80-100 Common Causes: Acute blood loss, Hemolysis, Anemia of chronic disease (can also be microcytic), Aplastic anemia, CKD (low EPO) Key Labs/Clues: Normal MCV Look at reticulocyte count: ↑ Retic → hemolysis or acute blood loss ↓ Retic → marrow failure, aplastic anemia, CKD

Question 29

A serum ferritin level > 200 excludes what?

Answer 29

Iron deficiency (EXCEPT in HD patients)

Question 30

What measurements are used to diagnose iron deficiency anemia?

Answer 30

TIBC, transferrin saturation, ferritin (serum iron alone is unreliable indicator d/t significant fluctuations after eating)