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NURO 504 Module 5 Hematological Exam Study Guide
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NURO 504 Module 5Hematological Exam Study
Guide
iron deficiency anemia - Answer Anemia resulting when there is not enough iron to build
hemoglobin for red blood cells
Most common in the world
Causes - GI blood loss or menorrhagia, diet, blood donations, malabsorption, increased
requirements = pregnancy, adolescence, infancy.
Daily Recommendations = 15mg/day & 30mg/day for pregnancy women
Iron absorption - Answer Substance that inhibits: soy, bran, dairy, vegetable sources
Substances that enhance: Vitamin C, citric acid, meat/poultry/fish sources
Severe IDA - Answer Non-specific: fatigue, exercise intolerance, weakness,
palpitations, irritability, headaches
Specific: paresthesia, sore tongue, brittle nails, spoon shaped nails, pica for starch, ice,
or clay
Clinical Presentation IDA - Answer Forceful apical pulse (working harder to transport)
Exertional tachycardia
Systolic flow murmur
Pallor of conjunctiva, mucus membranes, nail beds, and palmar creases
Spoon shaped nails (koilonychia)
IDA labs - Answer o Hgb: decreased
o Serum ferritin: decreased
o Serum iron: decreased
o TIBC: increased
oTransferrin saturation: decreased
Oral Iron Preparations - Answer Goal - 150-200mg of elemental iron/day until anemia is
, corrected (325mg tabs of ferrous sulfate 3 times a day). Continue empirically until
ferritin level is >50mcg/L
S/E: nausea, constipation, heartburn, upper GI discomfort, black stool, diarrhea
Empty stomach causes more S/E.
Thalassemia Alpha - Answer Alpha: commonly found in people with ancestry from SE
Asia, India, China, and the Philippines
· Complex inheritance pattern: multiple genes involved
o Silent carrier: one gene affected, asymptomatic normal hgb and RBC
o Alpha minor/trait: two genes affected, carrier, mild anemia, no sx
o Hemoglobin H disease: 3 genes affected, moderately to severely anemic
o Alpha thalassemia major (Hydrops fetalis): four genes affected, leads to premature
births that are either stillborn or die shortly after birth
Thalassemia Beta - Answer Beta: Mediterranean, Middle Eastern, African, or Asian
ancestry
· Autosomal recessive: only 2 genes involved (one from each parent)
o Beta thalassemia minor (trait): one gene affected
o Beta thalassemia intermedia: 2 genes affected, moderate anemia
o Beta thalassemia major (Cooley's anemia): 2 genes affected, severe anemia
Beta thalassemia intermedia - Answer o Moderate microcytic, hypochromic anemia
o Not transfusion dependent
Physical findings - short stature, abnormal facies - due to cranial marrow expansion,
pallor, jaundice, enlarged spleen, liver, heart.
Diagnostics
o Anemia (low hgb)—won't be correctable
o Low MCV
o Normal iron studies
o Hgb electrophoresis (high levels of hgb A2)
Tx - monitor, can progress to major if that happens refer to hematology
Beta thalassemia major - Answer managed by hematology - transfusion, iron chelation
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