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NSG 533 Hematological Pathophysiology: Anemias Questions With All Correct Answers 2024/2025
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NSG 533 Hematological Pathophysiology: Anemias Questions With All Correct Answers 2024/2025
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NSG 533 HematologicalPathophysiology: Anemias
Hemoglobin A - ANSHbA- 2 alpha, 2 beta globin chains
95-97% of our hemoglobin
*HbA2- 2 alpha and 2 delta chains; 2-3% of our hemoglobin.
Hemoglobin F - ANSFetal Hg located inside the fetus/new child till 6 months vintage.
-2 alpha and a couple of gamma chains
-Higher affinity for oxygen
Hemoglobin S - ANSSickle cell hemoglobin
Quality disorder of beta.
Lab values - ANSRBC : 4.Five-6
HgB : >thirteen in men, >12 in women
Hct : 40-50 in guys, 35-forty five in women (3X HgB)
Reticulocytes : zero.Five-2%
** Not a part of CBC. If low or everyday but HgB is low, there is some thing occurring with bone
marrow. If high however HgB is low, suppose lively bleed or destruction/hemolysis.
MCV : 80-one hundred (size indicator)
** <80 = Microcytic
>100 = Macrocytic
Microcytic anemia - ANS(MCV <80)
- Bone marrow dysfunction
- IRON DEFICIENCY
- Anemia of chronic disease (inflammation)
- Thalassemia
- Sideroblastic Disease
- Lead exposure
Example of Microcytic anemic patient - ANS-65 yo woman with a h/o obesity, GERD, type II DM,
and arthritis who presents with progressive fatigue x 2 months and anemia. Endorses
, occasional "dark stools" and has recently increased her naproxen use for better arthritis pain
control.
**Naproxen is an NSAID, can lead to peptic ulcer, can lead to bleed. Tarry/dark stools.
Normocytic anemia - ANS(MCV 80-100) ** Most common anemia in hospitalized patients.
- INFLAMMATION
- Elevated ferritin, normal or reduced TIBC, normal smear.
- Malignancy
- RBC aplasia (aplastic anemia)
- Suppression by parvovirus B19
- Medications
Patients with Normocytic anemia - ANS-CKD/ESRD
-Autoimmune disease SLE, RA, sarcoidosis, IBS
-Acute/chronic infections
-Cancer
-Endocrine diseases
-Liver diseases
Macrocytic anemia - ANS(MCV >100)
-Megaloblastic:
*B12 deficiency (pernicious anemia)
*Folic acid deficiency
*Antimetabolite drugs (methotrexate, zidovudine)
-Nonmegaloblastic
*ETOH
*Liver ailment
*MDS
*Hypothyroidism
*Medications (anti-seizure)
Example of patient with B12 deficiency (Macrocytic) - ANS75 year old guy with a records of
hysteria, GERD (takes omeprazole), hypothyroidism, Type II DM (takes metformin) and HTN
who gives with c/o confusion, peripheral neuropathy, and anemia
Omeprazole (or any PPI) with continual use can provide you with B12 deficiency
Metformin can provide you with B12 deficiency
Example of affected person with folate deficiency (Macrocytic) - ANS50 12 months vintage guy
with a h/o smoker, ETOH abuse, HTN, and depression affords with ETOH withdrawal and
anemia.
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