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Pathoma Anemia – Questions & Verified Solutions (A+)
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Pathoma Anemia – Questions & Verified Solutions (A+)
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Pathoma Anemia – Questions & Verified Solutions (A+)What components are surrogates RBC mass? (3) Right Ans - Hb, Hct, and
RBC count
MCV volumes values Microcytic, Normocytic, Macrocytic Right Ans -
Microcytic= less than 80
Normocytic= 80-100
Macrocytic= over 100
Anemia in males/females Hb values? Right Ans - Males= below 13.5
Females= below 12.5
Microcytic anemia are due to.... Right Ans - decreased production of
Hemoglobin concentration. Cells undergo an extra division to maintain Hb
concentration which makes the cells smaller (microcytic)
What are the ways we can get microcytic anemia? Right Ans - Hb= heme
(Fe+protophoryin) + globin
Decreases in any of these components= decreased Hb= Microcytic anemia
Microcytic anemia diseases/etiologies Right Ans - Fe deficiency, Anemia of
chronic disease (decreased Fe), sideroblastic anemia (decreased
protoporphyrin) , thalassemia (decreased globin)
Most common type of anemia? Right Ans - Fe deficiency
Where does Fe absorption take place in the GI tract?
The enterocytes take up Fe via what transporter?
And what transporter is used to put Fe into the blood? Right Ans -
Duodenum, DMT1, and Ferroportin (in Enterocytes determines whether Fe
should be absorbed into the blood stream)
When Fe is in the blood- what transporter is used to carry Fe?
Where does Fe get transported? Right Ans - Transferrin binds to Fe once in
the blood stream and shipped to the liver and bone marrow macrophages for
storage
,Intracellular Fe- when being stored is bound to which protein? Right Ans -
Ferritin- prevents iron from forming free radicals via Fenton rxn
Meat or vegetable iron is more readily absorbed? Right Ans - Meat Iron
(heme form) is more readily absorbed than vegetable (non-heme form)
Lab Measurements of Fe status
Serum Fe, Total Iron-binding Capacity, % saturation, serum ferritin Right
Ans - TIBC= measure of transferrin molecules in the blood (both bound to Fe
and unbounded)
%sat= %of transferrin molecules bound to Fe (33%=normal)
Serum ferritin- reflects Fe stores in bone marrow macrophages and the liver
causes of Fe deficiency in females/males Right Ans -
Females=menorrhagia/pregnancy. Males= usually due to peptic ulcer disease
( possible H.pylori)
Which protozoa can cause Fe deficiency? Transmission? Tx? Right Ans -
Ancylostoma duodenale and necator americanus. Transmission= penetrate
skin. Rx= Bendazole or pyrantel pamoate
How does gastrectomy cause Fe def.
How does celiac disease cause Fe def? Right Ans - Gastrectomy= removal of
acid production which keeps Fe as Fe2+ (more readily absorbed). Without
acid, Fe becomes Fe3+ (not readily absorbed)
Fe2+ goes in2+ the body
Celiac disease= malabsorption of Fe
Stages of Fe deficiency:
Storage of Fe is depleted= Ferritin;TIBC levels (up/down) Right Ans -
Beginning stage of Fe deficiency- we use up our storage of Fe. Ferritin (reflects
Fe stores in liver/marrow) decrease; TIBC (amount of transferrin in the blood
which fxns to transport Fe to liver/marrow)- increases
Serum Fe and %saturation decrease bc serum Fe is depleted
First initial stage of Fe deficiency is described as normocytic vs microcytic
anemia? Why? Right Ans - Normocytic anemia- Bone marrow makes few
, RBCs, but are normal in size to conserve Fe storage, progresses to microcytic
hypochromic anemia- makes smaller and few RBCs
Pt comes in with Fe deficiency: tell me 3 features that would clue you in to dx?
What Sx make up plummer vinson? Right Ans - Koilonychia (spoon nails),
pica (strange cravings/ice), conjunctiva pallor
Plummer vinson= esophageal web(dysphagia), atrophic glottis (beefy-red
tongue), and anemia
Why is Free erythrocyte protoporphyrin (FEP) increased in Fe deficient
anemia? Right Ans - Heme= Fe+Proto
Less Fe means more Protoporphyrin unbound to Fe thus is free floating within
the RBC
Pt with fever, white round spots on retina, hemorrhages on nailbed, and
lesions on palms and soles. Is most likely to develop which kind of anemia?
Right Ans - Microcytic anemia, specifically anemia of chronic disease- usually
a/w chronic inflammation (endocarditis- dx in stem or autoimmune
conditions) cancer; most common in hospitalized pts
What is acute phase reactant in anemia of chronic disease that contributes to
this anemia? And how does it do so? Right Ans - Hepcidin sequesters Fe in
storage sites by limiting Fe transfer from macrophages to erythroid
precursors (No Fe= low Heme= low Hb= microcytic anemia) and suppressing
EPO (no RBC production)
Lab findings in anemia of chronic disease?
Ferritin, TIBC, Serum Fe, and %saturation, FEP levels Right Ans - Ferritin
and FEP are increased (we have increased storage of Fe thus Ferritin is
increased. We have less Fe available to bind to protoporyhrin which means
more will be free/unbound)
TIBC, serum Fe, %sat are decreased (TIBC- theres less transferrin because we
dont need to transport anymore Fe to storage sites, bc the problem is we cant
get Fe out of the storage sites due to Hepcidin)
Anemia caused by defective protoporhyrin synthesis? Tx? Right Ans -
Sideroblastic Anemia (No Protoporhyrin= low production of Heme= low Hb=
microcytic anemia) Tx= pyroxidine (B6)
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