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Questions and Answers
Which of the following is NOT measured in a complete blood count (CBC)?
Macrocytic anemia is primarily caused by a deficiency in which nutrient?
Which classification describes red blood cells that are smaller than normal?
What condition is specifically associated with the destruction of parietal cells leading to a deficiency of intrinsic factor?
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What is a common symptom of macrocytic anemia?
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Which of the following is NOT a characteristic of normochromic red blood cells?
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Folate deficiency affects which critical process in the body?
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Which type of anemia is indicated by red blood cells that are larger than normal?
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Which of the following conditions can contribute to microcytic anemia?
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Which component is NOT typically included in a complete blood count (CBC)?
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A deficiency in which of the following factors leads to Hemophilia A?
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What type of anemia is primarily characterized by the presence of larger than normal red blood cells?
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What is a common laboratory finding in anemia caused by chronic disease?
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Which of the following conditions is most likely to trigger disseminated intravascular coagulation (DIC)?
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In a patient with suspected macrocytic anemia, which laboratory test is most critical to obtain?
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What is a characteristic feature of normocytic anemia?
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Which condition is MOST often associated with microcytic anemia due to a deficiency?
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Which of the following symptoms is NOT typically associated with folate deficiency?
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What is a primary treatment option for microcytic anemia caused by iron deficiency?
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Which of the following is NOT a common cause of iron deficiency anemia?
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Normocytic anemia is characterized by what feature of red blood cells?
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Which of the following disorders can lead to the development of microcytic anemia?
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Platelet dysfunction can lead to which condition?
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Von Willebrand disease is characterized by which of the following?
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Study Notes
Anemia Severity and CBC
- Anemia can range from mild to severe, impacting red blood cell production/function.
- A CBC assesses red blood cell count, hemoglobin, hematocrit, MCV, MCH, MCHC, and RDW.
Anemia Classification by Red Blood Cell Morphology
- Size: Macrocytic (larger), Microcytic (smaller), Normocytic (normal)
- Color: Normochromic (normal hemoglobin), Hypochromic (reduced hemoglobin, paler)
Macrocytic Anemia
- Larger than normal red blood cells.
- Often caused by Vitamin B12 or folate deficiency.
- Symptoms: fatigue, weakness, pale complexion, possible neurological issues (numbness, tingling)
- Treatment: replace deficient nutrient (B12 injections or folate supplements).
- Other causes: liver disease, hypothyroidism, medication side effects
Pernicious Anemia
- Type of macrocytic anemia caused by Vitamin B12 deficiency.
- Autoimmune destruction of stomach parietal cells, impacting intrinsic factor needed for B12 absorption.
Folate Deficiency
- Common cause of macrocytic anemia, impacting DNA synthesis.
- Folate absorbed in the upper small intestine, independent of intrinsic factor.
- Deficiency caused by lack of dietary folate, poor absorption, or increased need (pregnancy)
- Symptoms similar to B12 deficiency, but neurological symptoms are usually absent.
- Treatment: oral folate supplements.
Microcytic Anemia
- Smaller than normal red blood cells.
- Most commonly caused by iron deficiency, impacting hemoglobin production.
- Other causes: genetic disorders (thalassemia), chronic inflammation, kidney disease.
- Symptoms: fatigue, weakness, pale skin, shortness of breath, brittle nails.
- Treatment: oral iron supplements.
Iron Deficiency Anemia
- Most prevalent type of anemia globally.
- Caused by lack of dietary iron, poor absorption, or blood loss.
- Treatment: address underlying cause and supplement with oral iron.
Normocytic Anemia
- Normal-sized red blood cells.
- Causes:
- Hemolysis (destruction of red blood cells)
- Bone marrow suppression (reduced red blood cell production)
- Anemia of chronic disease (long-term inflammation)
Platelet Dysfunction and Coagulopathy
- Platelet dysfunction: platelets don’t function properly, leading to excessive bleeding.
- Coagulopathy: disorder of the coagulation system, impacting blood clot formation (increased or decreased).
Platelet Dysfunction
- Can be inherited (congenital) or acquired.
- Example: von Willebrand disease (autosomal dominant, defective platelet adhesion) - most common inherited bleeding disorder.
Coagulation Cascade Dysfunction
- Defective coagulation system, impacting clotting ability.
- Deficiency of clotting factors can cause excessive bleeding.
- Causes:
- Vitamin K deficiency (essential for clotting factor synthesis)
- Liver disease (liver produces clotting factors)
- Defective clotting factor absorption
- Medications (warfarin, heparin)
Hemophilia
- Inherited bleeding disorders caused by clotting factor deficiency.
- Hemophilia A: most common, factor VIII deficiency.
- Hemophilia B: factor IX deficiency.
- X-linked recessive disorder (more men affected).
Disseminated Intravascular Coagulation (DIC)
- Serious condition with widespread blood clotting and simultaneous bleeding.
- Triggered by severe underlying medical condition (sepsis, trauma, cancer, pregnancy).
- Complex disorder with potential for fatality.
- Overwhelming activation of the coagulation cascade leads to small clots throughout the bloodstream, blocking blood vessels and causing tissue damage and organ failure.
Anemia Workup - Case Study
- 56-year-old male with 6 months of anemia (hemoglobin 9.6 g/dL).
- Assessing cause:
- Obtain demographic information (age, sex, race)
- Determine duration and severity of symptoms
- Laboratory testing: CBC (including WBC, RBC, platelets), reticulocyte count, peripheral blood smear, iron studies (serum iron, ferritin, transferrin), vitamin B12 & folate levels.
- Treatment based on diagnosis.
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