Podcast
Questions and Answers
Which of the following is NOT measured in a complete blood count (CBC)?
Which of the following is NOT measured in a complete blood count (CBC)?
Macrocytic anemia is primarily caused by a deficiency in which nutrient?
Macrocytic anemia is primarily caused by a deficiency in which nutrient?
Which classification describes red blood cells that are smaller than normal?
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?
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?
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?
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?
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?
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?
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)?
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?
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?
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?
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)?
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?
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?
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?
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?
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?
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?
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?
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?
Which of the following disorders can lead to the development of microcytic anemia?
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Platelet dysfunction can lead to which condition?
Platelet dysfunction can lead to which condition?
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Von Willebrand disease is characterized by which of the following?
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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