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Questions and Answers
What is the normal range for the Mean Corpuscular Volume (MCV) in a patient with normocytic anemia?
What is the normal range for the Mean Corpuscular Volume (MCV) in a patient with normocytic anemia?
- 80-100 fL (correct)
- 120-140 fL
- 100-120 fL
- 70-90 fL
Which of the following iron indices is a direct measurement of the protein that transports iron throughout the body?
Which of the following iron indices is a direct measurement of the protein that transports iron throughout the body?
- Total Iron-Binding Capacity (TIBC)
- Transferrin (correct)
- Unsaturated Iron-Binding Capacity (UIBC)
- Serum Iron
A patient presents with symptoms of anemia. Their laboratory results show a low ferritin level and a high Total Iron-Binding Capacity (TIBC). Based on these findings, what is the most likely diagnosis?
A patient presents with symptoms of anemia. Their laboratory results show a low ferritin level and a high Total Iron-Binding Capacity (TIBC). Based on these findings, what is the most likely diagnosis?
- Folate Deficiency
- Vitamin B12 Deficiency
- Thalassemia
- Iron Deficiency Anemia (correct)
Which of the following laboratory tests would be most helpful in distinguishing between vitamin B12 deficiency and folate deficiency?
Which of the following laboratory tests would be most helpful in distinguishing between vitamin B12 deficiency and folate deficiency?
A patient with a history of thalassemia presents with anemia. What is the most appropriate next step in their management?
A patient with a history of thalassemia presents with anemia. What is the most appropriate next step in their management?
What is the level of hemoglobin that defines anemia in a pregnant woman during the second trimester?
What is the level of hemoglobin that defines anemia in a pregnant woman during the second trimester?
What is the expected MCV range for a patient with microcytic anemia?
What is the expected MCV range for a patient with microcytic anemia?
A patient presents with anemia and a low reticulocyte count. Which of the following conditions is most likely?
A patient presents with anemia and a low reticulocyte count. Which of the following conditions is most likely?
In a patient with iron deficiency anemia, which of the following iron indices is typically elevated?
In a patient with iron deficiency anemia, which of the following iron indices is typically elevated?
Which of the following conditions is characterized by a macrocytic anemia with an elevated serum methylmalonic acid level?
Which of the following conditions is characterized by a macrocytic anemia with an elevated serum methylmalonic acid level?
Flashcards
What defines anemia in women?
What defines anemia in women?
Hemoglobin level below 12 g/dL
What defines anemia in pregnant women?
What defines anemia in pregnant women?
Hemoglobin level below 11 g/dL in the 1st and 3rd trimesters; less than 10.5 g/dL in the 2nd trimester
What is the normal MCV range?
What is the normal MCV range?
80-100 fL
What is the MCV range for microcytic anemia?
What is the MCV range for microcytic anemia?
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What is the MCV range for macrocytic anemia?
What is the MCV range for macrocytic anemia?
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When is electrophoresis ordered?
When is electrophoresis ordered?
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What are the iron indices?
What are the iron indices?
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What does the serum iron test measure?
What does the serum iron test measure?
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What does the transferrin test measure?
What does the transferrin test measure?
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What does the TIBC test measure?
What does the TIBC test measure?
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Study Notes
Anemia
- Anemia in Women: Hemoglobin level below 12.8 g/dL defines anemia in women.
- Anemia in Pregnant Women: Hemoglobin level below 11.8 g/dL in the first and third trimesters, and below 10.5 g/dL in the second trimester.
- Normal MCV: 80-100 fL
- Microcytic Anemia MCV: <80 fL
- Macrocytic Anemia MCV: >100 fL
- Electrophoresis Indication: Ordered to diagnose thalassemia, especially if family history is present.
- Iron Indices:
- Serum Iron: Measures iron in the blood serum.
- Transferrin: Measures transferrin levels, a protein that transports iron. Normally, transferrin is about one-third saturated with iron.
- Total Iron-Binding Capacity (TIBC): Measures the total iron binding capacity of transferrin.
- Unsaturated Iron-Binding Capacity (UIBC): Measures the portion of transferrin not yet saturated with iron. Reflects transferrin levels.
- Transferrin Saturation: Percentage of transferrin saturated with iron.
- Ferritin: Measures stored iron in the body.
Anemia Differentiation
- Vitamin B12 vs. Folate Deficiency: Distinguished by serum methylmalonic acid (elevated in B12 deficiency) and total homocysteine levels.
Iron Deficiency Anemia
- Expected Lab Results:
- Low Ferritin
- Low Reticulocyte count
- High TIBC
- MCV < 80 fL
- Low Hemoglobin and Hematocrit (H&H)
- Low Serum Iron
- MCHC < 27 g/dL
Normocytic Anemia
- Underlying Diseases: Blood loss, chronic disease (e.g., IBD, lupus), renal failure, liver disease, cancer.
- Subjective Data: Fatigue, weakness, feeling cold, difficulty breathing with activity.
- Diagnostics: Ferritin levels, Reticulocyte count, TIBC levels.
Microcytic Anemia
- Underlying Diseases (most common): Iron deficiency anemia (IDA), Thalassemia.
- Subjective Data: Fatigue, tachycardia (fast heart rate), palpitations, lightheadedness, shortness of breath, medication history, menstrual history, pica (unusual cravings), blood in stool.
- Diagnostics: Ferritin, Reticulocyte count, TIBC, MCV < 80 fL, Hemoglobin and Hematocrit (H&H), Serum Iron, MCHC < 27 g/dL.
Macrocytic Anemia
- Underlying Diseases: Vitamin B12 deficiency, pernicious anemia, folate deficiency, alcohol abuse, hypothyroidism.
- Subjective Data: Fatigue, shortness of breath, difficulty walking, peripheral neuropathy (tingling, pain), memory/cognitive issues, depression, irritable bowel syndrome
- Important Questions: Gastric surgery history, thyroid disease, alcohol use, medication use (antacids, H2 blockers, PPIs, metformin).
- Diagnostics: Vitamin B12 (serum cobalamin), Methylmalonic acid, homocysteine, folate, hemoglobin, hematocrit, MCV > 100 fL.
Thalassemia
- Types: Alpha and Beta
- Diagnostic Test: Hemoglobin electrophoresis.
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