Clinical Features of Anemia
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Questions and Answers

What determines the clinical consequences of anemia?

  • Severity and rapidity of onset (correct)
  • Only the underlying pathogenic mechanism
  • Nutritional deficiencies alone
  • Age and gender of the patient
  • Which symptom is NOT typically associated with anemia?

  • Fatigue
  • Weight gain (correct)
  • Pallor
  • Jaundice
  • What compensatory mechanism occurs if anemia develops slowly?

  • Decreased red cell DPG levels
  • Decrease in cardiac output
  • Increased cardiac output (correct)
  • Decreased respiratory rate
  • What is NOT a clinical feature of untreated severe congenital anemia like β-thalassemia major?

    <p>Increased appetite</p> Signup and view all the answers

    What condition results from ineffective hematopoiesis?

    <p>Secondary hemochromatosis</p> Signup and view all the answers

    Which type of anemia is most prevalent due to nutritional deficiencies?

    <p>Iron deficiency anemia</p> Signup and view all the answers

    During acute blood loss, what type of anemia is typically presented?

    <p>Normocytic and normochromic anemia</p> Signup and view all the answers

    Which factor contributes to the increase in iron absorption from the gut in certain anemias?

    <p>Secondary hemochromatosis</p> Signup and view all the answers

    What is primarily indicated by the presence of hypersegmented neutrophils in peripheral blood?

    <p>Megaloblastic anemia</p> Signup and view all the answers

    Which of the following conditions could cause folate deficiency?

    <p>Malabsorptive disorders</p> Signup and view all the answers

    What is a common manifestation of thrombocytopenia?

    <p>Petechiae and ecchymoses</p> Signup and view all the answers

    What morphological characteristic distinguishes megaloblasts in the bone marrow?

    <p>Delicate, finely reticulated nuclear chromatin</p> Signup and view all the answers

    What is the typical size of red blood cells in macroovalocytosis related to folate deficiency?

    <p>Larger, egg-shaped macroovalocytes</p> Signup and view all the answers

    Which condition may lead to serious infections due to decreased levels of specific cells?

    <p>Neutropenia</p> Signup and view all the answers

    What is one of the main reasons that food folates must be converted into monoglutamates for absorption?

    <p>Only monoglutamates can bind to absorption receptors</p> Signup and view all the answers

    What is a hallmark feature of all hemolytic anemias?

    <p>Reticulocytosis</p> Signup and view all the answers

    What does MCV greater than 110 fL usually indicate?

    <p>Megaloblastic anemia</p> Signup and view all the answers

    Which of the following treatments is directed at the underlying condition in myelophthisic anemia?

    <p>Specific cancer therapies</p> Signup and view all the answers

    What condition might result from drugs such as phenytoin and methotrexate?

    <p>Impaired folate absorption or metabolism</p> Signup and view all the answers

    What does extramedullary hematopoiesis indicate in severe hemolytic anemias?

    <p>Production of blood cells outside the bone marrow</p> Signup and view all the answers

    What is a common feature of giant metamyelocytes in the bone marrow?

    <p>Larger size and abnormal nuclear morphology</p> Signup and view all the answers

    What is a notable outcome of low tissue oxygen levels in hemolytic anemias?

    <p>Increased erythropoietin production</p> Signup and view all the answers

    What type of disorders does hemolytic anemia include?

    <p>Both intrinsic and extrinsic factors</p> Signup and view all the answers

    Which of the following conditions is associated with leukoerythroblastosis?

    <p>Myelophthisic anemia</p> Signup and view all the answers

    What is the initial physiological change seen in iron deficiency anemia?

    <p>Depletion of iron stores</p> Signup and view all the answers

    Which symptom is indicative of long-standing iron deficiency anemia?

    <p>Abnormalities of the fingernails</p> Signup and view all the answers

    Which lab finding is NOT typically associated with iron deficiency anemia?

    <p>Low total iron-binding capacity</p> Signup and view all the answers

    What does the presence of pica indicate in patients with iron deficiency anemia?

    <p>Neurobehavioral complications</p> Signup and view all the answers

    Which statement is true regarding megaloblastic anemias?

    <p>They result from defects in DNA synthesis.</p> Signup and view all the answers

    Which factor is NOT a cause of anemia of diminished erythropoiesis?

    <p>External bleeding</p> Signup and view all the answers

    What is a common characteristic of microcytic hypochromic anemia?

    <p>Decreased serum iron levels</p> Signup and view all the answers

    Which vitamin deficiencies are primarily associated with megaloblastic anemia?

    <p>Folic acid and vitamin B12</p> Signup and view all the answers

    What is the role of tetrahydrofolate in cellular metabolism?

    <p>It serves as an acceptor and donor of one-carbon units in several reactions.</p> Signup and view all the answers

    Which vitamin deficiency is most frequently associated with pernicious anemia?

    <p>Vitamin B12 deficiency</p> Signup and view all the answers

    What is a common clinical feature of folate deficiency?

    <p>Sore tongue</p> Signup and view all the answers

    How does vitamin B12 bind in the stomach for absorption?

    <p>It attaches to haptocorrin.</p> Signup and view all the answers

    What consequence may arise if intracellular folate stores are low?

    <p>Blocked DNA replication due to insufficient dTMP synthesis.</p> Signup and view all the answers

    What initiates the absorption process of dietary vitamin B12?

    <p>Release from food via peptic digestion and binding to haptocorrin.</p> Signup and view all the answers

    Which of the following reflects a key aspect of vitamin B12 metabolism?

    <p>It involves an autoimmune response affecting intrinsic factor production.</p> Signup and view all the answers

    What may complicate the clinical features of folate deficiency?

    <p>Deficiency of other vitamins, particularly in alcoholics.</p> Signup and view all the answers

    Study Notes

    Clinical Features of Anemia

    • Severity, onset speed, and underlying cause dictate clinical consequences of anemia.
    • Slow onset leads to compensatory mechanisms: increased cardiac output, respiratory rate, and 2,3-diphosphoglycerate (DPG) in red blood cells.
    • Common symptoms: pallor, fatigue, hyperbilirubinemia, jaundice, and pigment gallstones.
    • Ineffective hematopoiesis results in secondary hemochromatosis due to increased iron absorption.
    • Untreated severe congenital anemia, like β-thalassemia major, causes growth retardation, skeletal abnormalities, and cachexia.

    Anemia of Blood Loss

    • Acute or chronic bleeding leads to normocytic and normochromic or microcytic anemia with iron deficiency.
    • Total iron-binding capacity (TIBC) is elevated in iron deficiency anemia.

    Iron Deficiency Anemia

    • Most prevalent nutritional deficiency worldwide.
    • Symptoms include shortness of breath, weakness, pallor, and dyspnea.
    • Thrombocytopenia may cause petechiae and ecchymoses; neutropenia can increase infection risk.
    • Common findings: microcytic and hypochromic red blood cells on peripheral smears, absence of splenomegaly.
    • Diagnostic criteria: anemia with low serum ferritin, serum iron, low transferrin saturation, and increased TIBC; positive response to iron therapy.

    Anemia of Diminished Erythropoiesis

    • Caused by inadequate dietary nutrients (iron, folic acid, vitamin B12), bone marrow failure, systemic inflammation, or tumor infiltration.

    Megaloblastic Anemias

    • Result from deficiencies in folate or vitamin B12, leading to impaired DNA synthesis and nuclear-cytoplasmic asynchrony in hematopoietic cells.
    • Symptoms include anemia, thrombocytopenia, and potential for leukopenia (pancytopenia).

    Morphological Features of Megaloblastic Anemia

    • Bone marrow is hypercellular with numerous megaloblasts characterized by immature nuclear chromatin.
    • Peripheral blood shows hypersegmented neutrophils and macroovalocytes; mean corpuscular volume (MCV) often exceeds 110 fL.

    Folate (Folic Acid) Deficiency Anemia

    • Caused by inadequate dietary intake, malabsorption, or metabolic issues; food folates require conversion for absorption.
    • Pathogenesis involves inadequate synthesis of deoxythymidine monophosphate (dTMP) leading to megaloblastic anemia.
    • Symptoms: weakness, easy fatigability, possible additional vitamin deficiencies. Diagnosis via serum and red cell folate tests.

    Vitamin B12 (Cobalamin) Deficiency Anemia

    • B12 is primarily absorbed in the ileum, aided by intrinsic factor secreted by gastric parietal cells.
    • Pernicious anemia, due to autoimmune destruction of intrinsic factor, is a frequent cause of B12 deficiency.
    • Symptoms mirror those of other anemias and may include neurological complications.

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    Description

    Explore the clinical features of anemia, focusing on its severity, onset speed, and underlying mechanisms. This quiz will test your understanding of how anemia affects the body and what compensatory mechanisms are involved. Prepare to dive deep into the physiological responses related to this condition.

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