Differential Diagnosis of Anemia Quiz
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Questions and Answers

Which of the following laboratory tests would NOT be used to diagnose anemia?

  • Liver function tests (correct)
  • Blood smear examination
  • Bone marrow smear and biopsy
  • Complete blood count (CBC)

    • A patient presents with a low MCV and MCH. Which of the following is the most likely diagnosis?

  • Aplastic anemia
  • Iron deficiency anemia (correct)
  • Vitamin B12 deficiency
  • Hemolytic anemia

    • What are the characteristic features of macrocytic normochromic anemia?

  • Low MCV, low MCH, normal MCHC
  • High MCV, high MCH, normal MCHC (correct)
  • Low MCV, low MCH, high MCHC
  • High MCV, high MCH, high MCHC

    • A patient with a diagnosis of thalassemia would likely present with which type of anemia?

    <p>Microcytic hypochromic (D)</p> Signup and view all the answers

    The mean corpuscular volume (MCV) is a measurement of:

    <p>The average size of red blood cells (B)</p> Signup and view all the answers

    What is the key characteristic of normocytic normochromic anemia?

    <p>Normal size and hemoglobin content of red blood cells (RBCs) but a decreased number of RBCs (A)</p> Signup and view all the answers

    Which of the following is NOT a type of hemolytic anemia?

    <p>Aplastic anemia (C)</p> Signup and view all the answers

    What is the primary cause of aplastic anemia?

    <p>Bone marrow failure (D)</p> Signup and view all the answers

    What is a hallmark feature of hemolytic anemia in a blood test?

    <p>Increased reticulocyte count (B)</p> Signup and view all the answers

    Which of the following describes the process of extravascular hemolysis?

    <p>Red blood cell destruction occurs mainly in the liver and spleen (A)</p> Signup and view all the answers

    What is a characteristic laboratory finding in intravascular hemolysis?

    <p>Hemoglobinuria (C)</p> Signup and view all the answers

    Which of the following is NOT a characteristic feature of aplastic anemia in a bone marrow examination?

    <p>Increased red blood cell precursors (A)</p> Signup and view all the answers

    What type of red blood cells are characteristically found in hereditary spherocytosis?

    <p>Spherocytes (C)</p> Signup and view all the answers

    What is the primary defect leading to hereditary spherocytosis?

    <p>Genetic mutations affecting red blood cell membrane structural proteins (A)</p> Signup and view all the answers

    What is a classic laboratory finding associated with G6PD deficiency?

    <p>Presence of Heinz bodies in red blood cells (A)</p> Signup and view all the answers

    Flashcards

    Complete Blood Count (CBC)

    A test measuring RBC count, Hct, Hb, indices, and reticulocyte count to evaluate anemia.

    Mean Corpuscular Volume (MCV)

    Average size of red blood cells, calculated as Hct divided by RBC count.

    Microcytic Hypochromic Anemia

    Anemia characterized by low red cell indices, often due to iron deficiency.

    Normocytic Normochromic Anemia

    Anemia with normal red cell indices, often caused by acute blood loss or hemolysis.

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    Bone Marrow Smear and Biopsy

    Procedure to assess maturation of RBC and WBC, and check for abnormalities.

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    Aplastic Anemia

    A condition of blood pancytopenia caused by bone marrow failure with decreased production of all blood cell lines.

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    Lab Features of Aplastic Anemia

    Includes normochromic, normocytic RBCs in peripheral blood and hypocellular bone marrow with increased fat spaces.

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    Hemolytic Anemia

    Anemia caused by an increase in the destruction of red blood cells, leading to erythropoietic hyperplasia.

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    Intravascular Hemolysis

    Destruction of red blood cells occurs within the circulation, often leading to hemoglobinemia and hemoglobinuria.

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    Extravascular Hemolysis

    Destruction of red blood cells occurs outside circulation, primarily in the reticuloendothelial system (RES).

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    Lab Features of Extravascular Hemolysis

    Includes increased serum bilirubin, stool stercobilinogen, and urine urobilinogen levels.

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    Hereditary Hemolytic Anemia

    Anemia due to intrinsic red cell defects, often genetic, affecting RBC structure or metabolism.

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    Hereditary Spherocytosis

    A type of hereditary hemolytic anemia characterized by sphere-shaped RBCs due to membrane defects.

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    G6PD Deficiency

    A metabolic defect leading to red cell damage during oxidative stress, resulting in bite cells and Heinz bodies.

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    Reticulocytosis

    An increased number of reticulocytes in response to high rates of RBC destruction or loss.

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    Study Notes

    Differential Diagnosis of Anemia

    • Complete Blood Count (CBC): Essential for diagnosing anemia. Includes RBC count, hematocrit (packed cell volume), hemoglobin determination, RBC indices calculation, and reticulocyte count.
    • Blood Smear Examination: Evaluates RBC size and shape (anisocytosis, poikilocytosis), and any abnormalities in leukocytes or platelets.
    • Bone Marrow Smear and Biopsy: Examines RBC and WBC series maturation, presence of megakaryocytes, ratio of myeloid to erythroid series, and any granulomas or tumor cells.
    • Hemoglobin Electrophoresis: Used to identify different types of hemoglobin.
    • Antiglobulin Test (Coombs Test): Identifies antibodies that coat red blood cells.
    • Osmotic Fragility Test: Measures the ability of red blood cells to withstand changes in osmotic pressure.
    • Hb F Test: Measures the level of fetal hemoglobin.
    • Sickling Test: Identifies sickle cell anemia.

    Red Blood Cell Indices

    • Mean Corpuscular Volume (MCV): Average size of red blood cells, calculated by dividing hematocrit by RBC count. Normal range: 78-98 fL.
    • Mean Corpuscular Hemoglobin (MCH): Average amount of hemoglobin per red blood cell, calculated by dividing hemoglobin by RBC count. Normal range: 27-32 pg/cell.
    • Mean Corpuscular Hemoglobin Concentration (MCHC): Average concentration of hemoglobin per packed red blood cell, calculated by dividing hemoglobin by hematocrit. Normal range: 32-36 g/dL.

    Morphological Classification of Anemia

    • Normocytic Normochromic Anemia: Normal red blood cell indices; caused by blood loss, hemolytic anemia (excluding thalassemia), aplastic anemia, and pure red cell aplasia (Parvovirus B19 infection).
    • Microcytic Hypochromic Anemia: Low red blood cell indices; caused by iron deficiency anemia, sideroblastic anemia, thalassemia, and chronic diseases.
    • Macrocytic Normochromic Anemia: High MCV and MCH, normal MCHC; caused by megaloblastic anemia (vitamin B12 or folate deficiency), liver disease, and others.

    Aplastic Anemia

    • A condition of blood pancytopenia caused by bone marrow failure. Red blood cell production is reduced leading to a decrease in all blood cell lines, and marrow is replaced by fat. Due to damaged stem cells, and suppression of the bone marrow environment.

    Hemolytic Anemia (HA)

    • Result: Increased rate of premature red blood cell destruction.
    • Response: Erythropoietic hyperplasia (bone marrow increases red blood cell production 6-8 times normal), and increased reticulocytes.
    • Mechanisms: Intravascular hemolysis (in the circulation) and extravascular hemolysis (in the reticulo-endothelial system).
    • Lab Features (Extravascular): Increased RBC breakdown, increased serum bilirubin, increased stool stercobilinogen, increased urine urobilinogen (dark urine).
    • Lab Features (Intravascular): Hemoglobinemia and hemoglobinuria, hemosiderinuria, reduced/absent serum haptoglobin.

    Hereditary Hemolytic Anemia

    • Cause: Genetic defects in red blood cell structure or function.
    • Types: Hereditary spherocytosis (spherocytes), elliptocytosis (cigar-shaped RBCs), and metabolic defects like G6PD deficiency.

    Acquired Hemolytic Anemia

    • Cause: Shortened survival of previously normal red cells.
    • Immune-mediated: Warm or cold-agglutinin hemolytic anemia, result from antibodies attacking RBCs.
    • Drug-induced: Certain drugs can trigger hemolysis, e.g. penicillin allergy.
    • Infectious: Infections like malaria can cause hemolytic anemia.

    Hemoglobin S Trait/Sickle Cell Trait (HbSA)

    • No anemia nor sickle cells present.
    • Target cells are present.
    • Hb S (Sickle) and Hgb A levels are approximately ~60% and ~40%, respectively.

    Sickle Cell Anemia

    • The presence of an abnormal hemoglobin S (HbS).
    • Valine replaces glutamic acid in the beta-globin chain.
    • Hemoglobin S is less soluble and causes the red blood cells to deform into sickle shapes.
    • Results in anemia, sickle cells and target cells, positive sickling test, and abnormal Hb electrophoresis.

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    Related Documents

    Differential Diagnosis of Anemia PDF

    Description

    Test your knowledge on the various methods for diagnosing anemia. This quiz covers essential techniques such as CBC, blood smear examination, and hemoglobin electrophoresis, among others. Challenge yourself to identify the significance of each diagnostic tool.

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