CMN 572 Exam 2 – Questions With Appropriate
Solutions
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Terms in this set (293)
What is anemia? A broad high yield diagnosis usually suspected by
physical findings & the lab parameters of low
hemoglobin and/or hematocrit. Can be thought of as
"symptom."
What is the most common presenting FATIGUE is the most common presenting symptom.
symptom/chief complaint? -Other c/o can be CC but an incidental lab finding
presents.
What do you look for w/ anemia? -Excess loss (acute hemorrhage, chronic loss)-- ex:
trauma (MVC accident -still blood loss-get CBC-
sometimes just acute & repair on own but can be
chronic (GI blood less from colon cancer)
-Excess destruction-- ex: sickle cell destroyed d/t
hereditary
-Decreased/impaired production of Fe --ex:
sometimes bone marrow or something else like iron
deficient like dietary (seen a lot in clinic)
,What kind of history do you look at w/ Medical hx:
anemia? -Injuries/trauma/abnormal bleeding (recent trauma
involving blood loss, decreased clotting, DUB in
females)
-Liver/thyroid disease
-Bleeding disorders
-GI (black tarry stools indicate PUD; chronic loss
even if not seeing bright red stool)
-Anorexia Nervosa (Vegetarians- poor intake)
-Inherited diseases
-Malignancies
-Frequent blood donations (acutely being taken from
system)
Social Hx
-Alcohol/drug use (alcohol causes liver damage)
-Dietary habits
-Activity level changes (fatigue)
-CO detector (CO takes place of oxygen on RBCs &
cause anemia)
-Medication use (Zinc) (Ppl taking zinc to prevent
COVID; Zinc causes decreased copper which causes
a decrease in absorption of iron aka sideroblastic
anemias)
-ASA NSAIDs (don't cause anemia but can blood loss
w/ PUD)
*History/physical necessary on everyone*
,What are the physical symptoms r/t to -CV
impaired O2 delivery (anemia)? -respiratory
-nervous system
-GI
-others
*Any patient in distress w/ fever or acute blood loss
shouldn't be evaluated based upon the anemia
algorithm
ex: Pallor, tachycardia, increased workload on the
hert, dizziness, SOB, numbness/tingling, n/v, smooth
tongue, Hematachezia.
-If H/H severely low & blood loss, whether acute or
chronic should be emergently treated.
-We don't treat acute, treat chronic, if it's urgent
REFER
What are the 3 RBC indices? MCV, MCH, MCHC (Reticulocytes)
Wha is RBC indices — MCV? (Size)
High value = macrocytosis
Low value = microcytosis
Wha is RBC indices — MCH? (color)
High value = hyperchromic
Low value = hypochromic
Wha is RBC indices — reticulocytes? Immature RBCs
Increased value = body tries to replenish when loss
occurs
Decreased value = bone marrow failure or nutritional
deficiency
, What is Mentzer index? described in 1973 by William C. Mentzer, is the MCV
divided by the RBC count. It is said to be helpful in
differentiating iron deficiency anemia from beta
thalassemia. The index is calculated from the results
of a complete blood count.
-Sometimes thalassemia with a low ferritin level will
have a normal RBC count. The Mentzer Index is <13
in Thalassemia and the RBC number is not
decreased.
What is other lab work up of anemia? -Serum ferritin, serum iron, transferrin, and TSAT (iron
studies next slide)
-Folate level
-B12 level
-Reticulocytes
-Serum bilirubin- hereditary
-Copper
-----Erythropoietin produced by kidney must be
present for synthesis of RBCs - renal disease (look at
this for lack of these) - can replace but expensive -
dialysis patients = chronic
----Serum bilirubin- hereditary
---Hemoccult - specific
---Electrophoresis - sick cell Diane
----Thyroid- hypo causes anemia (untreated)
----Renal panel -
What do transferrin saturation & TIBC 2 different tests but measure the same thing --> how
(Total iron binding capacity) measure? much transferrin is available for iron to attach to.
Studies interpretation
What is TIBC (Total Iron Binding Measurement of transferrin iron binding capability
Capacity) (1/3 of transferrin is typically bound with iron).
ex: Take pic of blood how much capacity is there; if
iron is there, why isn't it being used to capacity? Not
w/ iron deficiency - not enough iron there-high
capacity. A lot of places for iron to bind since iron
not present.
Solutions
Save
Terms in this set (293)
What is anemia? A broad high yield diagnosis usually suspected by
physical findings & the lab parameters of low
hemoglobin and/or hematocrit. Can be thought of as
"symptom."
What is the most common presenting FATIGUE is the most common presenting symptom.
symptom/chief complaint? -Other c/o can be CC but an incidental lab finding
presents.
What do you look for w/ anemia? -Excess loss (acute hemorrhage, chronic loss)-- ex:
trauma (MVC accident -still blood loss-get CBC-
sometimes just acute & repair on own but can be
chronic (GI blood less from colon cancer)
-Excess destruction-- ex: sickle cell destroyed d/t
hereditary
-Decreased/impaired production of Fe --ex:
sometimes bone marrow or something else like iron
deficient like dietary (seen a lot in clinic)
,What kind of history do you look at w/ Medical hx:
anemia? -Injuries/trauma/abnormal bleeding (recent trauma
involving blood loss, decreased clotting, DUB in
females)
-Liver/thyroid disease
-Bleeding disorders
-GI (black tarry stools indicate PUD; chronic loss
even if not seeing bright red stool)
-Anorexia Nervosa (Vegetarians- poor intake)
-Inherited diseases
-Malignancies
-Frequent blood donations (acutely being taken from
system)
Social Hx
-Alcohol/drug use (alcohol causes liver damage)
-Dietary habits
-Activity level changes (fatigue)
-CO detector (CO takes place of oxygen on RBCs &
cause anemia)
-Medication use (Zinc) (Ppl taking zinc to prevent
COVID; Zinc causes decreased copper which causes
a decrease in absorption of iron aka sideroblastic
anemias)
-ASA NSAIDs (don't cause anemia but can blood loss
w/ PUD)
*History/physical necessary on everyone*
,What are the physical symptoms r/t to -CV
impaired O2 delivery (anemia)? -respiratory
-nervous system
-GI
-others
*Any patient in distress w/ fever or acute blood loss
shouldn't be evaluated based upon the anemia
algorithm
ex: Pallor, tachycardia, increased workload on the
hert, dizziness, SOB, numbness/tingling, n/v, smooth
tongue, Hematachezia.
-If H/H severely low & blood loss, whether acute or
chronic should be emergently treated.
-We don't treat acute, treat chronic, if it's urgent
REFER
What are the 3 RBC indices? MCV, MCH, MCHC (Reticulocytes)
Wha is RBC indices — MCV? (Size)
High value = macrocytosis
Low value = microcytosis
Wha is RBC indices — MCH? (color)
High value = hyperchromic
Low value = hypochromic
Wha is RBC indices — reticulocytes? Immature RBCs
Increased value = body tries to replenish when loss
occurs
Decreased value = bone marrow failure or nutritional
deficiency
, What is Mentzer index? described in 1973 by William C. Mentzer, is the MCV
divided by the RBC count. It is said to be helpful in
differentiating iron deficiency anemia from beta
thalassemia. The index is calculated from the results
of a complete blood count.
-Sometimes thalassemia with a low ferritin level will
have a normal RBC count. The Mentzer Index is <13
in Thalassemia and the RBC number is not
decreased.
What is other lab work up of anemia? -Serum ferritin, serum iron, transferrin, and TSAT (iron
studies next slide)
-Folate level
-B12 level
-Reticulocytes
-Serum bilirubin- hereditary
-Copper
-----Erythropoietin produced by kidney must be
present for synthesis of RBCs - renal disease (look at
this for lack of these) - can replace but expensive -
dialysis patients = chronic
----Serum bilirubin- hereditary
---Hemoccult - specific
---Electrophoresis - sick cell Diane
----Thyroid- hypo causes anemia (untreated)
----Renal panel -
What do transferrin saturation & TIBC 2 different tests but measure the same thing --> how
(Total iron binding capacity) measure? much transferrin is available for iron to attach to.
Studies interpretation
What is TIBC (Total Iron Binding Measurement of transferrin iron binding capability
Capacity) (1/3 of transferrin is typically bound with iron).
ex: Take pic of blood how much capacity is there; if
iron is there, why isn't it being used to capacity? Not
w/ iron deficiency - not enough iron there-high
capacity. A lot of places for iron to bind since iron
not present.
