Anemias PEARLS - Smarty PANCE

Anemias (PEARLS) - Smarty PANCE (Latest /

• Normal or “ MCV, “ TIBC, ‘ Ferritin (high iron stores) “ serum erythropoie: t-in

Answer Anemia of chronic disease

• The only anemia where all three cell lines are decreased *(pancytopenia)* “ WBC, “ RBC, “

Platelets - will have normal MCV and “ Re:tAi

Answer Aplastic anemia

• “Folate, *‘ MCV (macrocytic anemia)* looks like B12 but no neurologic symptoms.

Common in alcoholics

Answer: Folate deficiency

• After infection or medication in an African American male + *Heinz Bodies and Bite Cells

on smear*. Flare triggers: Fava beans, antimalarials, sulfonamides

Answer: G6PD deficiency

• History of jaundice, transfusion, new medication or infection *(+) direct coombs test*

Answer: Autoimmune Hemolytic anemia

• *“MCV (microcytic)*, ‘ TIBC, “ Ferritin (low iron stores) “ MCH (hypochromic).

Associated with *pica* and nail spooning, target cells

Answer: Iron deficiency

• African American, pain, family history of blood disorder. *Hemoglobin electrophoresis:

Hemoglobin S*, Blood smear: Sickled RBCs, howell-Jolly bodies, target cells

Answer: Sickle cell anemia

• Microcytic hypochromic, elevated iron. Most severe, Mediterranean descent, failure to thrive.

Hemoglobin electrophoresis: Hemoglobin A2 and F.

Answer: Beta thalassemia major

• Microcytic hypochromic, elevated iron. Mild anemia, often misdiagnosed as iron deficient.

Hemoglobin electrophoresis: *Hemoglobin A2*

Answer: Beta thalassemia trait

• Chinese and southeast Asians. Hemoglobin electrophoresis: Hemoglobin H (H disease),

Hemoglobin Bart's (hydrops fetalis), Hemoglobin A (trait)

Answer: Alpha thalassemia

• *‘MCV (macrocytic anemia)*, *Hypersegmented Neutrophils* and normal folate,

*decreased vibratory and position sense*

Answer: Vitamin B12 deficiency 1 / 2

• Less than 10% radiolabeled vitamin B12 in urine. Normal results when repeated with

administration of intrinsic factor Answer: *Schilling test* for the diagnosis of *pernicious anemia (antibody to intrinsic factor)*

• What disorder is a hemoglobin electrophoresis result of "SS" indicative of?

Answer: Sickle cell disease

• What disorder is a hemoglobin electrophoresis result of "SA" indicative of?

Answer: Sickle cell trait

• What type of anemia are cephalosporins PCN NSAIDS methyldopa associated with?

Answer: Immune hemolytic anemia

• Erythropoietin analogs should be suspended once the hemoglobin is

> ?

Answer: 11 mg/dl

• Erythropoietin analogs should only be initiated if the hemoglobin is <

?

Answer: 10 mg/dl

• What two types of anemia have macroovalocytes?

Answer: B12 and folate deficiency

• Which anemia has a decreased MCV, decreased MCH (hypochromic) yet normal TIBC

and ferritin?

Answer: Thalassemia

• Acute chest syndrome occurs during the acute phase of which anemia?

Answer: -Hemolytic sickle cell crisis

• What are some common oxidative events which may trigger hemolysis in G6PD

deficiency?

Answer: Antimalarials - Sulfa drugs - Aspirin - Febrile Illness - Acidosis

• Fava beans

• What type of anemia does a + osmotic fragility test indicate?

Answer: Hereditary Spherocytosis

• What do an increased LDH, decreased Haptoglobin and an increased indirect Bilirubin

represent?

Answer: Hemolysis

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