IM - Clinical Approach to Anemia and Bleeding

Anemia

What is defined as a reduction in red blood cell mass or hemoglobin concentration below the normal range for age, sex, and physiological state?

Hemoglobiin

What laboratory test is typically low in anemia?

Hematocrit

What test measures the percentage of red blood cells in blood?

History taking

What is the first step in diagnosing anemia?

Reticulocyte count

Which blood count parameter assesses bone marrow function?

Pica

What physical finding suggests iron deficiency?

Vitamin B12 deficiency

What vitamin deficiency is associated with neuropathy?

Heart

What organ’s murmur may be heard in anemic patients?

Decreased oxygen delivery

What is the primary cause of tiredness in anemia?

Pallor

What color change in mucosa is commonly seen in anemia?

Increased cardiac output

What physiologic mechanism increases heart rate to maintain oxygen delivery?

2,3-Dipgosphoglycerate

What substance increases to lower hemoglobin’s oxygen affinity?

Hemodilution

What compensatory change preserves cardiac output by increasing plasma volume?

Mean corpuscular volume

What red cell index measures red blood cell size?

13-17 g/dL

What is the normal hemoglobin range in adult men?

Physiologic anemia

What is the classic blood finding in pregnancy-related anemia?

Biconcave disc

What is the appearance of a normal red blood cell?

Microcytosis

What morphology is smaller than a lymphocyte nucleus?

Macrocytosis

What morphology is larger and oval-shaped?

Schistocytes

What are fragmented red cells due to mechanical damage?

Echinocytes

What are RBCs with small, evenly spaced spines seen in uremia?

Spur cells

What RBCs have irregular thorn-like projections?

Howell-Jolly bodies

What inclusion body represents nuclear remnants in RBCs?

Dacrocytes

What RBC shape resembles a teardrop?

Target cell

What RBC shows a bull’s-eye appearance?

Anisocytosis

What is variation in RBC size called?

Poikilocytosis

What is variation in RBC shape called?

MCV classification

What classification is based on cell size?

Hyperproduction

What mechanism involves increased red cell destruction?

Underproduction

What mechanism involves decreased production?

Iron deficiency

What is the most common nutritional deficiency causing anemia?

Serum ferritin

What lab test measures total body iron stores?

Vitamin B12 deficiency

What vitamin deficiency leads to macrocytic anemia?

Folate deficiency

What vitamin deficiency causes megaloblastic anemia along with B12?

Vitamin C deficiency

What deficiency causes scurvy-related anemia?

Marrow replacement anemia

What is anemia due to marrow invasion by cancer called?

Erythropoietin deficiency

What hormone deficiency causes renal anemia?

Aplastic anemia

What disease features hypocellular marrow with pancytopenia?

Parvovirus B19

What viral infection causes pure red cell aplasia?

Acute myeloid leukemia

What leukemia commonly presents with anemia and elevated WBCs?

Posterior iliac

50 percent

What is the normal bone marrow cellularity percentage?

Biopsy

What should precede aspiration during marrow examination?

Teardrop cells

What finding indicates marrow infiltration on smear?

Koilonychia

What nail deformity indicates chronic iron deficiency?

Pallor and koilonychia

What are common mucocutaneous signs of anemia?

Tachycardia

What cardiovascular sign is common in severe anemia?

Dyspnea

What symptom occurs due to decreased oxygen delivery?

Complete blood count

What laboratory test measures RBC indices and Hb levels?

Less than 80fL

What MCV value defines microcytic anemia?

80-100fL

What MCV value defines normocytic anemia?

More than 100 fL

What MCV value defines macrocytic anemia?

Iron deficiency anemia

What type of anemia has low ferritin and high TIBC?

Thalassemia

What anemia shows normal ferritin and abnormal electrophoresis?

Anemia of chronic disease

What anemia has normal/high ferritin and low TIBC?

Megaloblastic anemia

What macrocytic anemia shows hypersegmented neutrophils?

IRON LAST

What mnemonic summarizes microcytic anemia causes?

Plummer-Vinson syndrome

What syndrome combines anemia, esophageal webs, and dysphagia?

CBC with iron studies

What is the best initial test for iron deficiency anemia?

Bone marrow iron stain

What is the most accurate diagnostic test for iron deficiency anemia?

Colorectal cancer

What condition should be ruled out in older adults with IDA?

Anemia of chronic disease

What anemia results from trapped iron in macrophages during inflammation?

Anemia of chronic disease

What anemia shows increased ferritin but low serum iron?

Thalassemia

What hereditary anemia involves decreased globin chain synthesis?

Hemoglobin electrophoresis

What diagnostic test confirms thalassemia?

Alpha thalassemia

What type of thalassemia involves gene deletions of alpha-globin?

Hemoglobin H

What inclusion is associated with three-gene deletion alpha-thalassemia?

Beta thalassemia major

What thalassemia type requires lifelong transfusion?

MOM PASS me the GLUCOSE

What mnemonic summarizes hemolytic anemia causes?

Glucose-6-phosphate dehydrogenase deficiency

What enzyme deficiency causes episodic hemolysis after oxidant stress?

Microangiopathic hemolytic anemia

What type of anemia involves RBC fragmentation in small vessels?

Impaired DNA synthesis

What is the pathologic basis of megaloblastic anemia?

Diphyllobothrium latum

What organism causes vitamin B12 deficiency via tapeworm infection?

Vitamin B12 deficiency

What deficiency presents with neurologic symptoms?

Methylmalonic acid

What lab finding is elevated in vitamin B12 deficiency but not folate deficiency?

Folate deficiency

What vitamin deficiency shows normal MMA but high homocysteine?

Hypersegmented neutrophils

What hematologic finding is unique to megaloblastic anemia?

Treat underlying cause

What is the primary principle in anemia treatment?

Blood transfusion

What is indicated for severe anemia with Hb <7 g/dL?

Reticulocyte count

What lab marker rises 5–7 days after treatment response?

Hereditary and acquired

What are two broad types of bleeding disorders by origin?

Epistaxis

What symptom is common in hereditary hemorrhagic telangiectasia?

More than 80 mL per cycle

What defines heavy menstrual bleeding quantitatively?

Tonsillectomy

What surgical procedure challenges hemostasis most?

ISTH-BAT

What screening tool is used for bleeding disorders in primary care?

0-3

What score range is normal for adult males on ISTH-BAT?

6 or higher

What bleeding score is considered abnormal for adult females?

Petechiae

What are pinpoint hemorrhages less than 2 mm called?

Purpura

What are purple patches 2–10 mm called?

Ecchymoses

What are large bruises over 10 mm called?

Platelet disorder

What type of bleeding involves mucosa and skin?

Coagulation disorder

What bleeding occurs deep in joints and muscles?

Less than 150,000/uL

What platelet count defines thrombocytopenia?

50,000/uL

What is the minimum platelet count safe for most procedures?

Bleeding time

What test is prolonged in thrombocytopenia?

Activated partial thromboplastin time

What lab finding is prolonged in hemophilia?

Prothrombin time

What coagulation test is prolonged in vitamin K deficiency?

Disseminated intravascular coagulation

What disease shows low fibrinogen and high D-dimer?

von Willebrand disease

What disease shows normal platelets but prolonged bleeding time?