Dr. Britt Anemia
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60 Terms
A patient has an MCV of 72 and an MCHC of 28. Which two anemias should you suspect first?
Iron Deficiency Anemia (IDA) and Thalassemia
A patient has an MCV of 88 and an MCHC of 34. What type of anemia is this?
Normocytic, normochromic
A patient has an MCV of 108 and an MCHC of 34. What type of anemia is this?
Macrocytic, normochromic
According to the 2-1-2 Rule, what are the two microcytic, hypochromic anemias?
Iron Deficiency Anemia and Thalassemia
According to the 2-1-2 Rule, what is the one normocytic, normochromic anemia?
Anemia of Chronic Disease
According to the 2-1-2 Rule, what are the two macrocytic, normochromic anemias?
Vitamin B12 Deficiency and Folate Deficiency
How many major anemias should you memorize for the AANP/ANCC exam?
Five
Name the five major anemias.
Iron Deficiency Anemia, Thalassemia, Anemia of Chronic Disease, Vitamin B12 Deficiency, Folate Deficiency
What does the 2-1-2 Rule mean?
2 Microcytic (IDA, Thalassemia), 1 Normocytic (Anemia of Chronic Disease), 2 Macrocytic (Vitamin B12 Deficiency, Folate Deficiency)
Mean Corpuscular volume (MCV) less than 80 means what?
Microcytic anemia
Mean Corpuscular Volume (MCV) between 80 and 100 means what?
Normocytic anemia
Mean Corpuscular volume (MCV) greater than 100 means what?
Macrocytic anemia
Mean Corpuscular Hemoglobin concentration (MCHC) less than 31 means what?
Hypochromic
Mean Corpuscular Hemoglobin concentration (MCHC) between 31 and 37 means what?
Normochromic
Mean Corpuscular Hemoglobin concentration (MCHC) greater than 37 means what?
Hyperchromic
A patient has fatigue, pica, and spoon-shaped nails. What is the diagnosis?
Iron Deficiency Anemia
A patient craves ice and has brittle spoon-shaped nails. What deficiency is present?
Iron Deficiency Anemia
A patient has low ferritin, low serum iron, and increased TIBC. What is the diagnosis?
Iron Deficiency Anemia
Which anemia has low ferritin?
Iron Deficiency Anemia
Which anemia has low serum iron?
Iron Deficiency Anemia
Which anemia has increased Total Iron Binding Capacity (TIBC)?
Iron Deficiency Anemia
What is the first-line oral treatment for Iron Deficiency Anemia?
Ferrous sulfate 325 mg three times daily
A Mediterranean patient has microcytic anemia with normal iron studies. What is the diagnosis?
Thalassemia
A Middle Eastern patient has chronic microcytic anemia with normal ferritin. What is the diagnosis?
Thalassemia
Which anemia has normal ferritin and normal serum iron?
Thalassemia
Which anemia has normal TIBC?
Thalassemia
What is the gold standard diagnostic test for Thalassemia?
Hemoglobin electrophoresis
A patient with chronic kidney disease develops normocytic anemia. What medication may be used?
Epoetin alfa (Epogen)
A patient with rheumatoid arthritis develops normocytic anemia. What is the diagnosis?
Anemia of Chronic Disease
Which anemia is associated with chronic inflammatory diseases?
Anemia of Chronic Disease
A patient with chronic infection develops normocytic, normochromic anemia. What is the diagnosis?
Anemia of Chronic Disease
A patient with chronic GI disease develops normocytic anemia. What diagnosis should you suspect?
Anemia of Chronic Disease
A patient has numbness, tingling, difficulty walking, and macrocytic anemia. What is the diagnosis?
Vitamin B12 Deficiency
Which macrocytic anemia causes neurologic symptoms?
Vitamin B12 Deficiency
A vegan develops macrocytic anemia with paresthesias. What deficiency is present?
Vitamin B12 Deficiency
A patient has macrocytic anemia without neurologic symptoms. What deficiency is most likely?
Folate Deficiency
Which macrocytic anemia does NOT cause neurologic symptoms?
Folate Deficiency
A pregnant woman develops macrocytic anemia. What deficiency is most likely?
Folate Deficiency
A patient has MCV 72, low MCHC, low ferritin, and high TIBC. What is the diagnosis?
Iron Deficiency Anemia
A patient has MCV 72, low MCHC, normal ferritin, and normal TIBC. What is the diagnosis?
Thalassemia
A patient has MCV 90, MCHC 34, and chronic inflammatory disease. What is the diagnosis?
Anemia of Chronic Disease
A patient has MCV 110 with numbness and loss of vibration sense. What is the diagnosis?
Vitamin B12 Deficiency
A patient has MCV 108 after poor nutrition with no neurologic symptoms. What is the diagnosis?
Folate Deficiency
Which anemia is microcytic, hypochromic, and associated with pica?
Iron Deficiency Anemia
Which anemia is microcytic, hypochromic, but has normal iron studies?
Thalassemia
Which anemia is normocytic and normochromic?
Anemia of Chronic Disease
Which two anemias are macrocytic and normochromic?
Vitamin B12 Deficiency and Folate Deficiency
A CBC shows Hgb 9.5, Hct 28.6, MCV 72, and MCH 21.6. What anemia pattern is present?
Microcytic, hypochromic anemia consistent with Iron Deficiency Anemia if ferritin is low and TIBC is high
Which anemia presents with pica?
Iron Deficiency Anemia
Which anemia presents with spoon-shaped nails (koilonychia)?
Iron Deficiency Anemia
Which anemia is common in Mediterranean ancestry?
Thalassemia
Which anemia is common in Middle Eastern ancestry?
Thalassemia
Which anemia is diagnosed with hemoglobin electrophoresis?
Thalassemia
Which anemia is associated with chronic inflammation?
Anemia of Chronic Disease
Which anemia is associated with chronic kidney disease?
Anemia of Chronic Disease
Which anemia causes neurologic deficits?
Vitamin B12 Deficiency
Which anemia is associated with pregnancy and alcoholism?
Folate Deficiency
Memory Trick: Iron = Low Iron, High TIBC. Thalassemia = Normal Iron.
Remember: Iron is LOW in IDA but NORMAL in Thalassemia.
Memory Trick: B12 = Brain. Folate = Fetus.
B12 deficiency causes neurologic symptoms. Folate deficiency does not.
Memory Trick: 2-1-2 Rule
2 Microcytic (IDA, Thalassemia), 1 Normocytic (Anemia of Chronic Disease), 2 Macrocytic (B12, Folate)