Comprehensive Hematology: Anemia
Types, Diagnostics, and Key Features
Exam Questions and Answers Graded A+
Iron Deficiency Anemia (IDA) - Correct answer-↓ Iron → ↓ Hb synthesis; ↓ Serum
iron, ↑ TIBC, ↓ Ferritin, ↑ RDW; Iron studies, Bone marrow (↓ stores, no
hemosiderin), Retic count low; Ferritin best single marker; microcytic,
hypochromic; pencil cells
Anemia of Chronic Inflammation (ACI) - Correct answer-Iron trapped in
macrophages due to ↑ hepcidin; ↓ Iron, ↓ TIBC, ↑ Ferritin, Normal/↓ Retic; CRP,
ESR, Hepcidin level (↑); Associated with inflammation, infection, malignancy
Thalassemia (α or β) - Correct answer-↓ Globin chain synthesis; MCV ↓ (<75 fL),
RBC count ↑, target cells; Hemoglobin electrophoresis: ↑ HbA₂ (β⁺), ↑ HbF (β⁰)
DNA analysis for α/β gene deletions; Normal iron studies; Mentzer Index < 13
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, Sideroblastic Anemia - Correct answer-Defective heme synthesis → Fe trapped in
mitochondria; ↑ Iron, ↑ Ferritin, Normal/↓ TIBC; Bone marrow Prussian blue:
Ringed sideroblasts; May be congenital (ALAS2) or acquired (lead, drugs, EtOH)
Lead Poisoning - Correct answer-Inhibits δ-ALA dehydratase and ferrochelatase;
Basophilic stippling, ↑ FEP/ZPP; Zinc protoporphyrin (ZPP) test; Microcytic,
hypochromic; neurologic signs
Megaloblastic Anemia (B₁₂ or Folate) - Correct answer-Defective DNA synthesis;
↑ MCV (>100 fL), hypersegmented neutrophils; Serum B₁₂ / Folate,
Methylmalonic acid, Homocysteine; Macro-ovalocytes, Howell-Jolly bodies;
normal iron
Pernicious Anemia - Correct answer-Autoimmune loss of intrinsic factor; ↓ B₁₂, ↑
MMA & homocysteine; IF antibody, Parietal cell antibody tests; May be associated
with other autoimmune diseases
Aplastic Anemia - Correct answer-Bone marrow failure / hypocellularity;
Pancytopenia, ↓ Retic; Bone marrow biopsy (fatty, hypocellular), Chromosomal
breakage (Fanconi); CD34 ↓ (stem cells); CD25, CD69 on abnormal clones in
some
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Types, Diagnostics, and Key Features
Exam Questions and Answers Graded A+
Iron Deficiency Anemia (IDA) - Correct answer-↓ Iron → ↓ Hb synthesis; ↓ Serum
iron, ↑ TIBC, ↓ Ferritin, ↑ RDW; Iron studies, Bone marrow (↓ stores, no
hemosiderin), Retic count low; Ferritin best single marker; microcytic,
hypochromic; pencil cells
Anemia of Chronic Inflammation (ACI) - Correct answer-Iron trapped in
macrophages due to ↑ hepcidin; ↓ Iron, ↓ TIBC, ↑ Ferritin, Normal/↓ Retic; CRP,
ESR, Hepcidin level (↑); Associated with inflammation, infection, malignancy
Thalassemia (α or β) - Correct answer-↓ Globin chain synthesis; MCV ↓ (<75 fL),
RBC count ↑, target cells; Hemoglobin electrophoresis: ↑ HbA₂ (β⁺), ↑ HbF (β⁰)
DNA analysis for α/β gene deletions; Normal iron studies; Mentzer Index < 13
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, Sideroblastic Anemia - Correct answer-Defective heme synthesis → Fe trapped in
mitochondria; ↑ Iron, ↑ Ferritin, Normal/↓ TIBC; Bone marrow Prussian blue:
Ringed sideroblasts; May be congenital (ALAS2) or acquired (lead, drugs, EtOH)
Lead Poisoning - Correct answer-Inhibits δ-ALA dehydratase and ferrochelatase;
Basophilic stippling, ↑ FEP/ZPP; Zinc protoporphyrin (ZPP) test; Microcytic,
hypochromic; neurologic signs
Megaloblastic Anemia (B₁₂ or Folate) - Correct answer-Defective DNA synthesis;
↑ MCV (>100 fL), hypersegmented neutrophils; Serum B₁₂ / Folate,
Methylmalonic acid, Homocysteine; Macro-ovalocytes, Howell-Jolly bodies;
normal iron
Pernicious Anemia - Correct answer-Autoimmune loss of intrinsic factor; ↓ B₁₂, ↑
MMA & homocysteine; IF antibody, Parietal cell antibody tests; May be associated
with other autoimmune diseases
Aplastic Anemia - Correct answer-Bone marrow failure / hypocellularity;
Pancytopenia, ↓ Retic; Bone marrow biopsy (fatty, hypocellular), Chromosomal
breakage (Fanconi); CD34 ↓ (stem cells); CD25, CD69 on abnormal clones in
some
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