AQUIFER_INTERNAL_MEDICINE_END_OF
_CASE_EXAM_ACTUAL_EXAM
anemia definition - ANSWER<12.5 women
<13.5 men
chronic anemia symptoms - ANSWERfatigue, exercise intolerance and SOB
with exertion
hx taking in pt with anemia - ANSWERmenstrual: cycle length, days of flow,
inter bleeding, amount
GI: hematochezia, melena
constitutional: fever/weight loss risk chronic infection or occult malignancy
PMH: chronic illness can cause anemia of chronic disease (esp rheumatologist
dz), CKD also a cause b/c decreased EPO
Surgical hx: gastric/bowel surgery can impair absorption of nutrients for
hematopoiesis
medications: GI losses (NSAIDs), decreased absorption vitamins (PPI) or
hemolysis (cephalosporins)
family hx: hereditary spherocytosis and thalassemia
diet: intake of folic acid and vitamin B12; alcohol use --> risk of being
malnourished
, conjunctival icterus - ANSWERserum bilirubin 2.0-2.5mg/dl --> hemolytic
anemia w/ breakdown Hgb results in unconjugated hyperbilirubinemia
exam findings anemia - ANSWERlymphadenopathy, angular chelitis (iron,
vitamin B12 deficiency), glossitis (iron deficiency anemia, pernicious anemia,
vitamin B deficiencies and aphthous ulcers), systolic murmur (increased
velocity of blood), splenomegaly (lymphoproliferative dz and autoimmune
hemolytic anemia), loss proprioception and vibratory sensation (vitamin B 12
def)
intravascular hemolysis - ANSWERdestroy RBC in circulation with release of
contents into the plasma
extravascular hemolysis - ANSWERoccurs when structural abnormalities of
RBC membrane so cannot pass thru splenic sinusoids; phagocytksed and
destroyed by macrophages of liver or spleen
treatment iron deficiency and pernicious anemia - ANSWERoral iron, vitamin
B12
NOT treat iron deficiency and pernicious anemia - ANSWERIV iron (only when
chronic uncorrectable bleeding, intestinal malabsorption and intolerance to
oral iron)
packed red blood cells
folic acid
transaction transmitted infections - ANSWERHIV, HCV, HBV, HTLV, CMV, WNV,
ZIKa, T pallidum, bacteria (sepsis), plasmodium, babesia, t Cruz (chagas)
vCJD (trasmissione spongiform encephalopathy)
_CASE_EXAM_ACTUAL_EXAM
anemia definition - ANSWER<12.5 women
<13.5 men
chronic anemia symptoms - ANSWERfatigue, exercise intolerance and SOB
with exertion
hx taking in pt with anemia - ANSWERmenstrual: cycle length, days of flow,
inter bleeding, amount
GI: hematochezia, melena
constitutional: fever/weight loss risk chronic infection or occult malignancy
PMH: chronic illness can cause anemia of chronic disease (esp rheumatologist
dz), CKD also a cause b/c decreased EPO
Surgical hx: gastric/bowel surgery can impair absorption of nutrients for
hematopoiesis
medications: GI losses (NSAIDs), decreased absorption vitamins (PPI) or
hemolysis (cephalosporins)
family hx: hereditary spherocytosis and thalassemia
diet: intake of folic acid and vitamin B12; alcohol use --> risk of being
malnourished
, conjunctival icterus - ANSWERserum bilirubin 2.0-2.5mg/dl --> hemolytic
anemia w/ breakdown Hgb results in unconjugated hyperbilirubinemia
exam findings anemia - ANSWERlymphadenopathy, angular chelitis (iron,
vitamin B12 deficiency), glossitis (iron deficiency anemia, pernicious anemia,
vitamin B deficiencies and aphthous ulcers), systolic murmur (increased
velocity of blood), splenomegaly (lymphoproliferative dz and autoimmune
hemolytic anemia), loss proprioception and vibratory sensation (vitamin B 12
def)
intravascular hemolysis - ANSWERdestroy RBC in circulation with release of
contents into the plasma
extravascular hemolysis - ANSWERoccurs when structural abnormalities of
RBC membrane so cannot pass thru splenic sinusoids; phagocytksed and
destroyed by macrophages of liver or spleen
treatment iron deficiency and pernicious anemia - ANSWERoral iron, vitamin
B12
NOT treat iron deficiency and pernicious anemia - ANSWERIV iron (only when
chronic uncorrectable bleeding, intestinal malabsorption and intolerance to
oral iron)
packed red blood cells
folic acid
transaction transmitted infections - ANSWERHIV, HCV, HBV, HTLV, CMV, WNV,
ZIKa, T pallidum, bacteria (sepsis), plasmodium, babesia, t Cruz (chagas)
vCJD (trasmissione spongiform encephalopathy)
