UNDERSTANDING PATHOPHYSIOLOGY
CHAPTER 40 COMPREHENSIVE SOLVED
QUESTIONS AND COMPLETE ANSWERS
◉ Folate deficiency anemia - symptoms vs pernicious.
Answer: Similar to pernicious anemia BUT generally NO neurologic
manifestations.
◉ Folate deficiency anemia - treatment.
Answer: Oral folate supplementation.
◉ Microcytic-hypochromic anemia (definition).
Answer: Abnormally small RBCs with insufficient (decreased)
hemoglobin content. Usually secondary to decreased iron (Fe).
◉ Microcytic-hypochromic anemias - related disorders.
Answer: Disorders of iron metabolism, disorders of porphyrin/heme
synthesis, and disorders of globin synthesis.
◉ Most common cause of microcytic-hypochromic anemia.
Answer: Iron deficiency.
,◉ Iron deficiency anemia - epidemiology.
Answer: Most common type of anemia worldwide; develops slowly
with a gradual, insidious onset.
◉ Iron deficiency anemia - causes.
Answer: Chronic blood loss or decreased iron intake (nutritional Fe
deficiency); metabolic or functional deficiency.
◉ Iron deficiency anemia - when symptoms manifest.
Answer: When serum Hgb drops to about 7 or 8 g/dL.
◉ Iron deficiency anemia - early symptoms.
Answer: Fatigue, SOB, pale earlobes/palms, pale conjunctiva; brittle,
ridged, spooned nails. (Key Points adds: weakness, alteration of
epithelial tissues, vague neuromuscular complaints.)
◉ Iron deficiency anemia - progression.
Answer: Koilonychia (spooned nails); red, sore, painful tongue;
angular cheilitis.
◉ Iron deficiency anemia - treatment.
Answer: Once the source of blood loss is identified and corrected,
iron replacement therapy can be initiated.
,◉ Sideroblastic anemia - hallmark.
Answer: Presence of RINGED SIDEROBLASTS in the marrow.
◉ Sideroblastic anemias - nature.
Answer: Heterogeneous group of inherited and acquired disorders
that all share ALTERED HEME SYNTHESIS.
◉ Sideroblastic anemia - subtypes.
Answer: Acquired, reversible, heritable, idiopathic.
◉ Sideroblastic anemia - most common cause.
Answer: Myelodysplastic syndrome.
◉ Sideroblastic anemia - manifestations.
Answer: Common anemia signs and symptoms.
◉ Normocytic-normochromic anemia (definition).
Answer: Insufficient numbers of NORMAL erythrocytes (RBCs).
◉ Types included in normocytic-normochromic anemia.
, Answer: Aplastic, posthemorrhagic, acquired hemolytic, hereditary
hemolytic, and anemia of chronic inflammation.
◉ Aplastic anemia.
Answer: Not enough RBCs produced.
◉ Posthemorrhagic anemia.
Answer: Lost too many RBCs from bleeding.
◉ Hemolytic anemias (acquired & hereditary).
Answer: RBCs ruptured.
◉ Anemia of chronic inflammation.
Answer: Anemia caused by inflammatory damage.
◉ Polycythemia (definition).
Answer: Overproduction of RBCs.
◉ Relative polycythemia.
Answer: Secondary to dehydration / fluid loss, causing a RELATIVE
increase in RBC, Hgb, and Hct values.
CHAPTER 40 COMPREHENSIVE SOLVED
QUESTIONS AND COMPLETE ANSWERS
◉ Folate deficiency anemia - symptoms vs pernicious.
Answer: Similar to pernicious anemia BUT generally NO neurologic
manifestations.
◉ Folate deficiency anemia - treatment.
Answer: Oral folate supplementation.
◉ Microcytic-hypochromic anemia (definition).
Answer: Abnormally small RBCs with insufficient (decreased)
hemoglobin content. Usually secondary to decreased iron (Fe).
◉ Microcytic-hypochromic anemias - related disorders.
Answer: Disorders of iron metabolism, disorders of porphyrin/heme
synthesis, and disorders of globin synthesis.
◉ Most common cause of microcytic-hypochromic anemia.
Answer: Iron deficiency.
,◉ Iron deficiency anemia - epidemiology.
Answer: Most common type of anemia worldwide; develops slowly
with a gradual, insidious onset.
◉ Iron deficiency anemia - causes.
Answer: Chronic blood loss or decreased iron intake (nutritional Fe
deficiency); metabolic or functional deficiency.
◉ Iron deficiency anemia - when symptoms manifest.
Answer: When serum Hgb drops to about 7 or 8 g/dL.
◉ Iron deficiency anemia - early symptoms.
Answer: Fatigue, SOB, pale earlobes/palms, pale conjunctiva; brittle,
ridged, spooned nails. (Key Points adds: weakness, alteration of
epithelial tissues, vague neuromuscular complaints.)
◉ Iron deficiency anemia - progression.
Answer: Koilonychia (spooned nails); red, sore, painful tongue;
angular cheilitis.
◉ Iron deficiency anemia - treatment.
Answer: Once the source of blood loss is identified and corrected,
iron replacement therapy can be initiated.
,◉ Sideroblastic anemia - hallmark.
Answer: Presence of RINGED SIDEROBLASTS in the marrow.
◉ Sideroblastic anemias - nature.
Answer: Heterogeneous group of inherited and acquired disorders
that all share ALTERED HEME SYNTHESIS.
◉ Sideroblastic anemia - subtypes.
Answer: Acquired, reversible, heritable, idiopathic.
◉ Sideroblastic anemia - most common cause.
Answer: Myelodysplastic syndrome.
◉ Sideroblastic anemia - manifestations.
Answer: Common anemia signs and symptoms.
◉ Normocytic-normochromic anemia (definition).
Answer: Insufficient numbers of NORMAL erythrocytes (RBCs).
◉ Types included in normocytic-normochromic anemia.
, Answer: Aplastic, posthemorrhagic, acquired hemolytic, hereditary
hemolytic, and anemia of chronic inflammation.
◉ Aplastic anemia.
Answer: Not enough RBCs produced.
◉ Posthemorrhagic anemia.
Answer: Lost too many RBCs from bleeding.
◉ Hemolytic anemias (acquired & hereditary).
Answer: RBCs ruptured.
◉ Anemia of chronic inflammation.
Answer: Anemia caused by inflammatory damage.
◉ Polycythemia (definition).
Answer: Overproduction of RBCs.
◉ Relative polycythemia.
Answer: Secondary to dehydration / fluid loss, causing a RELATIVE
increase in RBC, Hgb, and Hct values.
