ANEMIA PRIMARY CARE QUESTIONS
AND CORRECT ANSWERS
What is the clinical presentation of anemia in the healthy person? ✅✅CORRECT ANSW-gradual w/
few signs and symptoms until hgb value falls below 6 g/dL
What is the clinical presentation of long-term, moderate to severe anemia? ✅✅CORRECT ANSW-
wide pulse pressure, midsystolic or pansystolic murmur, confusion, lethargy, brittle nails, glossitis,
angular chilitis, paillary atrophy of the tongue, spoon shaped nails.
What are general s/s of anemia but do not help with judging severity of anemia? ✅✅CORRECT
ANSW-pallor of mucous membranes,lips, conjuctivae, nailbeds, and palmar creases
What will the retic count tell you in anemia work-up? ✅✅CORRECT ANSW-Evaluates BM
production of RBCs. Shows if anemia is r/t decreased production or increased blood loss.
What are the normal retic counts? ✅✅CORRECT ANSW-0.5%-1.5% total RBCs or 25 to 75 x 10(9)
In general, what is the hgb concentration for anemia? ✅✅CORRECT ANSW-Men: <14 g/dL
Women: < 12 g/dL
Define reticulocyte ✅✅CORRECT ANSW-Reticulocyte is an immature RBC, the immediate
precursor of the adult erythrocyte. Usually stays in the marrow until mature.
What happens to a erythrocyte at death? Where do its "parts" go? How are they "recycled"?
✅✅CORRECT ANSW-Globulin reduced to amino acids for use throughout body; Iron stored in liver
and spleen until needed; heme converted to bilirubin and excreted from body via urine or stool
What is the most important factor in erythropoeitin stimulation? ✅✅CORRECT ANSW-The
presence of iron. If no iron stores, erythropoesis can not be increased.
What value is considered a value responding to anemic conditions? ✅✅CORRECT ANSW-anything
higher than 100 x 10 (9)
, What value (retic) is considered a value consistent with a decrease in RBC production?
✅✅CORRECT ANSW-anything less than 75 x 10 (9)
Low retic count and anemia = ✅✅CORRECT ANSW-impaired erythropoiesis and red cell indexes
need reviewed (particuarly MCV)
What are conditions associated with decreased retic account? ✅✅CORRECT ANSW-IDA, aplastic
anemia, untreated megaloblastic anemia, radiotherapy, marrow tumors, myelodysplastic syndromes
What are conditions associated with increased retic counts? ✅✅CORRECT ANSW-Hemolytic
anemia, 3-4 days after acute blood loss, hemoglobinopathies, toxin exposures, hypersplenism, after
tx of anemia (adequate dose of iron, folate, B12)
Why is a peripheral smear valuable in diagnosing anemia? ✅✅CORRECT ANSW-because abnormal
cell populations can be too small to change the indexes.
What is serum ferritin? ✅✅CORRECT ANSW-reflects TOTAL body iron stores. First lab value to
become abnormal when irons stores are becoming depleted.
What is the proportion of ferritin to iron stores? ✅✅CORRECT ANSW-each nG/mL of serum
ferritin reflect 8-10 mg stored iron
What is the normal value of ferritin? ✅✅CORRECT ANSW-Women 12 - 150 mcg/L and 10-345
mcg/L for men
When are ferritin levels low? ✅✅CORRECT ANSW-IDA
When are ferritin levels normal to elevated? ✅✅CORRECT ANSW-ACD
What other diseases (non-anemic) have an elevated ferritin level? ✅✅CORRECT ANSW-iron
overload, inflammatory disorders, alcoholism
What is transferrin? ✅✅CORRECT ANSW-a plasma carrier protein that regulates iron transport in
the blood
AND CORRECT ANSWERS
What is the clinical presentation of anemia in the healthy person? ✅✅CORRECT ANSW-gradual w/
few signs and symptoms until hgb value falls below 6 g/dL
What is the clinical presentation of long-term, moderate to severe anemia? ✅✅CORRECT ANSW-
wide pulse pressure, midsystolic or pansystolic murmur, confusion, lethargy, brittle nails, glossitis,
angular chilitis, paillary atrophy of the tongue, spoon shaped nails.
What are general s/s of anemia but do not help with judging severity of anemia? ✅✅CORRECT
ANSW-pallor of mucous membranes,lips, conjuctivae, nailbeds, and palmar creases
What will the retic count tell you in anemia work-up? ✅✅CORRECT ANSW-Evaluates BM
production of RBCs. Shows if anemia is r/t decreased production or increased blood loss.
What are the normal retic counts? ✅✅CORRECT ANSW-0.5%-1.5% total RBCs or 25 to 75 x 10(9)
In general, what is the hgb concentration for anemia? ✅✅CORRECT ANSW-Men: <14 g/dL
Women: < 12 g/dL
Define reticulocyte ✅✅CORRECT ANSW-Reticulocyte is an immature RBC, the immediate
precursor of the adult erythrocyte. Usually stays in the marrow until mature.
What happens to a erythrocyte at death? Where do its "parts" go? How are they "recycled"?
✅✅CORRECT ANSW-Globulin reduced to amino acids for use throughout body; Iron stored in liver
and spleen until needed; heme converted to bilirubin and excreted from body via urine or stool
What is the most important factor in erythropoeitin stimulation? ✅✅CORRECT ANSW-The
presence of iron. If no iron stores, erythropoesis can not be increased.
What value is considered a value responding to anemic conditions? ✅✅CORRECT ANSW-anything
higher than 100 x 10 (9)
, What value (retic) is considered a value consistent with a decrease in RBC production?
✅✅CORRECT ANSW-anything less than 75 x 10 (9)
Low retic count and anemia = ✅✅CORRECT ANSW-impaired erythropoiesis and red cell indexes
need reviewed (particuarly MCV)
What are conditions associated with decreased retic account? ✅✅CORRECT ANSW-IDA, aplastic
anemia, untreated megaloblastic anemia, radiotherapy, marrow tumors, myelodysplastic syndromes
What are conditions associated with increased retic counts? ✅✅CORRECT ANSW-Hemolytic
anemia, 3-4 days after acute blood loss, hemoglobinopathies, toxin exposures, hypersplenism, after
tx of anemia (adequate dose of iron, folate, B12)
Why is a peripheral smear valuable in diagnosing anemia? ✅✅CORRECT ANSW-because abnormal
cell populations can be too small to change the indexes.
What is serum ferritin? ✅✅CORRECT ANSW-reflects TOTAL body iron stores. First lab value to
become abnormal when irons stores are becoming depleted.
What is the proportion of ferritin to iron stores? ✅✅CORRECT ANSW-each nG/mL of serum
ferritin reflect 8-10 mg stored iron
What is the normal value of ferritin? ✅✅CORRECT ANSW-Women 12 - 150 mcg/L and 10-345
mcg/L for men
When are ferritin levels low? ✅✅CORRECT ANSW-IDA
When are ferritin levels normal to elevated? ✅✅CORRECT ANSW-ACD
What other diseases (non-anemic) have an elevated ferritin level? ✅✅CORRECT ANSW-iron
overload, inflammatory disorders, alcoholism
What is transferrin? ✅✅CORRECT ANSW-a plasma carrier protein that regulates iron transport in
the blood
