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hematology

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6 Posts

asmi
Forum Hero

Topics: 1043
Posts: 4,609

06/21/04 - 04:47 PM

Name the first or most specific diagnostic test for each ;

1.B 12 def anemia
2. iron def anemia
3. PNH
4. G6PD def anemia
5. Sickle cell anemia
6. thalassemia's(alpha and beta)
7.herditary spherocytosis
8.sideroblastic anemia
9.anemia of chronic disease

docdoc
Forum Senior

Topics: 20
Posts: 104

06/22/04 - 08:36 AM

Peripheral blood picture should be the first test for all anemias.

Inc mcv:
vitamin b12: serum b12 levels or urine MMA.

Dec mcv:
Iron def. anemia: Serum Iron studies (Inc TIBC and low ferritin levels).
ACD: Serum Iron studies (dec TIBC and inc. ferritin levels)
Sideroblastic anemai: ring sideroblasts
Thalesemia:Hb electrophoresis (normal in alpha)

Normal mcv:
G6PD: enzyme levels (let acute episode subside), Heinz bodies during episode
Spherocytosis: osmotic fragility test
PNH: sugar water test, acidified serum test (confirmatory)
Sickle Cell: sickle cell screen, Hb electrophoresis

asmi
Forum Hero

Topics: 1043
Posts: 4,609

06/22/04 - 10:45 AM

Goodjob Docdoc smiling face

Thanks

BellKicker
Forum Junior

Topics: 3
Posts: 49

06/23/04 - 03:08 AM

"docdoc" wrote:
Peripheral blood picture should be the first test for all anemias.

Inc mcv:
vitamin b12: serum b12 levels or urine MMA.

I hate MMA. Is it high or low in B12 def? HIgh or low in folate deficinecy?

I can never remember.

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docdoc
Forum Senior

Topics: 20
Posts: 104

06/23/04 - 02:23 PM

MMA is high in B12 only, not folate.

Homocystein has only two ways to go. It is either converted to Methionine (by accepting a methyl group) OR it goes to Kreb Cycle by changing to Methylmalonyl to Succinyl CoA (Methylmalonyle CoA is an intermediate).

Both steps require B12. In deficiency states, Methylmalonyl CoA increases in the body and is excreted as MMA

BellKicker
Forum Junior

Topics: 3
Posts: 49

06/23/04 - 04:43 PM

Thanks, docdoc.

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