What disorder is characterized by a decrease in the volume of red blood cells and or a decrease in the concentration of hemoglobin? -Answer- anemia What is often the cause of anemia? -Answer- seen as a manifestation of an underlying disorder What are 2 potential disorders that a patient may have if you see increased destruction of RBCs? -Answer- - sickle cell anemia - thalassemia If a patient is tired, has headaches often, and often experiences lightheadedness and you notice pallor of mucous membranes, this patient may have: -Answer- anemia What are the 4 settings of iron-deficiency anemia? -Answer- - excessive blood loss - increased demand for RBCs - decreased uptake of iron - decreased absorption of iron In men, iron-deficiency anemia is typically due to: -Answer- GI disease (gastrointestinal disease can cause blood loss) In women, iron-deficiency anemia is typically due to: -Answer- excessive blood loss associated with menstruation Other than fatigue, weakness, and lack of energy, iron-deficiency anemia is often associated with what 3 general clinical signs? -Answer- - alopecia (loss of hair) - koilonychia (spoon-shaped nails) - atrophy of gastric mucosa iron-deficiency anemia is associated with what 4 orofacial manifestations? -Answer- - atrophic glossitis (bald tongue -- patient may have a burning sensation) - generalized mucosal atrophy - angular cheilitis - oral features similar to candidiasis If you see a reduced RBC indices on complete blood count this could be what type of anemia? -Answer- iron-deficiency anemia If a peripheral blood smear shows hypochromic (pale) and microcytic (small) RBCs this could be -Answer- iron-deficiency anemia iron-deficiency anemia is associated with a(n) (increase/decrease) in serum iron levels and ferritin concentration -Answer- decrease Plummer-Vinson syndrome is a form of: -Answer- iron-deficiency anemia (and the etiology is the same as iron-deficiency anemia) In addition to the signs of iron-deficiency anemia such as fatigue, shortness of breath, weakness, koilonychia, and alopecia, what is a symptom of Plummer-Vinson syndrome? -Answer- dysphagia due to esophageal webs What are the 3 orofacial manifestations of Plummer-Vinson syndrome? -Answer- - atrophic glossitis - mucosal atrophy - angular chelitis (similar to iron-deficiency anemia) True or false: the laboratory analysis of Plummer-Vinson syndrome will be the same as iron-deficiency anemia -Answer- true Histologically if you potentially see epithelial dysplasia this could be: -Answer- PlummerVinson syndrome True or false: Plummer-Vinson syndrome is a potentially premalignant condition - Answer- true (this had 2 red stars so know this) What condition that we discussed may require esophageal dilation for dysphagia? - Answer- Plummer-Vinson syndrome What is a key treatment for Plummer-Vinson syndrome? -Answer- periodic evaluation (because this can potentially be pre-malignant!! we need to stay on top of it) Patients with Plummer-Vinson syndrome are at risk for: -Answer- oral and esophageal carcinoma What are 3 potential etiologies of pernicious anemia? -Answer- - poor absorption of cobalamin (cobalamin = vitamin B12 = extrinsic factor) - lack of intrinsic factor - autoimmune destruction of parietal cells (leads to lack of intrinsic factor) Intrinsic factor is produced by: -Answer- parietal cells of the stomach Intrinsic factor binds to: -Answer- cobalamin (AKA vitamin B12) (forms the cobalamin intrinsic factor complex) True or false: significant absorption of cobalamin cannot occur without intrinsic factor - Answer- true What is the consequence of low cobalamin? -Answer- disruption of synthesis of nucleic acids True or false: low cobalamin levels affect all cells, especially rapidly dividing cells - Answer- true (affects synthesis of nucleic acdis) What is poor absorption of cobalamin with no deficiency of intrinsic factor known as? - Answer- pernicious anemia-like condition (not true pernicious anemia) Other than fatigue, weakness, and lightheadedness, what are 2 other general signs of pernicious anemia? -Answer- - CNS involvement (paresthesia, tingling, numbness of extremities) - atrophy of gastric mucosa