Anemias

Question 1

hemoglobin in the RBC binds to?

Answer 1

Oxygen – to be distributed in the tissues

Question 2

The term anemia is derived from the greek word?

Answer 2

“anaimia” which means without blood

Question 3

This is a result of decrease hemoglobin concentration and decrease number of RBC

Answer 3

decrease in oxygen delivery to the tissues; tissue hypoxia

Question 4

this condition is termed as the decrease in the oxygen-carrying capacity of the blood

Answer 4

Anemia

Question 5

These are the features that should be evaluated closely during physical examination to provide clues for hematologic disorders in anemia.

Answer 5

Skin for petechiae
Eyes for pallor, jaundice, and hemorrhage
Mouth for mucosal bleeding

Question 6

Hemoglobin concentration for:

moderate anemias
severe anemias

Answer 6

moderate: 7-10 g/dL
severe: less than 7 g/dL

Question 7

Severity of anemia is gauged by

Answer 7

• degree of reduction in hemoglobin
• cardiopulmonary adaptation
• rapidity of progression of the anemia

Question 8

How do the body compensate for the decreased number of oxygen delivered to the tissue caused by decreased hemoglobin concentration?

Answer 8

the condition elicits an increase in erythropoietin secretion by the kidneys. This will then stimulate the RBC precursors in the bone marrow, thus releasing more RBCs into the circulation.

Question 9

Life span of RBC in the circulation

Answer 9

120 days or 4 months

Question 10

Nutritional factors necessary in adequate RBC production

Answer 10

• Iron, vitamin b12, and folate.

Question 11

Differentiate hematopoiesis from erythropoiesis

Answer 11

Haematopoeisis describes the production of cells that circulate in the bloodstream including red blood cell, platelets, and all types of white blood cell. Consequently, erythropoiesis is the process by which red blood cells (erythrocytes) are produced

Question 12

Hormone that controls the regulation of erythropoiesis

Answer 12

• Erythropoietin (produced by the kidney)

Question 13

This refers to the production of erythroid precursor cells that are defective

a. ) Insufficient erythropoiesis
b. ) Ineffective erythropoiesis
c. ) Effective erythropoiesis

Answer 13

B. Ineffective erythropoiesis

Question 14

This refers to a decrease in the number of erythroid precursor cells in the bone marrow, resulting in decreased RBC production and anemia

a. ) Insufficient erythropoiesis
b. ) Ineffective erythropoiesis
c. ) Effective erythropoiesis

Answer 14

A. insufficient erythropoiesis

Question 15

What happens to cells in ineffective erythropoiesis

Answer 15

-They undergo apoptosis (programmed cell death) in the bone marrow before they can mature into reticulocyte stage and be released into circulation

Question 16

Laboratory Diagnosis of Anemia

CBC - Complete blood count determine:

Answer 16

• RBC count
• Hgb concentration
• Hematocrit
• Platelet count
• RBC indices such as
  - MCV (mean corpuscular volume)
  - MCH (mean cell hemoglobin)
  - MCHC (mean cell hemoglobin conc.)

Question 17

This is a measure of the average RBC volume in femtoliters (fL). This also measured the average size of your RBC.

Answer 17

MCV- mean corpuscular volume

Question 18

What does it mean when your MCV is high?

Answer 18

If someone has a high MCV level, their red blood cells are larger than usual, and they have macrocytic anemia.

Question 19

This is the coefficient variation of RBC volume expressed as percentage. It also indicates variation in RBC volume within the population .measured.

Answer 19

RDW - red cell distribution width

Note: an increase RDW correlates with anisocytosis in the peripheral blood film

Question 20

This serves as an important tool to assess the bone marrow’s ability to increase RBC production in response to anemia

Answer 20

Reticulocyte count

Question 21

These are young RBCs that lack a nucleus but still contain residual RNA to complete the production of hemoglobin

Answer 21

• Reticulocyte

Question 22

The time it takes for reticulocyte to mature to RBC (erythroid) in the peripheral circulation

Answer 22

• 1 day

Question 23

Adult reference interval for Reticulocyte count

Answer 23

0.5-2.5 % expressed as percentage of the total number of RBC

Question 24

Newborn interval for reticulocyte count

Answer 24

1.5-6.0% but gradually changes to an adult interval after few weeks of birth.

Question 25

How to determine absolute reticulocyte count

Answer 25

• it is determined by multiplying percent reticulocytes by the RBC count

Question 26

Reference interval for absolute Reticulocyte count

Answer 26

20-115 x 10⁹/L

Question 27

What does the bone marrow do in response to hemolytic anemias or shortened RBC survival?

Answer 27

• the bone marrow tries to compensate by increasing RBC production thus increasing reticulocyte in peripheral circulation
• increased reticulocyte count