MedComplex-Exam 3 Part 1 (SickleCell,PA,FolateAnemias)

Question 1

What is the most common type of MEGALOBLASTIC anemia?

Answer 1

Pernicious Anemia

Question 2

What type of anemia is Pernicious anemia?

Answer 2

Megaloblastic anemia

Question 3

Pernicious anemia is a CHRONIC condition caused by malabsorption of _______, usually due to a lack of gastric _________, needed for absorption.

Answer 3

Vitamin B12 (in the small intestine), intrinsic factor

Question 4

Pernicious Anemia is Most common in _____ adult life and is rare under the age of ____.

Answer 4

LATE….30

Question 5

Where are the three most common areas to see Pernicious Anemia?

Answer 5

England, Ireland, Scandinavia

Question 6

How do you test for Pernicious Anemia?

Answer 6

The (Curt) Schilling Test (The bloody sock test)

Question 7

What is the substance tested for in a (curt) Schilling test for pernicious anemia? Which bodily fluid is looked at in this test?

Answer 7

Cobal-Amine (uh aka Vit B-12)…Urine (pt given cobalamine-it cannot be absorbed ORALLY by the PA patient-and then its peed out)

Question 8

What is a prussian blue test looking for?

Answer 8

Iron deficiency anemia

Question 9

What is another name for an IRON stain? What color does it stain the iron?

Answer 9

Prussian Blue

Question 10

Which condition will the histo show HYPERSEGMENTATION of Neutrophils and Basophilic Stippling of the RBCs?

Answer 10

Pernicious Anemia

Question 11

In hyper segmentation of neutrophils, how many nuclear segments are shown? How many are normal?

Answer 11

5-6 are shown whereas only 3-4 are normal

Question 12

In a megaloblastic anemia which cells will be hyperhsegmented and which cells will show basophilic stippling?

Answer 12

hyperhsegmented NEUTROPHILS and basophilic stippling of RBCs

Question 13

What amount of people with Pernicious Anemia have CNS lesions? What degeneration can this lead to?

Answer 13

3/4 have CNS lesions..can lead to SUBactue Combined degeneration (loss of vibratory sense)

Question 14

What is the tongue manifestation of pernicious anemia?

Answer 14

red-beefy tongue w loss of papillae

Question 15

What is the only difference in the presentation of Pernicious Anemia and Folic Acid deficiency?

Answer 15

FA does not have the CNS effects

Question 16

What are the two most common cause of anemia? What is second?

Answer 16

Iron deficiency….thalassimia

Question 17

Sickle cell anemia is caused by a genetic defect in the synthesis of the _____ chain of hemoglobin.

Answer 17

BETA

Question 18

Sickle cell anemia: Substitution of ________ by _____ at the ___th position of the _____ chain.

Answer 18

Glutamic Acid by Valine…6th position…beta chain

Question 19

In Sickle Cell Anemia: The abnormal beta chain still combines with alpha chains, but instead of normal Hgb A, an abnormal _____ is formed.

Answer 19

Hgb S

Question 20

What type of electrophoresis is used in the diagnosis of Sickle cell anemia?

Answer 20

Hemoglobin Electrophoresis (not a protein electrophoresis) (NOT a plasma electrophoresis) (Hgb S migrates differently than Hgb A)

Question 21

What group of people is most affected by Sickle Cell Anemia? What group of people is NOT as affected?

Answer 21

African Americans and Africans affected.. Meditarrainian’s not affected (thalassemia)

Question 22

Like 3 questions for Sickle Crisis: What aggravates it (3)? Can they occur spontaneously?

Answer 22

aggravated by Fever, Respiratory Disease or Hypoxia…YES they can occur spontaneously

Question 23

Like 3 questions for Sickle Crisis: all situations characterized by ___________ can induce a sickling crisis

Answer 23

reduced oxygen tension

Question 24

Like 3 questions for Sickle Crisis: What 3 activities/life events can cause a crisis?

Answer 24

Mountain climbing, strenuous exercise…pregnancy

Question 25

Like 3 questions for Sickle Crisis: What is a characteristic feature in children?

Answer 25

DACT-YL-ITIS (swelling of dorsum of hands and feet)

Question 26

Complications of Sickle Cell Anemia: _______ of the skull due to bone marrow hyperplasia with “_______” appearance on skull X-ray.

Answer 26

BOSSING…“hair on end”

Question 27

Complications of Sickle Cell Anemia: _________ are common and cause visual problems.

Answer 27

Retinal infarcts

Question 28

Complications of Sickle Cell Anemia: What is the root cause of “Hair on End” appearance on the skull X-ray?

Answer 28

due to Bone Marrow Hyperplasia

Question 29

Complications of Sickle Cell Anemia: Which organ becomes fibrotic and shrinks? What is the clinical term for this?

Answer 29

the spleen…autosplenectomy

Question 30

Complications of Sickle Cell Anemia: Hemolysis results in WHAT 2 events in the liver? The increased excretion of WHAT?? in bile leads to the formation of _______.

Answer 30

hyperbilirubinemia and jaundice..Bilirubin…..bile stones

Question 31

Complications of Sickle Cell Anemia: Foci of _______ necrosis, which heals by fibrous scarring can be detected in ALL organs.

Answer 31

ischemic

Question 32

Complications of Sickle Cell Anemia: Retarded intellectual development, a consequence of brain ischemia and infarcts, the larger infarcts may cause a ______ syndrome.

Answer 32

stroke

Question 33

Complications of Sickle Cell Anemia: The attempts of the heart to compensate for inadequate oxygen transport results in cardiac ________ and ultimately, heart failure.

Answer 33

hypertrophy

Question 34

Complications of Sickle Cell Anemia: The occlusion of small peripheral blood vessels with sickled cells and thrombi aggravates the circulatory situation even more by increasing the __________.

Answer 34

peripheral resistance (blood pressure)

Question 35

Complications of Sickle Cell Anemia: Pulmonary _____ is common due to the heart failure, and it tends to predispose to patients to PNEUMONIA.

Answer 35

edema

Question 36

Complications of Sickle Cell Anemia: Infections are facilitated by changes in the ______ and _____.

Answer 36

SPLEEN and LIVER

Question 37

Complications of Sickle Cell Anemia: Other infections are common and recurrent, and usually involve foci of aseptic _____ necrosis, infarcts of internal organs, and ischemic skin ulcers.

Answer 37

BONE

Question 38

Complications of Sickle Cell Anemia: Both the spleen and liver are overloaded with _________ derived from hemolyzed red cells.

Answer 38

hemosiderin

Question 39

What is the most common cause of a FOLATE deficiency?

Answer 39

pregnancy

Question 40

Pregnancy is the most common cause of a ______ deficiency, but its only a minor cause in a ______ deficiency.

Answer 40

folate….Vit B12