Hematology Week 1: Introduction to Anemia

Question 1

The mature Red Blood Cell is ___% hemoglobin

Answer 1

95%

Question 2

Anemia Definition

Answer 2

Reduction of total mass of circulating red cells below normal limits

Question 3

Identify

Answer 3

Question 4

Symptoms of Anemia

5 listed

Answer 4

• Fatigue
• Dizziness
• Headache
• Shortness of breath
• Pallor

Question 5

The amount of oxygen delivered by the blood is monitored by?

Answer 5

the kidney

if levels are low then the kidney will release EPO

Question 6

Erythroid Maturation Sequence

Answer 6

Question 7

ways to identify a reticulocyte?

3 listed

Answer 7

Question 8

The presence of adequate reticulocytes indicates?

Answer 8

That the bone marrow production of red blood cells is intact

Question 9

Identify

Answer 9

Question 10

Identify Reticulocytes

Answer 10

Question 11

Question 1

Answer 11

C

Increased reticulocyte count

Question 12

Causes of Anemia

3 listed

Answer 12

• Acute Bleeding
• Decreased production of RBCs in the bone marrow
• Decreased survival of RBCs in the blood

Question 13

Causes of decreased RBC production in the BM

2 listed

Answer 13

Issues with

• Nuclear maturation
• Cytoplasmic maturation

Question 14

Question 2

Answer 14

Macrocytic cells

Question 15

Question 3 & 4

Answer 15

• microcytic cells
• increased pallor (hypochromic)

Question 16

Hypochromic meaning

Answer 16

Pale color

Question 17

Question 5

Answer 17

A

Decreased MCV

and

Decreased MCHC

Question 18

Hemolysis Definition

Answer 18

Premature destruction of RBCs

Question 19

Extrinsic anemia example immune hemolysis

Answer 19

antibodies to RBC cell surface causes the RBCs destruction

Question 20

Extrinsic anemia example fragmentation hemolysis

Answer 20

microangiopathic hemolytic anemia

Question 21

Schistocytes

Answer 21

RBC fragments

Question 22

Intrinsic Hemolysis Examples

4 listed

Answer 22

Question 23

Free Hemoglobin is ______ to the body

Answer 23

Toxic

Question 24

Haptoglobin

Answer 24

binds to free hemoglobin

Question 25

Haptoglobin bound to free hemoglobin is then processed by?

Answer 25

Macrophages into unconjugated bilirubin (can cause jaundice)

Question 26

Unconjugated bilirubin can cause

Answer 26

Jaundice

Question 27

Unconjugated bilirubin is taken up by?

Answer 27

by the liver and is then conjugated and then is excreted into the bile and can then be excreted

Question 28

When there is excess free hemoglobin intravascularly that cannot be bound by haptoglobin

Answer 28

the excess free hemoglobin reaches the kidney where it is filtered out into the urine causing hemoglobinuria and urine hemosiderin which is the deposition into the parenchyma

Question 29

LDH results from

Answer 29

free hemoglobin intravascularly from intravascular hemolysis

Question 30

LDH AKA

Answer 30

Lactate dehydrogenase

Question 31

Extravascular hemolysis is?

Answer 31

hemolysis occurring outside of a vessel

Question 32

Common site of Extravascular hemolysis

Answer 32

Spleen

Question 33

Extravascular hemolysis in the spleen

Answer 33

• macrophages in the spleen pick up abnormal RBCs
• unconjugated bilirubin is produced
• Spherocytes produced from parts eaten away from macrophages
• A little bit of free hemoglobin and a little bit of LDH but not as much as from intravascular hemolysis
  *

Question 34

Spherocytes are produced by?

Answer 34

nibbling of macrophages taken some membrane and cytoplasm making small RBCs

Question 35

How to differentiate intravascular and extravascular hemolysis

6 listed

Answer 35

Measure

• LDH
• unconjugated bilirubin
• haptoglobin level in the blood
• see if the patient is jaundiced
• do we see schistocytes or spherocytes
• hemoglobinuria

Question 36

Question 6

Answer 36

A

Haptoglobin

because it will bind free hemoglobin

Question 37

Unconjugated Bilirubin AKA

Answer 37

Indirect Bilirubin

Question 38

As RBC reach end of lifespan

Answer 38

• is not as deformable and gets stuck in splenic sinuses
• gets gobbled up by macrophages