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Gen Path > Anemia/ RBC disorders - Exam 3 > Flashcards

Anemia/ RBC disorders - Exam 3 Flashcards

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1
Q

Low RBC or hemoglobin content

A

Anemia

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2
Q

What is low hemoglobin in men and in women

A

<13 men
<12 women

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3
Q

Polycythemia / erythrocytosis

A

increased RBC
(primary - neoplasm of BM)
(secondary - increased altitude, sleep apnea, cyanotic heart disease)

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4
Q

Anemia occurs due to these 3 things

A

Low erythropoiesis
Increased RBC loss / Decreased RBC like span
Dilutional anemia

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5
Q

Tissue hypoxia is a symptom of anemia - what is a response that occurs due to this

A

Cardiovascular-pulmonary compensatory responses

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6
Q

A hematocrit at 30%
<30%
<20 %

A

asymptomatic
moderate anemia (weakness, headache, tinnitus, vertigo)
Severe anemia (loss of period, libido, GI complaints, heart failure / shock)

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7
Q

Production defect due to heme/ globin synthesis alterations

A

Microcytic-hypochromic RBC
(Iron def. or malabsorption)

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8
Q

Hypoplastic or hypoproliferative mechanism

A

Normochromic-normocytic RB
(Leukemia or metastatic cancer)

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9
Q

Defect in DNA synthesis, defect in Vitamin B12, folate or folic acid

A

Macrocytic (megaloblastic) RBC

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10
Q

Anemias due to reduced or ineffective erythropoiesis (4)

A

Iron deficiency anemia
Anemia of chronic disease
Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency anemia

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11
Q

Most common cause of anemia

A

Iron deficiency anemia

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12
Q

Second most common cause of anemia - most common type in hospitalized patients

A

Anemia of chronic disease

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13
Q

Blood loss
Poor iron intake
poor iron absorption

A

Iron deficiency anemia

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14
Q

Koilonychia
Pica
Dysphagia
Atrophic glossitis
Glossodynia

A

Iron deficiency anemia
Anemia of chronic Disease

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15
Q

Iron deficiency anemia + dysphagia + esophageal webs

A

Plummer-Vinson syndrome

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16
Q

Results in microcytic hypochromic anemia

A

Iron deficiency anemia

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17
Q

Associated with underlying diseases that have sustained inflammation

A

Anemia of chronic disease

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18
Q

Anemia of chronic disease :
Inflammatory cytokines release __ that blocks iron channels so iron is stuck in macrophages =

A

hepcidin
low erythropoietin production

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19
Q

Normocytic, normochromic, mild to moderate anemia

A

anemia of chronic disease

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20
Q

Decreased reticulocyte count

A

anemia of chronic disease

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21
Q

Autoimmune disease and H. pylori infection

A

Vitamin B12 deficiency / pernicious anemia

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22
Q

Hereditary in N. european ancestry : Scandinavia

A

Vitamin B12 deficiency / pernicious anemia

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23
Q

Autoimmune-mediated destruction of gastric mucosa that decreases production of intrinsic factor

A

Vitamin B12 deficiency / pernicious anemia
(intrinsic factor helps absorb B12)

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24
Q

Parietal cell antibodies present (70%)
Intrinsic factor antibodies present (50%)

A

Vitamin B12 deficiency / pernicious anemia

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25
Prevalence in black women
Vitamin B12 deficiency / pernicious anemia
26
Atrophic gastritis
Vitamin B12 deficiency / pernicious anemia (inflammation of stomach lining) Folate (folic acid) deficiency Anemia
27
Achlorhydria
Vitamin B12 deficiency / pernicious anemia (stomach doesn't produce hydrochloric acid) Folate (folic acid) deficiency Anemia
28
Atrophy of gastric glands histologically (achlorhydria) GI symptoms
Vitamin B12 deficiency / pernicious anemia Folate (folic acid) deficiency Anemia
29
Mild jaundice
Vitamin B12 deficiency / pernicious anemia Folate (folic acid) deficiency Anemia
30
Complex neurologic syndrome secondary to methionine deficiency (Decreased proprioception, bad balance/ hard to walk, impaired memory)
Vitamin B12 deficiency / pernicious anemia only!
31
Glossitis (as well as lips, buccal mucosa, other mucosal sites)
Vitamin B12 deficiency / pernicious anemia
32
Oral mucosal erythema and atrophy (redness)
Vitamin B12 deficiency / pernicious anemia
33
Do NOT use nitrous oxide sedation
Vitamin B12 deficiency / pernicious anemia
34
Megaloblastic macrocytic anemia
Vitamin B12 deficiency / pernicious anemia (macrocytosis is absent in >30% of patients)
35
Can have non-hematologic signs for months before they develop a detectable anemia (anemia is absent in >20% of patients)
Vitamin B12 deficiency / pernicious anemia (Vit. B12 def does not = anemia)
36
Comes from green veggies and some fruits
Folic acid
37
If cellular stores of folate fall --> __ is blocked and this leads to __
DNA replication megaloblastic anemia
38
Does Folate (folic acid) deficiency Anemia involve neurologic abnormalities
NO
39
Megaloblastic, macrocytic anemia
Folate (folic acid) deficiency Anemia
40
CBC and smear are indistinguishable from Vit. B12 deficiency
Folate (folic acid) deficiency Anemia
41
How is Folate (folic acid) deficiency Anemia distinguished from Vit. B12 deficiency
Measuring serum and red cell folate and Vit. B12 levels
42
CBC shows increased platelet count
Iron deficiency anemia
43
CBC shows increased RDW
Iron deficiency anemia
44
CBC shows decreased MCV MCHC
Iron deficiency anemia
45
Blood smear shows microcytic hypochromic RBCs
Iron deficiency anemia
46
Blood smear shows poikilocytosis and anisocytosis (abnormal variation in size and abnormal variation in shape)
Iron deficiency anemia Vitamin B12 deficiency / pernicious anemia
47
Decreased Ferritin and serum iron
Iron deficiency anemia (ferritin = iron storage)
48
Increased TIBIC
Iron deficiency anemia (total iron binding capacity)
49
CBC shows Low reticulocyte count
Anemia of chronic disease
50
Blood smear shows normocytic normochromic OR microcytic hypochromic RBC
Anemia of chronic disease
51
CBC shows increased MCV and MCH
Vitamin B12 deficiency / pernicious anemia Folate (folic acid) deficiency anemia
52
CBC shows a normal MCHC
Vitamin B12 deficiency / pernicious anemia Folate (folic acid) deficiency anemia
53
CBC shows a decreased platelet count
Vitamin B12 deficiency / pernicious anemia Folate (folic acid) deficiency anemia
54
CBC shows a low WBC count
Vitamin B12 deficiency / pernicious anemia Folate (folic acid) deficiency anemia
55
Blood smear shows LARGE, macroovalocyte RBCs
Vitamin B12 deficiency / pernicious anemia Folate (folic acid) deficiency anemia
56
Blood smear shows hyper-segmented neutrophils
Vitamin B12 deficiency / pernicious anemia Folate (folic acid) deficiency anemia
57
Low serum vitamin B12
Vitamin B12 deficiency / pernicious anemia
58
Increased methylmalonic acid and homocysteine
Vitamin B12 deficiency / pernicious anemia
59
Low serum and red cell folate
Folate (folic acid) deficiency anemia
60
Increased homocysteine
Folate (folic acid) deficiency anemia
61
Normal methymalonic acid
Folate (folic acid) deficiency anemia
62
Anemias due to hemolysis (RBC destruction of reduced lifespan) can be congenital or acquired
Congenital = intrinsic RBC defect Acquired = abnormal marrow or systemic disease (RBC itself is perfect)
63
Congenital hemolytic anemias can be a congenital defect it __, __, or in __
hemoglobin structure RBC metabolism hemoglobin synthesis
64
Hemolytic anemia caused by congenital, hereditary abnormality in the hemoglobin molecule
Hemoglobinopathies
65
2 anemias due to congenital hemolytic anemias
Sickle cell anemia Thalassemia / Beta-thalassemia
66
Most common hereditary hemolytic anemia
Sickle cell anemia
67
Production of an abnormal hemoglobin molecule (hemoglobin S HbS)
Sickle cell anemia
68
Hemoglobin S HbS is due to a
single AA substitution of valine for glutamic acid
69
HbS is unstable and polymerizes when exposed to hypoxemia and acidosis =
RBDs deform into a sickle shape
70
Hemolysis in SCD is mainly __
extracellular (spleen)
71
Disease vs trait of SCD
Disease = 85-90% of normal Hbg is replaced Trait = 30-45% per RBC = asymptomatic - carrier
72
Affects persons of african descent
Sickle cell anemia
73
Painful vaso-occlusive crises
Sickle cell anemia
74
Vaso-occlusive crises can be predicted by
hypoxia and dehydration
75
Splenic sequestration
Sickle cell anemia
76
Dactylitis
Sickle cell anemia
77
Leading cause of death with Sickle cell anemia
acute chest syndrome
78
Leading cause of death in children with Sickle cell anemia
Strep. pneumoniae infection
79
Renal failure (glomerulopathy)
Sickle cell anemia
80
Osteomyelitis
Sickle cell anemia
81
Jaundice in oral mucosal tissue
Sickle cell anemia
82
Erythropoietic activity observable on dental x-rays within the bone
Sickle cell anemia
83
Delayed dental eruption
Sickle cell anemia
84
Hypoplasia
Sickle cell anemia
85
Ischemic necrosis within the mandible and peripheral neuropathy from vaso-occlusive events
Sickle cell anemia
86
Occurs in patients from the mediterranean region
Thalassemia / beta-thalassemia
87
Caused by more than 200 point mutation that lead to defects in transcription, splicing, or translation of beta-globin mRNA
Thalassemia / beta-thalassemia
88
Heterozygous form of Thalassemia / beta-thalassemia
Beta-thalassemia minor
89
Cooleys anemia or mediterranean fever
Beta-thalassemia major (homozygous)
90
Blood transfusion dependence
Beta-thalassemia major
91
Severe anemia
Thalassemia / beta-thalassemia
92
Growth retardation
Beta-thalassemia major (homozygous)
93
Skeletal deformities
Beta-thalassemia major (homozygous)
94
Splenomegaly, hepatomegaly, and lymphadenopathy - gallstone and or cirrhosis
Beta-thalassemia major (homozygous)
95
Enlargement of the mandible and maxilla
Thalassemia / beta-thalassemia
96
Chipmunk faces - frontal bossing, maxillary hytrophy, depression of nasal bridge, class II malocclusion of teeth
Thalassemia / beta-thalassemia
97
CBC shows moderate to severe anemia with decreased RBC count, HCT and Hgb
Sickle cell disease
98
Blood smear shows reticulocytes, nucleated RBCs and target or bullseye cells
sickle cell disease
99
Major increase of lactic dehydrogenase (LDH)
sickle cell disease
100
CBC shows sever anemia, decreased MCV and MCHC
Thalassemia / beta-thalassemia major
101
CBC shows increased RDW
Thalassemia / beta-thalassemia major
102
Blood smear show deformed RBCs, microcytic and hypochromic
Thalassemia / beta-thalassemia major
103
Blood smear shows nucleated RBCs and target cells
Thalassemia / beta-thalassemia major
104
Blood smear shows anisocytosis, poikilocytosis, polychromatophilia
Thalassemia / beta-thalassemia major
105
Elevated indirect bilirubin and lactate dehyrdogenase (LDH)
Thalassemia / beta-thalassemia major
106
Decrease haptoglobin
Thalassemia / beta-thalassemia major

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