Ch. 23 in class notes

Question 1

look at first in cbc with rbc

Answer 1

hemoglobin- see anemia or polycythemia

Question 2

rbc #

Answer 2

5 million

Question 3

hemoglobin and hematocrit

Answer 3

look at the same time- 1. determine anemia vs polycythemia 2. mcv (microcytic less than 80 or normocytic or macrocytic over 120)

Question 4

microcytic size

Answer 4

80

Question 5

macrocytic size

Answer 5

120

Question 6

if microcytic

Answer 6

iron deficiency, thalassemia

Question 7

if high ferritin and high iron and serum iron is low

Answer 7

anemia of chronic disease

Question 8

total iron binding capacity low

Answer 8

anemia of chronic disease

Question 9

thalassemia confiremed by

Answer 9

hemoglobin electrophoresis

Question 10

variation btw lg and sm cells. if rate is high means the bone marrow is stimulated. is the case in…

Answer 10

rdw/fe deficiency

Question 11

normal rdw

Answer 11

thalassemia

Question 12

target cells

Answer 12

thalassemia

Question 13

high reticulocytes

Answer 13

losing blood or blood destroyed from overactive spleen (hemolysis) (normocytic)

Question 14

low reticulocytes (normocytic)

Answer 14

low production of rbc- ckd lowering erythropoietin, aplastic anemia

Question 15

ow hemoglobin and hematocrit and normal MCV but have low reticulocytes. normal kidney function

Answer 15

could be early fe def deficiency bc typically microcytic but normocytic so early

Question 16

macrocytic above 100 what do first

Answer 16

smear (ex. hypersegmented) then b12 test and folate test

Question 17

if normocytic what do u do

Answer 17

reticulocytes

Question 18

b12 sx

Answer 18

neurologic

Question 19

drugs and liver disease can cause

Answer 19

macrocytic

Question 20

if high reticulocyte expect hemolysis test for

Answer 20

bc hemoglobin broken into heme and bilirubin so have high LDH and high bilirubin

Question 21

what protein gets attached to hemoglobin

Answer 21

haptoglobin

Question 22

expect high or low haptoglobin if?

Answer 22

low

Answer 23

sicklecell anemia
spherocytosis
g6pd
?

Question 24

g6pd

Answer 24

beans? trigger hemolysis

Question 25

hemolytic and aquired

Answer 25

thrombotic thrombocytic p... (ttp)(microangioblastic hemolysis. bc squeeze into capillaries) DIC

Question 26

hypoxia JAK2 mutation

Answer 26

polycythemia

Question 27

maintains RBC shape

Answer 27

Spectrin-ankyrin cytoskeleton

Question 28

2 α + 2 β chains; each with a heme unit (Fe²⁺ binds O₂).

Answer 28

hemoglobin A

Question 29

: 2 α + 2 γ chains → ↑ O₂ affinity (important for fetal gas exchange).

Answer 29

hemoglobin F

Question 30

what regulates hemoglobin synthesis?

Answer 30

iron availibility

Question 31

index of marrow activity

Answer 31

reticulocyte count

Question 32

bone marrow reacting appropriately rest, determine if bone marrow biopsy is needed

Answer 32

Reticulocyte Index

Question 33

high unconjugated bilirubin

Answer 33

jaundice

Question 34

what rbc rely on for atp

Answer 34

anaerobic glycolysis bc lack mitochondria

Question 35

reduces Hb’s affinity for O₂ → enhances tissue oxygen delivery.

Answer 35

2,3-DPG

Question 36

protects against oxidatice damage in rbc

Answer 36

G6PD

Question 37

Oxidative stress → Heinz bodies → hemolysis (e.g., G6PD deficiency).

Question 38

mix donor RBCs + recipient serum → observe for agglutination

Answer 38

crossmatch

Question 39

screen for antibodies in recipient

Answer 39

indirect coombs

Question 40

detects antibodies bound to RBCs

Answer 40

direct coombs

Question 41

Hb <7 g/dL or symptomatic anemia

Answer 41

transfusion indications

Question 42

transfuse for massive acute loss

Answer 42

whole blood

Question 43

transfude if anemic to increase o2 delivery

Answer 43

PRBCs

Question 44

transfuse if thrombocytopenia under 10k or active bleeding

Answer 44

platelets

Question 45

transfuse if coagulation factor replacement

Answer 45

ffp

Question 46

transfuse if fibrinoge, vwf, factor 8

Answer 46

cryoprecipitate

Question 47

acute lung injury

Answer 47

TRALI

Question 48

...

Answer 48

taco

Question 49

cause abo incompartibility to intravascular hemolysis

Answer 49

Acute Hemolytic Transfusion Reaction (AHTR)

Question 50

Symptoms (within minutes): fever, chills, back pain, hypotension, hemoglobinuria

Answer 50

AHTR

Question 51

Labs: ↑ LDH, ↓ haptoglobin, hemoglobinemia, positive Coombs

Answer 51

ahtr

Question 52

Complications: DIC, renal failure, death

Answer 52

ahtr

Question 53

Donor anti-leukocyte antibodies trigger capillary leak Onset <6 hrs → hypoxia, bilateral infiltrates, normal CVP

Answer 53

trali

Question 54

Volume overload, esp. in elderly, heart failure Onset <6 hrs → dyspnea, ↑ CVP, BNP ↑, pulmonary edema

Answer 54

taco

Question 55

immune

Answer 55

trali

Question 56

fluid volume excess

Answer 56

taco