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Flashcards in Chapter 11 Deck (125):
1

Where does hematopoiesis occur in children?

Marrow of long bones

2

Where does hematopoiesis occur in adults?

Pelvis, cranium, vertebra, sternum, ribs

3

Where does extra medullary hematopoiesis occur?

Spleen and liver, lymph nodes, thymus

4

What is hemolysis?

Ruptured RBCs

5

What is erythropoiesis?

Red bone marrow

6

What is a reticulocyte?

Immature RBC

7

What is polythemia? Q

Increased RBC

8

What is reduced red blood cells with reduced o2 capacity more common in women?

Anemia

9

Hemorrhagic Anemia causes what?

Hypoxia

10

Hypoxia in hemorrhagic anemia results in what?

Increased erythropoietin (EPO)

11

If hemorrhagic anemia results in a loss of more that_____% of blood what can happen?

Hypovololemic shock

12

Chronic blood loss in hemorrhagic anemia leads to a depletion of what which can cause what?

Iron stores, IDA

13

What does hypoxia for 3 days result in?

Increased plasma (hemodilution)

14

Hypoxia for 7 days results in what?

Increased reticulocytes (reticulocytosis)

15

What are symptoms of anemia?

Pallor, fatigue, weakness (lassitude) decreased growth, cachexia, ossenous malformations

16

Hemolytic anemia can lean to what?

Jaundice/gall stones

17

Anemia can produces tissue hypoxia that can increase erythropoiesis how much?

Up to 8x

18

What is hemolytic anemia?

Decreased RBC life span (less than 120 days)

19

Is iron retained in hemolytic anemia?

Yes, it's recycled

20

What type of hemolytic anemia is hereditary and has abnormal RBC membranes, enzyme def

Intracorpuscular defect

21

What hemolytic anemia is acquired, RBC trauma, and antibodies, malaria?

Extra corpuscular defect

22

Where is the hemolytic anemia most common? Q

Extra vascular hemolysis (in spleen and liver

23

What form of hemolysis is also acted with physical or biochemical damage, (heart) ?

Intravascular hemolysis

24

What is an abnormally shaped RBC?

Poikilocyte

25

What is a irregular shaped RBC from hemolysis ?

Schistocyte

26

What is a tear drop shaped RBC?

Dacrocyte

27

What is an autosomal dominant abnormal RBC membrane problem?

Hereditary spherocytosis

28

What form of anemia is fragile RBC that causes them to shed pieces?

Hereditary spherocytosis

29

A possible aplastic crisis (parvovirus b19) is associated with what form of anemia ?

Hereditary spherocytosis

30

What is the treatment for hereditary spherocytosis ?

Splenectomy

31

What is associated with B-global mutation?

Sickle cell anemia

32

Is sickle cell anemia autosomal dominant or rescessive?

Recessive

33

What is heterozygous sickle cell anemia mean?

Sickle cell train, carries, not affected. 8% of African Americans

34

What is homozygous sickle cell anemia?

Means they have the disease, 1 in every 600 African Americans

35

What 4 thing are associated with sickle cell anemia?

Acute chest syndrome, stroke, infection/septicemia, fatty changes

36

Stasis increases what?

Sickling

37

What are symptoms of sickle cell anemia, ?

Chronic low level joint pain., priapism, gallstones stunted growth

38

Is you have homozygous sickle cell anemia only 50% live beyond_____?

5th decade

39

What condition is assopacted with an H shaped vertebrae (Lincoln log vertebra) ?

Sickle cell anemia

40

What is associated with mutated alpha or beta blobin genes ?

Thalassemia

41

Is thalassemia auto dominated or recessive ?

Recessive

42

Beta thalassemia is associated with what chromosome?

11

43

Alpha thalassemia is associated with what chromosome?

16

44

What areas are commonly have a lot of thalassemia?

Africa, SE Asia, Mediterranean because of malaria

45

What condition causes a excess of opposite globin chain?

Thalassemia

46

What form of beta thalassemia is more severe?

Major (2 alleles)

47

Asymptomatic thalassemia =

Minor ( 1 allele)

48

What is associated with beta thalassemia major?

Skeletal deformities

49

What form of beta thalassemia is microcytic and hypochromic?

Minor

50

How is beta thalassemia minor diagnosed?

Electrophoresis

51

What is the treatment for beta thalassemia major?

Blood transfusions and iron chelation

52

What eventually happens in beta thalassemia major?

Hemochromatosis (iron overload)

53

What is the lethal side affect of beta thalassemia?

Dilated cardiomyopathy

54

What type of facies is associated with beta thalassemia major?

Chipmunk facies

55

Alpha thalassemia is a mutated alpha globin gene that creates an excess of what?

B-globin chains (less damaging that excessive alpha)

56

Which is more severe alpha or beta thalassemia?

BETA

57

How many genes need to be altered for alpha thalassemia?

4

58

Abnormal Hb in alpha thalassemia results in what?

Decreased o2 capacity

59

If you have 4 deletions in alpha thalassemia what is the outcome?

No o2 capacity, lethal hydrops fetalis

60

What protects RBCs against hemolysis ?

Glutathione (GSH)

61

A G6PD results in what and is most common in who:?

Decreased GSH, older RBCs at risk for hemolysis, males

62

Bite cells and Heinz bodies are associated with what?

G6PD

63

What are causes of G6PD?

Infections (MC), fava beans (favism) , ADR

64

How long after exposure does hemolysis in
G6PD?

2-3 days

65

What are symptoms of G6PD?

Fatigue, splenomegaly, BACK PAIN, dark urine

66

What are risks for G6PD?>

Males, Africans, areas of malaria

67

Paroxysmal nocturnal hemoglobinuria (PNH) is associated with what gene and in who?

PIGA, X chromosome

68

What is associated with increased complement fixation, decreased pH and respiration while sleeping and increase thrombosis?

Paroxysmal nocturnal hemoglobinuria

69

What is the treatment for PNH?

Antibodies that inhibit the Mac

70

What disorder is associated with Immue attack on RBCs?

Immunohemolytic anemias

71

How does one diagnose immunohemolytic anemia?

DIRECT COOMBS anti globulin test

72

For form of immunohemolytic anemia is spontaneous and idiopathic ?

Endogenous

73

Exogenous immunohemolytic anemia is caused by what?

Toxic exposure or ADR

74

Warm antibody immunohemolytic anemia is also acted with what ?

IgG opsonization

75

Cold antibody immunohemolytic anemia occurs at what temp, and because of what?

Less that 86 degrees, IgM opsonization

76

What in particular is associated with immunohemolytic anemia?

Raynaud phenomenon

77

What are causes of traumatic hemolysis?

Prosthetic heart valves "blender effect "

78

Narrowing of the blood vessels can cause what kind of anemia?

Microangiopathic hemolytic anemia

79

What cells are associated with traumatic hemolysis ?

Burr cells, helmet cells (schistocytes)

80

How many people does malaria affect each year and how many die?

500 million, 1 million die.

81

What is the name of the protozoan that causes malaria?

Plasmodium falciparum

82

What transmits malaria?

female Anopheles mosquito

83

What is another name for malaria ?

Black water fever

84

Merozoite showers happen how often in malaria?

Every 48 hours

85

What are symptoms of malaria?

Epsodic shaking, chills, fever, splenomegaly, jaunmadce, headache, joint paint

86

Cerebral malaria is associated with what?

Seizures coma death, lethal in days

87

Anemias of diminished erythropoiesis are a combination of what to things?

Anemia and reticulocytopenia

88

What are to nutritional deficiencies associated with anemias of de insisted erythropoiesis?

Iron deficiency anemia, mealoblastic anemias :(folate, b12)

89

What are the four anemias of diminished erythropoiesis?

Nutritional deficiencies, an exam of chronic disease, aplastic anemia, myelopththisic anmea,

90

What is the worlds most common nutritional def?

Iron

91

What is the most common cause of anemia?

IRON DEF

92

Iron def affects what perfect of developed counties? Developing countries. ?

10, 25-50

93

Who stores more iron Men or woman?

Men 3.5 to woman 2.5

94

How is iron transported ?

Transferrin

95

What is the most common cause of iron def in developing nations?

Low intake

96

What is the most common cause of iron def in developed countries>?

Chronic blood loss

97

What 3 things cause iron def?

Poor bioavailability, increased metabolic demand, chronic blood loss

98

In what way does iron def cause anemia?

Reduced hemoglobin synth

99

What are symptoms of iron deficiency anemia?

Pica, fingernail spooning, fatigue, decreased immunity, insidious onset

100

What are to common causes of chronic blood loss?

GI tract, female genital tract

101

Someone who is deficient in either folate, or vit b12 could have what?

Mealoblastic anemia

102

Mealoblastic anemia produce what kind of RBCs?

Macrocytic, hyperchromic

103

Pancytopenia is seen in what condition?

Megaloblastic anemia

104

What type of disjunction do we not see with folate deficiency anemia?

Neurologic dysfunction

105

Vit B12 def (pernicious anemia) can effect what?

PNS and spinal cord

106

What can chronic malabsorption of vit b12 cause ?

Autoimmune gastritis (decrease in intrinsic factor

107

Vitamin b12 def is most common in what population?

Old

108

What are features of b12 def?

Fatigue, neuropathy, ataxia

109

Is neurological recovery likely in someone who has had a B12 def anemia?

No

110

Vit B12 def anemia puts one at a slight risk for what kind of cancer?

Gastric carcinoma

111

Anemia of chronic disease is most common seen where?

Hospitalizations

112

What are 3 things anemia of chronic diseases can cause?

Infections, autoimmunity, cancer

113

What is associated with suppression of myeloid stem cells?

Aplastic anemia

114

Pancytopenia is seen in what ?

Aplastic anemia

115

What attacks the marrow in aplastic anemia ?

T cells

116

What are the causes of aplastic anemia ?>

1/2 idiopathic, rest myelotoxic agent

117

80% of aplastic anemia patients respond to what treatment?

Immunosuppressive medication

118

What is the worst prognosis for aplastic anmea ?

If it is idiopathic

119

What are features of aplastic anemia?

Thrombocytopenia, graulocytopenia

120

What is characteristicly absent from aplastic anemia?

Splenomegaly

121

What type of anemia is normocytic, normochromic, reticulocytopenia?

Aplastic

122

For form of anemia is associated with extensive marrow infiltration

Myelophthisic anemia

123

What is the most common cause of myelophthisic anemia?

Mets to bone (breast, lung, prostate)

124

What are 2 other causes of myelophthisic anemia besides mets to bone?

Granulomatous disease (TB, bridges good syndrome,) and lipid storage disease ( niemann pick type C)

125

Dacrocytes are seen in what kind of anemia ?

Myelophthisic anemia