Flashcards in Chapter 11 Deck (125):
Where does hematopoiesis occur in children?
Marrow of long bones
Where does hematopoiesis occur in adults?
Pelvis, cranium, vertebra, sternum, ribs
Where does extra medullary hematopoiesis occur?
Spleen and liver, lymph nodes, thymus
What is hemolysis?
What is erythropoiesis?
Red bone marrow
What is a reticulocyte?
What is polythemia? Q
What is reduced red blood cells with reduced o2 capacity more common in women?
Hemorrhagic Anemia causes what?
Hypoxia in hemorrhagic anemia results in what?
Increased erythropoietin (EPO)
If hemorrhagic anemia results in a loss of more that_____% of blood what can happen?
Chronic blood loss in hemorrhagic anemia leads to a depletion of what which can cause what?
Iron stores, IDA
What does hypoxia for 3 days result in?
Increased plasma (hemodilution)
Hypoxia for 7 days results in what?
Increased reticulocytes (reticulocytosis)
What are symptoms of anemia?
Pallor, fatigue, weakness (lassitude) decreased growth, cachexia, ossenous malformations
Hemolytic anemia can lean to what?
Anemia can produces tissue hypoxia that can increase erythropoiesis how much?
Up to 8x
What is hemolytic anemia?
Decreased RBC life span (less than 120 days)
Is iron retained in hemolytic anemia?
Yes, it's recycled
What type of hemolytic anemia is hereditary and has abnormal RBC membranes, enzyme def
What hemolytic anemia is acquired, RBC trauma, and antibodies, malaria?
Extra corpuscular defect
Where is the hemolytic anemia most common? Q
Extra vascular hemolysis (in spleen and liver
What form of hemolysis is also acted with physical or biochemical damage, (heart) ?
What is an abnormally shaped RBC?
What is a irregular shaped RBC from hemolysis ?
What is a tear drop shaped RBC?
What is an autosomal dominant abnormal RBC membrane problem?
What form of anemia is fragile RBC that causes them to shed pieces?
A possible aplastic crisis (parvovirus b19) is associated with what form of anemia ?
What is the treatment for hereditary spherocytosis ?
What is associated with B-global mutation?
Sickle cell anemia
Is sickle cell anemia autosomal dominant or rescessive?
What is heterozygous sickle cell anemia mean?
Sickle cell train, carries, not affected. 8% of African Americans
What is homozygous sickle cell anemia?
Means they have the disease, 1 in every 600 African Americans
What 4 thing are associated with sickle cell anemia?
Acute chest syndrome, stroke, infection/septicemia, fatty changes
Stasis increases what?
What are symptoms of sickle cell anemia, ?
Chronic low level joint pain., priapism, gallstones stunted growth
Is you have homozygous sickle cell anemia only 50% live beyond_____?
What condition is assopacted with an H shaped vertebrae (Lincoln log vertebra) ?
Sickle cell anemia
What is associated with mutated alpha or beta blobin genes ?
Is thalassemia auto dominated or recessive ?
Beta thalassemia is associated with what chromosome?
Alpha thalassemia is associated with what chromosome?
What areas are commonly have a lot of thalassemia?
Africa, SE Asia, Mediterranean because of malaria
What condition causes a excess of opposite globin chain?
What form of beta thalassemia is more severe?
Major (2 alleles)
Asymptomatic thalassemia =
Minor ( 1 allele)
What is associated with beta thalassemia major?
What form of beta thalassemia is microcytic and hypochromic?
How is beta thalassemia minor diagnosed?
What is the treatment for beta thalassemia major?
Blood transfusions and iron chelation
What eventually happens in beta thalassemia major?
Hemochromatosis (iron overload)
What is the lethal side affect of beta thalassemia?
What type of facies is associated with beta thalassemia major?
Alpha thalassemia is a mutated alpha globin gene that creates an excess of what?
B-globin chains (less damaging that excessive alpha)
Which is more severe alpha or beta thalassemia?
How many genes need to be altered for alpha thalassemia?
Abnormal Hb in alpha thalassemia results in what?
Decreased o2 capacity
If you have 4 deletions in alpha thalassemia what is the outcome?
No o2 capacity, lethal hydrops fetalis
What protects RBCs against hemolysis ?
A G6PD results in what and is most common in who:?
Decreased GSH, older RBCs at risk for hemolysis, males
Bite cells and Heinz bodies are associated with what?
What are causes of G6PD?
Infections (MC), fava beans (favism) , ADR
How long after exposure does hemolysis in
What are symptoms of G6PD?
Fatigue, splenomegaly, BACK PAIN, dark urine
What are risks for G6PD?>
Males, Africans, areas of malaria
Paroxysmal nocturnal hemoglobinuria (PNH) is associated with what gene and in who?
PIGA, X chromosome
What is associated with increased complement fixation, decreased pH and respiration while sleeping and increase thrombosis?
Paroxysmal nocturnal hemoglobinuria
What is the treatment for PNH?
Antibodies that inhibit the Mac
What disorder is associated with Immue attack on RBCs?
How does one diagnose immunohemolytic anemia?
DIRECT COOMBS anti globulin test
For form of immunohemolytic anemia is spontaneous and idiopathic ?
Exogenous immunohemolytic anemia is caused by what?
Toxic exposure or ADR
Warm antibody immunohemolytic anemia is also acted with what ?
Cold antibody immunohemolytic anemia occurs at what temp, and because of what?
Less that 86 degrees, IgM opsonization
What in particular is associated with immunohemolytic anemia?
What are causes of traumatic hemolysis?
Prosthetic heart valves "blender effect "
Narrowing of the blood vessels can cause what kind of anemia?
Microangiopathic hemolytic anemia
What cells are associated with traumatic hemolysis ?
Burr cells, helmet cells (schistocytes)
How many people does malaria affect each year and how many die?
500 million, 1 million die.
What is the name of the protozoan that causes malaria?
What transmits malaria?
female Anopheles mosquito
What is another name for malaria ?
Black water fever
Merozoite showers happen how often in malaria?
Every 48 hours
What are symptoms of malaria?
Epsodic shaking, chills, fever, splenomegaly, jaunmadce, headache, joint paint
Cerebral malaria is associated with what?
Seizures coma death, lethal in days
Anemias of diminished erythropoiesis are a combination of what to things?
Anemia and reticulocytopenia
What are to nutritional deficiencies associated with anemias of de insisted erythropoiesis?
Iron deficiency anemia, mealoblastic anemias :(folate, b12)
What are the four anemias of diminished erythropoiesis?
Nutritional deficiencies, an exam of chronic disease, aplastic anemia, myelopththisic anmea,
What is the worlds most common nutritional def?
What is the most common cause of anemia?
Iron def affects what perfect of developed counties? Developing countries. ?
Who stores more iron Men or woman?
Men 3.5 to woman 2.5
How is iron transported ?
What is the most common cause of iron def in developing nations?
What is the most common cause of iron def in developed countries>?
Chronic blood loss
What 3 things cause iron def?
Poor bioavailability, increased metabolic demand, chronic blood loss
In what way does iron def cause anemia?
Reduced hemoglobin synth
What are symptoms of iron deficiency anemia?
Pica, fingernail spooning, fatigue, decreased immunity, insidious onset
What are to common causes of chronic blood loss?
GI tract, female genital tract
Someone who is deficient in either folate, or vit b12 could have what?
Mealoblastic anemia produce what kind of RBCs?
Pancytopenia is seen in what condition?
What type of disjunction do we not see with folate deficiency anemia?
Vit B12 def (pernicious anemia) can effect what?
PNS and spinal cord
What can chronic malabsorption of vit b12 cause ?
Autoimmune gastritis (decrease in intrinsic factor
Vitamin b12 def is most common in what population?
What are features of b12 def?
Fatigue, neuropathy, ataxia
Is neurological recovery likely in someone who has had a B12 def anemia?
Vit B12 def anemia puts one at a slight risk for what kind of cancer?
Anemia of chronic disease is most common seen where?
What are 3 things anemia of chronic diseases can cause?
Infections, autoimmunity, cancer
What is associated with suppression of myeloid stem cells?
Pancytopenia is seen in what ?
What attacks the marrow in aplastic anemia ?
What are the causes of aplastic anemia ?>
1/2 idiopathic, rest myelotoxic agent
80% of aplastic anemia patients respond to what treatment?
What is the worst prognosis for aplastic anmea ?
If it is idiopathic
What are features of aplastic anemia?
What is characteristicly absent from aplastic anemia?
What type of anemia is normocytic, normochromic, reticulocytopenia?
For form of anemia is associated with extensive marrow infiltration
What is the most common cause of myelophthisic anemia?
Mets to bone (breast, lung, prostate)
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)