Chapter 11 Flashcards
(125 cards)
1
Q
Where does hematopoiesis occur in children?
A
Marrow of long bones
2
Q
Where does hematopoiesis occur in adults?
A
Pelvis, cranium, vertebra, sternum, ribs
3
Q
Where does extra medullary hematopoiesis occur?
A
Spleen and liver, lymph nodes, thymus
4
Q
What is hemolysis?
A
Ruptured RBCs
5
Q
What is erythropoiesis?
A
Red bone marrow
6
Q
What is a reticulocyte?
A
Immature RBC
7
Q
What is polythemia? Q
A
Increased RBC
8
Q
What is reduced red blood cells with reduced o2 capacity more common in women?
A
Anemia
9
Q
Hemorrhagic Anemia causes what?
A
Hypoxia
10
Q
Hypoxia in hemorrhagic anemia results in what?
A
Increased erythropoietin (EPO)
11
Q
If hemorrhagic anemia results in a loss of more that_____% of blood what can happen?
A
Hypovololemic shock
12
Q
Chronic blood loss in hemorrhagic anemia leads to a depletion of what which can cause what?
A
Iron stores, IDA
13
Q
What does hypoxia for 3 days result in?
A
Increased plasma (hemodilution)
14
Q
Hypoxia for 7 days results in what?
A
Increased reticulocytes (reticulocytosis)
15
Q
What are symptoms of anemia?
A
Pallor, fatigue, weakness (lassitude) decreased growth, cachexia, ossenous malformations
16
Q
Hemolytic anemia can lean to what?
A
Jaundice/gall stones
17
Q
Anemia can produces tissue hypoxia that can increase erythropoiesis how much?
A
Up to 8x
18
Q
What is hemolytic anemia?
A
Decreased RBC life span (less than 120 days)
19
Q
Is iron retained in hemolytic anemia?
A
Yes, it’s recycled
20
Q
What type of hemolytic anemia is hereditary and has abnormal RBC membranes, enzyme def
A
Intracorpuscular defect
21
Q
What hemolytic anemia is acquired, RBC trauma, and antibodies, malaria?
A
Extra corpuscular defect
22
Q
Where is the hemolytic anemia most common? Q
A
Extra vascular hemolysis (in spleen and liver
23
Q
What form of hemolysis is also acted with physical or biochemical damage, (heart) ?
A
Intravascular hemolysis
24
Q
What is an abnormally shaped RBC?
A
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
