chapter 20 Flashcards by Desiree Namou

hemoglobin synthesis requires:

iron
vitamin B12, and B6
folic acid

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it is mediated by the kidneys which produce _________
increases RBC production
can be a drug

erythropoeietin

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the volume of packed RBC expressed as a percentage of total peripheral blood

hematocrit

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reduction of hemoglobin in the blood to below-normal levels

When Hb levels are below ____ g/dL then blood transfusion is needed

anemia

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chronic inflammation a nd malignant condition

anemia due to chronic disease

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due to decreased production of hemoglobin (Fe, Hb, & protoporhyrin ring structure)
examples: iron deficiency anemia, anemia due to chronic disease, sideroblastic anemia, thalassemia

microcytic homochromic anemia

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dietary lack or blood loss
infants - human milk is low in _____
children - poor _____
adults - _________ in males and ______ or ________ in females
elderly - ____________ in the western world; ______ infection in the developing world
other causes include malnutrition and gastrectomy surgery ( acid aids iron absorption by maintaining the Fe2+ which is more absorbed than Fe3+) - iron deficiency + vitamin D

iron deficiency anemia
iron
diet
peptic ulcer disease
menorrhagia or pregnancy
colon polyps/carcinoma
hookworm

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two forms: ________ and ________
bone marrow depleted of hematopoietic cells and consists only of fibroblasts, fat cells, and scattered lymphocytes
uncontrollanle infections, bleeding tendency, chronic fatigue, sleepiness, and weakness
patient often craves ________

aplastic anemia
idopathic and secondary
ice cubes

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caused by a deficiency in B12 or folic acid
folic acid deficiency: dietary folate is obtained from _______ and some _______. it is absorbed in the __________
-inadequate intake in the diet or because of mal absorption caused by intestinal disease like in ______, ______, or increased demand like ______ or _______

Vitamin B12 deficiency
_________: autoimmune disorder due to autoantibodies against parietal cells and intrinsic factor. common cause of deficiency of vitamin b12
- lack of the gastric intrinsic factor: _______ or ______
diagnosis: ________: by oral _____ b12 with or followed by ____ b12

macrocytic (megaloblastic) anemia
green veggies
fruit
jejunum
alcoholics, elderly, pregnancy, cancer
pernicious anemia
stomach cancer, gastric bypass surgery
SCHILLING TEST
radioactive
cold

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fatigue, shortness of breath, weakness and neurologic symptoms
with appropriate and prompt therapy neurological may be reversible

megaloblastic anemia

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substition of _______ by ______ (point mutation)
synthesis of an abnormal beta chain of ________
_______: 7-10% are heterozygous HbAS, sickle cell trait and 0.4 are homozygous; HbSS sickle cell anemia
pathogenesis: at low oxygen partial pressures on the ______ side of the circulatory system, the abnormal ___ molecules crystallize into long, insoluble polymerized rods, distorting the shape of the RBC which leads to resulting in occlusion of the capillaries, comprimising oxygen delivery to the tissues, which causes headaches, pain, cardiopulmonary insuffeiciency recurrent infections and retarded intellectual development and neurologic deficits in children
-_______ falciparum protection
treatment*** on slide

sickle cell anemia
glutamic acid by valine
globin
american blacks
venuous, HbS
malaria

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genetic defect in the synthesis of _____ that reduces the rate of globin chain cells
no abnormal hemoglobin produced
________ - reduced synthesis of the alpha chain of globin
usually due to _______; normally __ alpha genes are present on chromosome 16
one gene deleted - __________
two genes deleted - _______ mild ______ with _____ blood count
three genes deleted - severe _________
four genes deleted - lethal in utero (________). the r chains form ____ (______) that damage RBCs. Mothers carrying a fetus with Hb bart have a increased risk for obstertric complications

thalassemia
HbA
a-thalssemia
gene deletion
asymptomatic
anemia, increased
severe anemia
hydrops fetalis
tetramers, Hb Barts

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\_\_\_\_\_\_\_ - reduced synthesis of beta chain of globin
\_\_\_\_\_\_\_\_\_\_\_\_\_
- heterozygotes
- mild non sepcific symptoms
\_\_\_\_\_\_\_\_\_\_\_\_\_\_
- homozygotes
- severe and serious disease
- chronic transfusions are often necessary for survival

B thalassemia
B - thalassemia minor
heterozygotes
B thalassemia major

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these patients have distorted long bones, facial bones and cranial bones in a characteristic in crew-cut appearance

B thalassemia

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antibody mediated ( IgG or IgM) destruction of RBCs
IgG mediated disease usually involves ______ hemolysis
IgG binds RBCs in the relatively ___ temp of the central body ( ____ agglutinin); membrane of antibody coated RBC is consumed by splenic macrophages, resulting in _________
-associated with ___ and certain drugs ( clasically ______ and _______)
treatment involves stoppage of the drug, steroids and if necessary, splenectomy

IgM mediated disease usually involves ________
IgM binds RBCs and fixes complement in the relatively _____ temp of the extremities (____ agglutinin)
associated with _____ and ____

immune hemolytic anemia
extravascular
warm
spherocytes
SLE
penicillin, cephalosporins
intravascular
cold
mycoplasma, IM

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clonal proliferation of hematopoietic stem cells
uncontrolled production of red blood cells due to mutation. erythropoietin level is ______
clinical symptoms are mostly due to _______ of blood. blurry vision and headache, increased risk of venuous ______,. flushed face due to congestion plethora and itching, especially after ____ (due to histamine release from increased mast cells)

primary polycythemia
decreased
hyperviscosity
thrombosis
bathing

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-increased red blood cell volume owing to bone marrow _______caused by erythropoietin
usually caused by prolonged _____
-living at high altitudes, anoxia secondary to chronic lung disease, congential heart disease

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secondary polycythemia (erythrocytosis)
hyperpasia
hypoxia

reduction in white blood cell count to below normal levels

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leukopenia

decreased number of circulating neutrophils

-bacterial infection and drug toxicitiy

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neutropenia (agranulocytosis)

decreased number of circulating lymphocytes

bacterial, viral, funcgual and parasitic infections
example: SLE, HIV etc

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lymphopenia

increased number of white blood cells in the peripheral blood

_________: bacterial infection (beginning of the infection)
_____________: allergies and some skin diseases or parasitic infections
___________: viral infections, chronic infections, some autoimmune disorders

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leukocytosis
granulocytosis
eosinophilic leukocytosis
lymphocytosis

malignant disease involving white blood cell precursors in the bone marrow and peripheral blood (acute and chronic)

myeloid
lymphoid

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malignant disease of white blood cells

leukemias

lymphoid cell malignant diseases predominantly involving the lymph nodes

Non hodgkins lymphoma
hodgkins lymphoma

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malignant disease of white blood cells

lymphomas

malignant disease of plasma cells

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malignant disease of white blood cells

multiple myeloma

viruses associated w lymphomas and leukemias

HTLV-1 | EBV

endogenous oncogenes associated w lymphomas and leukemias

chronic myelogenous (philedelphia chromosome)

bone marrow is infiltrated with malignant cells _________ proliferation of blasts; defined as the accumulation of >20% blasts in the bone marrow increased blasts "crowd out" normal hematopoiesis, resulting in an acute anemia, thrombocytopenia, or neutropenia blasts usually enter the blood stream, resulting in a high _______

leukemia neoplastic WBCs

most common form of leukemia in children massive infiltration of the bone marrow and peripheral blood with immature ________ (blasts) recurrent infections, generalized weakness, and bleedng into the skin and major internal organs treatment - excellent prognosis with __________

acute lymphoblastic leukemia lymphoid cells chemotherapy

most common form of acute leukemia in adults ther is _______ proliferation of myeloblasts in the bone marrow without treatment, most patients die within 6 months after the onset of symphtoms treatment: all __________ (vitamin A derivative) for M3

acute myelogenous leukemia clonal trans retinoic acid

malignant disease of pluripotent hematopoietic stem cells (cancer stem cell) - ______ and peripheral ______ overgrown with malignant stem cells. associated w __________ - treatment: _______ inhibitors, _________ transplant and chemo

``` chronic myelogenous leukemia bone marrow blood Philedelphia chromosome tyrosine kinase bone marrow ```

neoplastic proliferation of mature _____ cells characterized by hairy cytoplasmic processes. cells are ______ for tartrate-resistant acid phosphatase (TRAP) - clincical features include ________ (due to accumulation of hairy cells in red pulp area) - excellent response to 2-CDA (_____), an adenosine deaminase inhibitor (adeno

``` hairy cell leukemia B cell positive splenomegaly chemo ```

malignant disease involving lymphoid cells - involvement of lymph nodes leads to generalized lymphadenopathy and is called ______________ - most patients survive 7 to 9 hyears from the time of diagnosis

chronic lymphocytic leukemia | small lymphocytic lymphoma

``` it affects any age group malignant cells often infiltrate the lymph nodes, spleen, thymus, or bone marrow, but the may also involve any other organ in the body extranodal spread of lymphoma there are no ______ lymphomas all age groups are affected more common in _______ ```

lymphoma benign adults

this is the most common form of lymphoma in the US it is mostly seen in _____ people the tumor is ___ growing most patients present with long standing enlargement of the lymph nodes and only mild constitutional symptoms -most patients survive 7 to 9 ears after diagnosis of the disease

NHL: follicular lymphoma older slow

this is most common aggressive form of NHL tissue is infiltrated with large ________ cells that have irregular nuclear outlines and prominent nucleoli. clinically aggressive (high-grade) treatment: chemo

NHL: diffuse large-cell lymphomas | lymphoid

this is a highly malignant tumor composed of small B cells associated with _____ -extranodal masses are often more prominent than lymph nodes - Sub-Saharan AFrica ( involves ___) -children infected with ____ sporadic variant: children and young adults most often and _______ mass (ex. ovarian or intestinal mass) most children and young adults can be cured lab test: characterized by high _______ index and _______ appearance on microscopy

``` Burkitt's Lymphoma EBV jaw EBV abdominal mitotic starry sky ```

EBV infection that results in a ___________ comprised of reactive CD8 T cells -EBV is transmitted by ____ classically affects teenagers & also affects _____ clinical symptoms: oropharynx, resulting in ________. liver, resulting in _______ with hepatomegaly and elevated liver enzymes diagnostic test: monotest: detects ____

``` infectious mononucleosis lymphocytic leukocytosis saliva infants pharyngitis hepatitis IgM ```

``` age distribution bimodal, with one peak at ___ years old and another at ___ years there are four types of this disease 1. ____________ 2. _____________ 3. ____________ 4. ________________ ________ cells are present -bilobed or multilobed nucleus and prominent nucleoli surrounded by a clear halo ```

``` hodgkin's lymphoma 25 55 nodular sclerosis lymphocyte-rich mixed cellularity lymphocyte-depleted reed-stemberg cells ```

lymph nodes are enlarged (_____ and ________) extranodal involvement and leukemic spread are ______ prognosis of the disease depends on the clincal ________ stage _ and _ tumors are associated with an excellent prognosis and a high rate of cure (>90%) with chemo -advanced disease has a less favorable diagnosis

hodgkin's disease continued neck, mediastinum rare I, II

malignant disease of plasma cells most patients older than ___ years of age malignant plasma cells typically proliferate in the ______ and destroy the surrounding bone (bone fractures) punched out holes (lytic lesions in the _____, ______ and __________ - _________ - ____ failure and ______ infection - ______ formation of RBCs on blood smear -diagnosis is based on the following: ____ studies (lytic lesions) - urine contains ___________ (IgG) - bone marrow biopsy: _____ appearance - most patients die within 3 to 4 years, primarily of kidney failure or infection

``` multiple myeloma 45 bone marrow skull, ribs, vertebrae hypercalcemia renal, proteinuria rouleaux X-ray Bence Jones Protein fried egg ```

clotting factor deficiencies conginital clotting factor defects: ________ acquired clotting factor deficiencies - ________ production of clotting factors

hemophilia | inadequate

sex-linked congential clotting factor deficiency ________: deficiency of factor VIII ________: deficiency of factor IX -uncontrollable _____ following trauma -subcutaneous ______(collection of blood in the tissues under skin)

``` hemophilia hemophilia A hemophilia B bleeding hematomas ```

chapter 20 Flashcards

(42 cards)