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Hematology > Chapter 27, 9, 10, 11 > Flashcards

Chapter 27, 9, 10, 11 Flashcards

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0
Q

What is a laser light?

A

Light amplification by stimulated emission of radiation.

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1
Q

What is the Coulter Principle?

A

A method of cell counting and volumetric sizing based on detection and measurement of changes in electrical resistance produced by a particle, suspended in a conductive liquid, traversing a small aperture.

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2
Q

What is a channel analyzer?

A

A device which individual pulses are categorized into specific-sized channels forming a histogram, with size on the x-axis and frequency on the y-axis.

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3
Q

What is the electrical impedance principle?

A

A method of cell counting and sizing based on the detection and measurement of changes in electrical resistance.

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4
Q

What is a histogram?

A

A pictorial display of frequency and class limits of a sample.

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5
Q

What are cold agglutinations?

A

Antibodies in the plasma that react best at 0 degrees to 20 degrees Celcius.

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6
Q

What is an aplastic anemia?

A

Hypo - Proliferative blood disorder caused by decreased cell production.

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7
Q

What are some causes of aplastic anemias?

A 
70% are idiopathic (unknown or uncertain)
Iatrogenic (drug related)
Radiation 
Immune disorders
Infections 
Genetic diseases
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8
Q

What is pancytopenia?

A

Decreased RBCs, WBCs, and platelets.

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9
Q

What is pancytopenia?

A

All cells are decreased (RBC,WBC,and Plts)

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10
Q

What does aplastic mean?

A

Not producing.

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11
Q

What are aplastic anemias?

A

Hypo-proliferative disorders that are caused by decreased cell production.

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12
Q

What does the RBC morphology usually look like in a person with aplastic anemia?

A

Normal!

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13
Q

What are the main causes of aplastic anemias?

A

70 % are idiopathic (unknown or uncertain)
Iatrogenic
Radiation
Immune disorders

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14
Q

What is Falconi’s Anemia?

A

Recessive genetic congenital disorder that prevents cells from fixing damaged DNA or removing toxic, oxygen-free radicals that damage cells. Causes pancytopenia.

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15
Q

What is Pure Red Cell Aplasia (PRCA)?

A

Autoimmune attack (Antibody and Lymphocytes) on RBCs HPCs (stem cells). Decreased RBC counts and increased erythropoietin production.

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16
Q

What is Diamond - Blackfan Syndrome?

A

Causes physical defects (malformed thumbs). Defective stem cells (BFU-E) that are unresponsive to erythropoietin. Progressive anemia with normal WBC and Plts.
Causes normochromic or slight microcytosis, increased Hgb F production.

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17
Q

What is Transient Erythroblastopenia of Children (TEC)?

A

Acute anemia in previously healthy children following a viral infection. Immune mediated attack on RBC HPCs. Usually self limiting in 1-2 months.

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18
Q

What is one of the most common anemias worldwide?

A

Iron deficient anemias

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19
Q

What causes iron deficiency anemias?

A

Nutritional deficiencies
GI disease
Increased demand for erythropoiesis
Excess iron loss (excessive bleeding)

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20
Q

How much iron is in a person?

A

3.5 - 5.0 grams

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21
Q

When does milk anemia occur?

A

In infants that depend solely on cows milk.

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22
Q

What factors increase non-heme iron absorption?

A

Meats and ascorbic acid (OJ)

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23
Q

What factors decrease non-heme iron absorption?

A

Vegetable fibers and tea

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24
Ingested _______ iron is reduced to ________ iron by stomach acid.
Ferric (Fe+3) and Ferrous (Fe+2)
25
Where is most iron absorbed?
Upper jejunum
26
Iron is transported to plasma by what?
Transferrin
27
Transferrin delivers iron to where?
Bone marrow
28
What is PICA syndrome?
Pattern of eating non-food materials such as dirt or paper. Usually stimulated by iron deficiency. Most common in pregnant women, young women, and children.
29
What happens to your CBC result when you're anemic? What do your RBCs look like?
Decreased RBC, HGB, HCT, MCH, MCHC, MCV. | Hypochromic - Microcytic RBCs.
30
1. ) Total serum iron is _________. 2. ) TIBC is _________. 3. ) % Iron Saturation is ________. 4. ) Plasma Ferritin (iron storage) is _______.
1. ) Decreased 2. ) Increased 3. ) Decreased 4. ) Decreased
31
What is the single best test and earliest indication of iron deficiency?
Decreased plasma ferritin
32
What RBC morphology is common in iron deficiency?
Teardrop cells and elliptocytes.
33
What type of anemia is associated with infections, SLE, cancers, rheumatoid arthritis, liver, and renal diseases?
Anemias of Inflammation or Anemias of Chronic Disorders
34
What happens when you have an Anemia of Inflammation?
Iron is sequested (stuck) in the cells (RE system, spleen and macrophages).
35
What happens with a Sideroblastic anemia?
Ineffective erythropoiesis with excess iron accumulation in the mitochondria of bone marrow precursors. Iron is "trapped" in NRBCs cytoplasm.
36
What causes Sideroblastic anemias?
Genetics Leukemias Myselodysplastic Syndromes Drugs/Toxins
37
Why does you become anemic when you have a Sideroblastic anemias?
You have adequate iron, but its unavailable for heme synthesis.
38
What happens when you have Hereditary Hemochromatosis (HH)?
Excess iron in the tissues. This is a genetic disorder of excessive GI iron absorption.
39
Can people with HH donate?
NO
40
In what race is HH common in?
Celtic ancestry (white folk)
41
What increases when you have HH?
Plasma ferritin and transferrin saturation
42
What is the most common... | B12 deficiency or Folic acid deficiency?
Folic acid
43
What is a megaloblastic anemia?
Anemia associated with vitamin B12 or folic acid deficiency.
44
What happens to cells when you have a megaloblastic anemia?
Ansynchronous cell maturation - matured cytoplasm, immature nucleus
45
What are some causes of B12 deficiencies?
Increased B12 utillization Malabsorption of B12 of GI tract Nutritional deficiency Pernicious Anemia (PA)
46
What are some causes of folic acid deficiency?
GI malabsorption Increased utilization (pregnancy, Leukemias) Antimetabolites (drugs that inhibit folic acid)
47
How long does it take for you to become B12 deficient from poor diet?
5-6 years
48
Does folic acid have a large or small storage in the body?
Small
49
What is the most important binding protein for B12 absorption?
Intrinsic factor
50
What is intrinsic factor?
A glycoprotein secreted by stomach parietal cells.
51
What causes pernicious anemia?
Decreased intrinsic factor
52
What happens when you have a hemolytic anemia?
Increased destruction and/or decreased survival of RBCs
53
What are the two general causes of hemolytic anemias?
Intrinsic and Extrinsic
54
What is an Intrinsic Hemolytic Anemia?
A RBC defect.
55
What is an Extrinsic Hemolytic Anemia?
Normal RBCs but damaged from outside force.
56
What do RBCs look like when they are damaged?
Schistocytes and spherocytes
57
Hemolysis can occur in what two places....
Intravascular (plasma) | Extravascular (RE cells-spleen and liver)
58
What are three general causes of Inherited Hemolytic Anemias?
Defective RBC membranes. RBC enzyme deficiencies. Abnormal hemoglobin molecules.
59
What are the three general characteristics of RBC membrane defects?
Usually genetic. Decreased stabibility, flexibility, and lose of bi-concave shape. Abnormalities of the RBC cytoskeleton.
60
What happens to damaged or dysfunctional RBCs?
Phagocytized by the spleen.
61
What is hereditary spherocytosis (HS)?
Genetic disorder Northern European Ancestry Cytoskeleton deficiency
62
What happens to cells when you have Hereditary Spherocytosis (HS)?
Spherocytes | Loss of bi-concave shape and elasticity
63
How is Hereditary Spherocytosis (HS) diagnosed?
Osmotic Fragility Test
64
What happens to the RBCs in a Osmotic Fragility Test?
Since HS cells are spherocytes, they are more susceptible to hemolysis when placed under osmotic stress.
65
What happens to your CBC results if you have a megaloblastic anemia?
Decreased RBC, HCT, HGB, WBC, PLT | Increased MCV
66
What will you see on a differential if you have megaloblastic anemia?
Hypersegs Macrocytics RBC Aniso, Poik, Oval Macrocytes
67
What are folic acid deficiencies usually associated with?
Poor diet, malabsorption, newborn neural tube defects, pregnant women.
68
What are hemoglobinopathies?
Genetic defects related to abnormal hemoglobin synthesis
69
What are three general types of hemoglobinopathies?
Abnormal polypeptides (amino acid substiutions) Defective (decreased) rates of polypeptide synthesis Combination of the first two
70
What is sickle cell anemia?
Genetic linked production of abnormal Hemoglobin S. Valine is substituted for glutamic acid at 6th position of the Beta chain. Deoxygenated Hgb S crystalizes and sickles.
71
What happens to RBCs when they sickle?
RBC membrane becomes permanently damaged and loses flexibility. They become inflexible, crescent shaped and get stuck in the capillaries, obstructing blood flow to tissues and organs.They have a decreased survival and are phagocytized by the spleen.
72
What race with associated with Sickle Cell disease?
African or Mediterranean ancestry
73
What promotes sickling?
``` Decreased oxygen (hypoxia) Decreased pH (acidity) Increased 2,3 DPG ```
74
If patient has sickle cells, what else should you look for to make sure patient's bone marrow is still working?
Polychromasia and NRBCs
75
What do the CBC results look like in a sickle cell patient?
Decreased RBC, Hgb, Hct | Increased WBC
76
What is the adult hemoglobin electrophoresis?
80-95% Hgb S
77
What is the newborn electrophoresis?
20% Hgb S
78
What promotes Hemoglobin F synthesis?
Hydroxyurea
79
What is sickle cell trait?
Heterozygous trait so only one bad gene was received. 8% of African Americans are heterozygous. Usually no symptoms. Sickling occurs during hypoxia.
80
What is the RBC morphology in a patient with sickle cell trait?
Normal
81
What is Hemoglobin C disease?
Lysine is substituted for Glutamic Acid on 6th position of Beta chain. Homo or heterozygous. Causes Hgb C crystals and 50% target cells
82
What is Hemoglobin D disease?
Glycine is subbed for Glutamic Acid on 121st position on Beta chain. Causes target cells
83
What is Hemoglobin E disease?
Lysine is subbed for glutamic acid on 26th position on Beta chain. Target cells, hypo-micro. Most common in Southeast Asia (Cambodia, Vietnam)
84
What is Hemoglobin SC disease?
Inheritance of Hgb S and Hgb C. Moderate anemia, target cells, and knuckle cells (folded sickle cells)
85
What is the order of Hemoglobins on the electrophoresis strip test? From fastest particles to slowest moving particles.
A F S, D, G C, E, O, A2
86
What are Thalassemias?
Genetic decreased (absent) synthesis of hemoglobin polypeptides
87
How many different genes are required for normal Alpha polypeptide synthesis?
4
88
How many genes are needed for normal Beta polypeptide chains?
2
89
What is the RBC morphology in a person with Thalassemia?
Hypo-Micro
90
Where are Thalassemia's most common?
China and Southeast Asia
91
What is Beta Minor Trait?
1 gene missing (asymptomatic to mild anemia)
92
What is Beta Major (Cooleys Anemia)?
Both genes are missing, Beta chains absent. Severe anemia.
93
What's counted in RBC bath?
RBC, PLTS, WBCS, and MCV
94
What is counted in WBC bath?
WBC and Hgb
95
Whats the MCV formula?
MCV = HCT/RBC x 10
96
What is the Hct formula?
Hct = MCV x RBC -------------- 10
97
What does increased WBC counts affect in cell counters?
Increase hemoglobin, or the RBC count.
98
What do cold agglutinins do to cell counters?
Causes RBCs to clump together as they pass through the apertures, causes falsely increased MCVs, decreased RBC, and increased MCHC
99
What does lipemic plasma cause in cell counters?
Falsely increased hemoglobin concentrations from increased turbidity in WBC/HGB bath
100
What are large or giant platelets sometimes counted as in cell counters?
WBCs
101
What is the corrected WBC count?
Corrected WBC count = (Uncorrected WBC count) ----------------------------- X100 # of NRBCs + 100
102
What is the formula for MCH?
Hgb/ RBC x 10
103
What is the MCHC formula?
Hgb/Hct X 100
104
What is hereditary acanthocytosis?
Genetic lipoprotein disorder that has inability to synthesize transport protein
105
What is Spur Cell anemia?
Abnormal membrane cholesterol associated with alcoholic cirrhosis and can cause severe anemia and acanthocytes.
106
What is Paroxysmal Nocturnal Hemoglobinuria (PNH)?
Sleep associated RBC membrane sensitivity to complement and intravascular hemolysis. Causes severe acute anemia, hypo-micro, and usually progresses to aplastic anemia.
107
What is G6PD?
Genetic linked deficiency. Important enzyme in the RBC glycotoic pathway and is responsible for production of an anti-oxidant that prevent accumulation of oxidizing agents in the RBC. Heinz bodies occur. Associated with Africans and Mediterranean ancestry. Most common. Associated with malaria resistance.
108
What can cause Hemolysis in patients with G6PD?
Anti-malarial drugs, antibiotics, and FAVA beans.
109
What are general causes of extrinsic hemolytic anemias?
Immune diseases (antibodies against RBC antigens) Direct physical damage to RBCs RBCs exposure to toxic substances
110
What is an autoimmune hemolytic anemia?
Antibody against self antigens.
111
What is an isoimmune hemolytic anemia?
Maternal antibodies can cross the placenta and attack fetal RBCs.

Hematology (7 decks)

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