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Hematology and Oncology > EXAM #1: PATHOLOGY OF ANEMIA > Flashcards

EXAM #1: PATHOLOGY OF ANEMIA Flashcards

(54 cards)

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1
Q

What is anemia?

A

Decreased RBC mass leading to decrease tissue oxygenation

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2
Q

Practically, what is anemia?

A
  • Low Hb

- Low Hematocrit

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3
Q

What is important to remember when you come to the diagnosis of “anemia?”

A

This is an intermediate diagnosis and you need to find the UNDERLYING CAUSE

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4
Q

How do you classify anemia?

A

MCV

  • Microcytic
  • Normocytic
  • Macrocytic

Etiology

  • Increased blood loss
  • Impaired production
  • Increased destruction
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5
Q

What are the acute causes of blood loss?

A

Trauma

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6
Q

What are the chronic causes of blood loss?

A
  • Lesion of GI tract i.e. ulcer, colonic tumor…etc.

- Gynecological disturbance e.g. uterine leiomyoma

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7
Q

What is the cause of Fanconi anemia?

A

Defect in RBC stem cells

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8
Q

What is the cause of Thalassemia?

A

Defect in erythroblast maturation

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9
Q

What does Vitamin B12/Folate deficiency result in?

A

Defective DNA synthesis

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10
Q

What does iron deficiency result in?

A

Defective Hb synthesis

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11
Q

How does renal failure result in anemia?

A

Decrease EPO production

EPO is produced in the kidneys

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12
Q

Describe the basic etiology of ACD.

A

Inflammation induced iron sequestration

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13
Q

What are the primary hepatpoietic neoplasms?

A

Acute leukemia
Myelodysplasia
Myeloproliferative disorder

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14
Q

What virus is associated with anemia?

A

Parvovirus B12 infection

This results in an infection of RBC progenitors

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15
Q

What are the inherited RBC membrane disorders?

A

Hereditary spherocytosis

Hereditary elliptocytosis

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16
Q

What are the inherited enzymes deficiencies that result in anemia?

A
  • HMP shunt (G6PD)

- Glyoclytic (pyruvate kinase)

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17
Q

What are the inherited Hb abnormalities that result in anemia?

A
  • Thalassemia= defective globin synthesis

- Hemoglobinopathies

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18
Q

What are the acquired causes of increased RBC destruction?

A
  • PIGA deficiency
  • Autoimmune causes
  • Mechanical trauma
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19
Q

What are the autoimmune disorders that can lead to anemia?

A

1) Transfusion reaction
2) Hemoluytic disease of the newborn
3) Drugs
4) Auto-immune disorders

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20
Q

What are the causes of mechanical trauma to RBCs?

A

1) DIC
2) Cardiac trauma (valve disorders)
3) Infection– malaria, babesiosis
4) Chemical injury– lead poisoning
5) Sequestration of monoculear phagocyte system–hypersplenism

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21
Q

What is the normal size of a RBC on microscopy?

A

6-8 um

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22
Q

List the characteristics of a normal PBS (Peripheral Blood Smear).

Study These Flashcards
A

1) Normochromic= normal Hb
2) Minimal poikilocytosis= irregular shape
3) Minimal anisocytosis= different sizes
4) Nothing “weird”

“Weird” things include nucleated RBCs, infectious organisms, iron aggregates, Howell-Jolly bodies.

23
Q

Where do you read the PBS?

Study These Flashcards
A

Near to the tail, but not at the tail

24
Q

How can you tell a RBC is normochromic?

Study These Flashcards
A

Central portion is 1/3 of the total diameter

25
What are the features of a hypochromic RBC? Hyperchromic?
Hypo= central protion is greater than 1/3 of the RBC Hyper= central portion is less than 1/3 of the RBC
26
See ppt examples to distinguish anisocytosis and poikilocytosis.
N/A
27
See ppt. examples to distinguish between hyperchromic and hypochromic.
N/A
28
What is "polychromasia?"
RBCs with more than one color - Pink - Blue - Blue-gray This is a sign of anemia?
29
What are immature RBCs blue or blue-gray?
- H & E staining of retics with RNA | - Straining of the RNA with acid is BLUE
30
See ppt. example of polychromasia.
N/A
31
What is normoblastemia? What is this an indication of?
- Presence of nucleated RBCs in PBS | - Hemolytic anemia
32
See ppt example of normoblastemia.
N/A
33
What are the characteristics of a spherocyte?
- Spherical - Small - Darker in color
34
What are the the underlying causes of spherocytes on PBS?
- Hereditary spherocytosis | - Autoimmune hemolytic anemia
35
See ppt. example of spherocytes.
N/A
36
What is a schistocyte?
"Broken" or fragmented RBC
37
What are the causes of schistocytes?
- Microangiopathic hemolytic anemia (DIC, TTP, HUS) - Other hemolytic anemia *****Any situation of hemolytic anemia may cause schistocytes.*****
38
See ppt. example of a schistocyte.
N/A
39
What is punctate basophilia/ basophilic stippling?
Tiny blue dots in the periphery of the RBC
40
What are the causes of punctate basophilia?
- Lead poisoning - Severe anemia - Severe infection - Drugs - Alcoholism
41
See ppt slide example of basophilic stippling.
N/A
42
What is a Howell-Jolly body or H-J body?
- RBC with a purple dot | - Purple nuclear remnant that are LARGER than basophilic stippling
43
What causes Howell-Jolly bodies?
- S/p splentectomy - Hemolysis Spleen cannot rid the body of abnormal RBCs.
44
See ppt example of H-J body.
N/A
45
What are the features of reticulocytes?
Blue staining cell with blue staining darker central features
46
See ppt. examples of reticulocytes.
N/A
47
List the causes of microcytic anemia.
1) Iron deficiency 2) ACD 3) Thalassemia 4) Siderblastic anemia
48
What are the causes of defects in heme synthesis?
1) Iron deficiency anemia 2) ACD 3) Sideroblastic anemia
49
What causes defects in the synthesis of globin chains (alpha or beta)?
Thalassemia
50
See ppt example of microcytic anemia.
N/A
51
What is a typical reference for RBC size in a PBS?
Lymphocyte--the RBC should be the same size as the NUCLEUS of the lymphocyte
52
What are the common causes of macrocytic anemia?
1) Vitamin B12/ Folate deficiency-->decreased DNA synthesis 2) Alcohol use-->increased RBC membrane 3) Liver disease 4) Reticulocytosis 5) Myelodysplastic syndrome* 6) Hypothyroidism* *uncommon causes
53
What is the common cause of normocytic anemia?
Blood loss
54
Describe the physiologic response to acute blood loss.
1) Intravascular shift of water 2) Hemodilution 3) EPO stimulation Reticulocytes appear in peripheral blood after 5 days.

Hematology and Oncology (38 decks)

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