EXAM #1: PATHOLOGY OF ANEMIA Flashcards Preview

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

Flashcards in EXAM #1: PATHOLOGY OF ANEMIA Deck (54):
1

What is anemia?

Decreased RBC mass leading to decrease tissue oxygenation

2

Practically, what is anemia?

- Low Hb
- Low Hematocrit

3

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

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

4

How do you classify anemia?

MCV
- Microcytic
- Normocytic
- Macrocytic

Etiology
- Increased blood loss
- Impaired production
- Increased destruction

5

What are the acute causes of blood loss?

Trauma

6

What are the chronic causes of blood loss?

- Lesion of GI tract i.e. ulcer, colonic tumor...etc.
- Gynecological disturbance e.g. uterine leiomyoma

7

What is the cause of Fanconi anemia?

Defect in RBC stem cells

8

What is the cause of Thalassemia?

Defect in erythroblast maturation

9

What does Vitamin B12/Folate deficiency result in?

Defective DNA synthesis

10

What does iron deficiency result in?

Defective Hb synthesis

11

How does renal failure result in anemia?

Decrease EPO production

EPO is produced in the kidneys

12

Describe the basic etiology of ACD.

Inflammation induced iron sequestration

13

What are the primary hepatpoietic neoplasms?

Acute leukemia
Myelodysplasia
Myeloproliferative disorder

14

What virus is associated with anemia?

Parvovirus B12 infection

This results in an infection of RBC progenitors

15

What are the inherited RBC membrane disorders?

Hereditary spherocytosis
Hereditary elliptocytosis

16

What are the inherited enzymes deficiencies that result in anemia?

- HMP shunt (G6PD)
- Glyoclytic (pyruvate kinase)

17

What are the inherited Hb abnormalities that result in anemia?

- Thalassemia= defective globin synthesis
- Hemoglobinopathies

18

What are the acquired causes of increased RBC destruction?

- PIGA deficiency
- Autoimmune causes
- Mechanical trauma

19

What are the autoimmune disorders that can lead to anemia?

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

20

What are the causes of mechanical trauma to RBCs?

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

21

What is the normal size of a RBC on microscopy?

6-8 um

22

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

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

Where do you read the PBS?

Near to the tail, but not at the tail

24

How can you tell a RBC is normochromic?

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.