Flashcards in EXAM #1: PATHOLOGY OF ANEMIA Deck (54)
What is anemia?
Decreased RBC mass leading to decrease tissue oxygenation
Practically, what is anemia?
- Low Hb
- Low Hematocrit
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
How do you classify anemia?
- Increased blood loss
- Impaired production
- Increased destruction
What are the acute causes of blood loss?
What are the chronic causes of blood loss?
- Lesion of GI tract i.e. ulcer, colonic tumor...etc.
- Gynecological disturbance e.g. uterine leiomyoma
What is the cause of Fanconi anemia?
Defect in RBC stem cells
What is the cause of Thalassemia?
Defect in erythroblast maturation
What does Vitamin B12/Folate deficiency result in?
Defective DNA synthesis
What does iron deficiency result in?
Defective Hb synthesis
How does renal failure result in anemia?
Decrease EPO production
EPO is produced in the kidneys
Describe the basic etiology of ACD.
Inflammation induced iron sequestration
What are the primary hepatpoietic neoplasms?
What virus is associated with anemia?
Parvovirus B12 infection
This results in an infection of RBC progenitors
What are the inherited RBC membrane disorders?
What are the inherited enzymes deficiencies that result in anemia?
- HMP shunt (G6PD)
- Glyoclytic (pyruvate kinase)
What are the inherited Hb abnormalities that result in anemia?
- Thalassemia= defective globin synthesis
What are the acquired causes of increased RBC destruction?
- PIGA deficiency
- Autoimmune causes
- Mechanical trauma
What are the autoimmune disorders that can lead to anemia?
1) Transfusion reaction
2) Hemoluytic disease of the newborn
4) Auto-immune disorders
What are the causes of mechanical trauma to RBCs?
2) Cardiac trauma (valve disorders)
3) Infection-- malaria, babesiosis
4) Chemical injury-- lead poisoning
5) Sequestration of monoculear phagocyte system--hypersplenism
What is the normal size of a RBC on microscopy?
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.
Where do you read the PBS?
Near to the tail, but not at the tail
How can you tell a RBC is normochromic?
Central portion is 1/3 of the total diameter
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
See ppt examples to distinguish anisocytosis and poikilocytosis.
See ppt. examples to distinguish between hyperchromic and hypochromic.
What is "polychromasia?"
RBCs with more than one color
This is a sign of anemia?
What are immature RBCs blue or blue-gray?
- H & E staining of retics with RNA
- Straining of the RNA with acid is BLUE