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Hematology > Exam II > Flashcards

Exam II Flashcards

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1
Q

How are anemias classified according to cause?

A

hemolytic

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2
Q

How are anemias classified according to morphology?

A

macrocytic normochromic, normocytic normochromic, microcytic hypochromic

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3
Q

Lab results indicate that MCV is increased and MCHC is normal. Suggest a possible diagnosis.

A

macrocytic; liver disease, B12 deficiency, folate deficiency, pernicious anemias, alcoholism

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4
Q

What are the symptoms of anemia?

A

weak, pallored, shortness of breath, hypotension, fatigue, increased cardiac output, syncompe

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5
Q

Lab results indicate that MCV and MCHC are normal. Suggest a possible diagnosis.

A

normocytic; aplastic anemia, thyroid deficiency, hemoglobinopathies, hemolytic anemias

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6
Q

Lab results indicate that MCV and MCHC are low. Suggest a possible diagnosis.

A

iron deficiency anemias, thalassemia, sideroblastic anemia, lead poisoning

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7
Q

What is the peripheral blood picture in vitamin B12 and folate deficiency?

A

macrocytic, pancytopenia, ovalocytes, hypersegs (WBCs)

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8
Q

What do you see in the bone marrow in vitamin B12 and folate deficiency?

A

megaloblasts, giant bands, large precursors, M:E ratio lowered (E is elevated)

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9
Q

What deficiency diseases cause megaloblastic erythropoiesis and what cellular constituents are affected?

A

B12 and folate deficiency; DNA and RNA

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10
Q

What specifically causes pernicious anemia?

A

lack of intrinsic factor

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11
Q

What main clinical manifestation distinguishes vitamin B12 deficiency from folic acid deficiency?

A

B12 is needed for myelin sheath synthesis; patients with this deficiency often exhibit neurological symptoms

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12
Q

What conditions can produce non-megaloblastic macrocytic anemia?

A

liver disease and alcoholism

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13
Q

What poikilocytes are often seen in liver disease?

A

round macrocytes, target cells

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14
Q

What parameters are increased in aplastic anemia and what bone marrow precursor cells are decreased?

A

all

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15
Q

What is the peripheral blood picture in aplastic anemia and what would the reticulocyte count be expected to be?

A

lowered reticulocyte count

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16
Q

What are the most common causes of aplastic anemia?

A

drugs and chemicals (chloramphenicol, benzene*, radiation)

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17
Q

Name several causes of myelophthisic anemia?

A

leukemia, lymphoma, metastatic carcinoma, multiple myeloma

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18
Q

What poikilocyte is especially associated with the above condition because it indicates extramedullary hematopoiesis?

A

teardrop cells

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19
Q

What is the blood picture in chronic renal disease?

A

Burr cells, helmet cells, schistocytes

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20
Q

What is the main cause of anemia due to renal disease and to what kidney function test is the anemia frequently proportional?

A

kidney fails to make erythropoietin; BUN

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21
Q

What are the characteristics of anemia due to chronic disorders?

A

starts out normocytic normochromic, becomes microcytic hypochromic; BUN is increased, similar to iron deficiency; TIBC normal

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22
Q

What is the common characteristic of ALL hemolytic anemias?

A

RBC destruction

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23
Q

What type of RBC abnormality results in hereditary spherocytosis and how does it affect the shape and osmotic fragility of the RBC?

A

membrane is abnormal - cell is perfectly round as opposed to biconcave; osmotic fragility is increased

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24
Q

What biochemical pathway involves the enzyme glucose-6-phosphate dehydrogenase (G6PD)?

A

HMP shunt (AKA hexose monophosphate shunt, glucose pathway)

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25
What usually precipitates a hemolytic crisis in G6PD deficiency? What RBC inclusion does this deficiency produce?
presence of the oxidizing agent; Heinz bodies
26
What is the most unusual characteristic laboratory finding in ABO erythroblastosis of the newborn?
spherocytes
27
What is the most unusual characteristic laboratory finding in AIHA?
+ direct Coomb's (DAT)
28
How do PCH and PNH differ?
PCH has an antibody (extracorpuscular); PNH is and intracorpuscular defect
29
What in the difference between an intrinsic (intracorpuscular) defect and an extrinsic (extracorpuscular) defect?
intracorpuscular defects are generally genetic - there is something wrong inside the RBC that makes it sensitive to complement; extracorpuscular defects occur outside the RBC
30
In what condition is the Donath-Landsteiner antibody found?
PCH
31
What RBC abnormality is responsible for the formation of Burr cells and thorn cells?
cell membrane
32
What globin chains are found in A2 hemoglobin?
alpha-2-delta-2
33
What globin chains are found in F hemoglobin?
alpha-2-gamma-2
34
What globin chains are found in H hemoglobin?
four beta
35
Which globins are present only during embryonic development?
zeta and epsilon
36
What is the major hemoglobin of the newborn?
F
37
What hemoglobin is insoluble when reduced?
S
38
What hemoglobin is resistant to alkali?
F
39
What are the normal mobilities of hemoglobins A,C,F, and S on hemoglobin electrophoresis at pH 8.6?
C crawls, S is slow, F is fast, A accelerates faster than S
40
What poikilocyte is the "common denominator" of peripheral blood smears of patients with hereditary hemoglobinopathies?
target cells
41
What is the specific amino acid substitution in hemoglobin S? In hemoglobin C?
valine; lysine both are substitutions for glutamic acid at the 6 position on the beta chain
42
What are the clinical manifestations of sickle cell anemia?
aplastic/ thrombotic crises, decreased osmotic fragility due to target cells
43
What is the best test to use to differentiate sickles cell anemia from sickle cell trait?
hemoglobin electrophoresis
44
What does the peripheral blood smear usually show in sickle cell trait?
occasional target cell
45
What are the characteristics of hemoglobin C disease?
target cells, envelope cells, rod-shaped crystals, mild hemolytic anemia, = solubility test (no Hgb S)
46
What are the characteristics of hemoglobin SC disease?
bird/monument crystals, + solubility test
47
Why does the hemoglobin combination of S and D create a problem in the laboratory diagnosis of hemoglobinopathies?
they migrate together on hemoglobin electrophoresis at pH 8.6; pH 6 citrate agar is needed to separate them out
48
What does the peripheral blood smear usually show in IDA?
microcytic hypochromic, polychromasia, NRBCs
49
What does the serum iron and TIBC show in IDA?
increased serum iron and decreased TIBC
50
Define chlorosis.
greenish skin discoloration due to IDA
51
Define favism.
G6PD deficiency
52
Define koilonychia.
spoon-shaped fingernails
53
Define pica syndrome.
eating non-food items
54
What are some causes of IDA?
chronic bleeding, hookworm, menstrual issues, early formula conversion for infants
55
What is the specific cause of the thalassemias?
decreased rate of synthesis of certain polypeptide chains
56
What is another name for beta thalassemia?
Codey's or Mediterranean
57
What hemoglobins are increased in thalassemia major? Why are they increased?
A2 and F; beta chain synthesis is impaired
58
Define Bart's disease.
homozygous alpha thalassemia
59
Define Cooley's trait.
thalassemia minor
60
Define Fanconi's anemia.
congenital aplastic anemia
61
Define hemoglobin H disease.
heterozygous alpha thalassemia
62
What are the characteristics of sideroblastic anemia?
microcytic hypochromic, increased iron stores, ringed sideroblasts (NRBCs with iron)
63
What is the RBC inclusion most frequently associated with lead poisoning?
basophilic stippling
64
What blood cell parameters are increased in polycythemia?
RBCs, WBCs, and platelets
65
What is the cause of secondary polycythemia?
increased secretion of erythropoietin
66
What parameters are increased in secondary polycythemia?
RBCs (Hgb, Hct, RBC count)
67
What are some possible causes of relative polycythemia?
decreased plasma volume, dehydration, severe burns, stress
68
How do hemachromatosis and hemosiderosis differ?
hemachromatosis has organ damage due to increased iron storage in tissue; hemosiderosis is increased in normal areas

Hematology (4 decks)

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