FINALS - ANEMIA P2

Question 1

Anemia due to mechanical extracorpuscular abnormality

Answer 1

• Microangiopathic hemolytic anemia (MAHA)
   thrombotic thrombocytopenic purpura
   hemolytic uremic syndrome (HUS)
• Traumatic cardiac hemolytic anemia

Question 2

is a group of clinical disorders characterized by RBC fragmentation
in the circulation resulting in intravascular hemolysis

Answer 2

Microangiopathic hemolytic anemia (MAHA)

Question 3

Microangiopathic hemolytic anemia (MAHA)

fragmentation occurs as a result of:

Answer 3

RBCs passing through fibrin deposits inside the lumen of
arterioles and capillaries

damaged epithelium and vessel walls

Question 4

Lab findings of Microangiopathic hemolytic anemia (MAHA)

Answer 4

anemia (low hgb, hct), presence of
schistocytes

Question 5

MAHA is characterized by schistocytes or also called as

Answer 5

helmet cell

Question 6

4 Disorders/conditions of MAHA:

Answer 6

Thrombotic thrombocytopenic purpura (TTP)
Hemolytic uremic syndrome (HUS)
Disseminated Intravascular coagulation (DIC)
hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP)

Question 7

is rare and potentially fatal characterized by disseminated
thrombotic occlusions of the microcirculation.

Answer 7

Thrombotic thrombocytopenic purpura (TTP)

Question 8

Ecchymosis largest
purpura - 2nd to the largest
petechiae - 3rd

true or false

Answer 8

true

Question 9

caused by deposition of microthrombi that contain platelets
and von Willebrand factor in arterioles and capillaries of many
organs can be found commonly in adults and can be seen also in children
but rare

thrombi - clots
von willebrand factor - adhesion

Answer 9

Thrombotic thrombocytopenic purpura (TTP)

Question 10

Hemolytic uremic syndrome (HUS)

severe microangiopathic anemia caused by E. coli serotype ___

Answer 10

0:157 H7

Question 11

Hemolytic uremic syndrome (HUS) difference to TTP

Answer 11

same thrombocytopenia (dec platelets)
both chance of bleeding

renal failure is only for HUS

Question 12

causes of Hemolytic uremic syndrome (HUS)

Answer 12

 renal failure
 thrombocytopenia (dec platelets)
 mucocutaneous hemorrhage

Question 13

Lab findings of HUS

Answer 13

schistocytes, gastroenteritis (bloody diarrhea,
develops after 1-3 days), affected and kidney

Question 14

Characterized by a widespread activation of the hemostatic
system, once it was activated it results into fibrin and thrombi
formation, kaya merong pagbara

Answer 14

Disseminated Intravascular coagulation (DIC)

Question 15

is Disseminated Intravascular coagulation (DIC) as well a secondary complication?

Answer 15

yes

Question 16

a condition of MAHA that is a very serious complication during pregnancy

Answer 16

hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP)

Question 17

anemia is caused by injury and fragmentation RBCs exposed to high shear stresses on a foreign surface during cardiac surgery

Answer 17

Traumatic cardiac hemolytic anemia/ Macrovascular
hemoglobinuria

Question 18

Lab findings of Traumatic cardiac hemolytic anemia/ Macrovascular
hemoglobinuria

Answer 18

presence of schistocytes, inc. reticulocytes, dec.
platelets, inc. LDH (Lactate dehydrogenase is an enzyme found in
nearly all living cells

Question 19

cardiac surgery nagkakaron ng hemolysis, magiging normal after the surgery

Answer 19

Traumatic cardiac hemolytic anemia/ Macrovascular
hemoglobinuria

Question 20

MARCH HEMOGLOBINURIA is also known as

Answer 20

Sports anemia

Question 21

Sports anemia, wherein there is a destruction of RBC due to

Answer 21

o Extreme Training
o Marching for many hours

Question 22

Laboratory findings of
MARCH HEMOGLOBINURIA

Answer 22

o Destruction of RBC/Schistocytes
o Decrease Hct and Hgb
o Macrocytic: Tea colored urine
o Increase in Retics

Question 23

ANEMIA DUE TO INFECTIONS

Answer 23

1. malaria
2. Babesiosis
3. Bartonellosis (Carrion disease)
4. Erlichiosis

Question 24

Acute, chronic or recurrent febrile protozoan infection
transmitted by the bite of the female Anopheles
mosquito.

Answer 24

malaria

Question 25

Can cause anemia by the rupture of infected cells at the end of the asexual cycle

Answer 25

Malaria

Question 26

Amount of hemolysis is related to the number of RBC parasitized by the plasmodium

Answer 26

Malaria

Question 27

Medication for malaria

Answer 27

quinine

Question 28

Laboratory findings of Malaria

Answer 28

i. Decrease survival rate of RBC (Does not reach 120 days) ii. Spherocytosis

Question 29

An uncommon hemolytic disorder caused by protozoan babesia microti

Answer 29

Babesiosis

Question 30

It can the transmitted either from deer, mice to humans by vector (Ixodes dammini) or blood transfusion

Answer 30

Babesiosis

Question 31

Babesiosis treatement

Answer 31

Clindamycin

Question 32

Caused by B. bacilliformis transmitted by the sandfly

Answer 32

Bartonellosis (Carrion disease)

Question 33

Two clinical stages of Bartonellosis (Carrion disease)

Answer 33

Oroya fever Veruga pernuana

Question 34

Oroya fever AKA ___

Answer 34

Autoimmune hemolytic anemia or AHA

Question 35

Veruga pernuana has a clinical manifestation of

Answer 35

 Blisters  Swelling to the highest level

Question 36

Diagnosis for Bartonellosis (Carrion disease)

Answer 36

Blood culture

Question 37

Disease caused by a small intracellular bacateria, ehlichia transmitted by ticks to humans

Answer 37

Erlichiosis

Question 38

LABORATORY TEST OF ANEMIA DUE TO INFECTION

Answer 38

1. CBC 2. Peripheral smear Species of malarial parasite 3. Reticulocyte count increases because of lysis 4. Serological test

Question 39

ANEMIA DUE TO CHEMICAL AND PHYSIAL AGENTS

Answer 39

1. Drugs and chemicals 2. Venom 3. Thermal injury

Question 40

Caused by oxidative denaturation of hemoglobin leading to the formation of:

Answer 40

i. Methemoglobin ii. Sulfhemoglobin iii. Heinz bodiess and chemicals

Question 41

Example of Drugs and chemicals

Answer 41

i. Naphthalene (Moth balls) ii. Dapsone (for leprosy) iii. Arsenic, copper, lead (for intravascular hemolysis)

Question 42

Venom will cause

Answer 42

lysis

Question 43

Brown recluse spider (loxoscheles reclusa)

Answer 43

venom

Question 44

 Third 3rd degree burns  Damage to RBC circulating in he involved skin and tissues leading to hemolysis

Answer 44

third injury

Question 45

H. Spherocytosis Type of inheritance:

Answer 45

Abnormal Autosomal

Question 46

Physical feature of H. Spherocytosis

Answer 46

Physical feature:  Enlargement of the spleen  Jaundice  Anemia

Question 47

Clinical findings of H. Spherocytosis

Answer 47

 Assymptomatic to severe type  Rbc become spherocytosis  75% autosomal dominant  25% autosomal non-dominant

Question 48

Defects of H. Spherocytosis

Answer 48

 ANK1 or Ankyrin and  Alpha and beta spectrin  Protein 4.2

Question 49

H. elliptocytosis is also known as

Answer 49

Hereditary ovalocytosis

Question 50

Type of inheritance of H. elliptocytosis

Answer 50

Autosomal dominant

Question 51

Physical Feature of H. elliptocytosis

Answer 51

 Splenomegaly  Neonatal jaundice

Question 52

Clinical findings of H. elliptocytosis

Answer 52

 90% cases asymptomatic  10% moderate to severe type of anemia (must be managed with blood transfusion and splenectomy)

Question 53

Defects in H. elliptocytosis

Answer 53

 Spectrin  Protein 4.1  Alpha or beta spectrin

Question 54

seen in PS of pyropoikilocytosis

Answer 54

micropyropoikilocytosis and fragmentation of RBC  Very sensitive to heat

Question 55

Type of inheritance of H, pyropoikilocytosis

Answer 55

Autosomal recessive

Question 56

Defects in H , pyropoikilocytosis

Answer 56

 Spectrin  Alpha or beta spectrin

Question 57

Type of inheritance: H. stomatocytosis

Answer 57

Autosomal recessive

Question 58

H. stomatocytosis is known as

Answer 58

Hereditary hydrocytosis

Question 59

H. stomatocytosis is caused by

Answer 59

 Increase in sodium and decrease in potassium  Due to increased permeability of the membrane

Question 60

H. acanthocytosis is caused by

Answer 60

Caused by absence of beta-lipoprotein

Question 61

H. acanthocytosis Associated with ____ condition

Answer 61

Abeta;lipoproteinemia

Question 62

Type of inheritance: H. acanthocytosis

Answer 62

Autosomal recessive

Question 63

Result from heme suppression and lack Rh antigen in the RBC membranes

Answer 63

RH null disease

Question 64

Type of inheritance of RH null

Answer 64

Autosomal recessive

Question 65

PAROXYSMAL NOCTURNAL HEMOGLOBINURIA Also known as ___

Answer 65

Marchiafava-micheli syndrome

Question 66

Rare chronic defect in RBC membrane considered to be sleep related hemoglobinuria

Answer 66

PAROXYSMAL NOCTURNAL HEMOGLOBINURIA

Question 67

Etiology of PAROXYSMAL NOCTURNAL HEMOGLOBINURIA

Answer 67

UNKNOWN

Question 68

Lahat ng cells natin dito very sensitive to lysis by complement causing chronic intravascular hemolysis

Answer 68

PAROXYSMAL NOCTURNAL HEMOGLOBINURIA

Question 69

Red cells are sensitive to low pH of plasma and occurs during depressed respiration while sleeping, caused by retention of CO2 resulting in acidosis

Answer 69

PAROXYSMAL NOCTURNAL HEMOGLOBINURIA

Question 70

PAROXYSMAL NOCTURNAL HEMOGLOBINURIA Major problem dito walang ___

Answer 70

C55 CD55 CD59

Question 71

hemolysis in PAROXYSMAL NOCTURNAL HEMOGLOBINURIA is called as

Answer 71

Intravascular hemolysis

Question 72

in PNH Kapag nagkaroon na ng intravascular hemolysis that’s the time na magkakaroon na tayo ng hemoglobinuria and hemosidinuria  ___ it is a yellowish brown crystal that can be found in urine

Answer 72

Hemosidinuria

Question 73

Special tests for Paroxysmal nocturnal hemoglobin

Answer 73

Ham’s Test/Ham’s Acidified Serum Test Sugar Water Test/Sucrose Hemolysis Crosby’s thrombin test Cobra-venom test Heat Resistance Test Insulin Test

Question 74

two common test for PNH

Answer 74

Ham’s Test/Ham’s Acidified Serum Test Sugar Water Test/Sucrose Hemolysis

Question 75

screening test for PNH

Answer 75

Sugar Water Test/Sucrose Hemolysis

Question 76

most common metabolic disorder of RBCs involving the HMP (aerobic glycolysis) involving hexose monophosphate

Answer 76

G6PD Deficiency

Question 77

most common metabolic disorder of RBCs involving the EMP (anaerobic glycolysis)

Answer 77

Pyruvate Kinase Deficiency

Question 78

lack of ATP  decreased erythrocytes deformability that reduces the lifespan of RBC

Answer 78

Pyruvate Kinase Deficiency

Question 79

Laboratory findings of Pyruvate Kinase Deficiency

Answer 79

o Fluorescent Spot Test (+) o Quantitative assay of PK (dec.) o ↑ Reticulocyte count

Question 80

also known as sickle cell disease or drepanocytosis

Answer 80

Sickle Cell Anemia

Question 81

inherited defect that results in abnormal structure of one of the globin chains of the hemoglobin molecule caused by genetic mutations.

Answer 81

Hemoglobinopathy - Globin abnormality

Question 82

Hemoglobinopathy - Globin abnormality most common in ethnic population from

Answer 82

Africa, the Mediterranean basin and Southeast Asia

Question 83

homozygous Hb S disease

Answer 83

Sickle Cell Anemia

Question 84

the abnormality is due to substitution of valine for glutamic acid in position 6 in the beta chain

Answer 84

Sickle Cell Anemia

Question 85

distribution of Hgb is thru Hgb __

Answer 85

electrophoresis

Question 86

Hgb distribution of Sickle cell anemia

Answer 86

o HgbA: 0% o Hgb S: >80%) o Hgb F:1-20% o HgbA₂: 2-5%