Hematologic Disorders

Question 1

what are the cells in the blood

Answer 1

rbc, wbc, thrombocytes ( platelets)

Question 2

what is blood made of

Answer 2

cells and plasma

Question 3

what is plasma

Answer 3

water, proteins, glucose, cholesterol, Ca, hormones, metabolic waste, etc

Question 4

what is the fluid remaining after blood clots called; contains no fibrinogen and cannot clot again ; used for lab analyses since clotting can affect tests

Answer 4

serum

Question 5

what are the diff types of hematopoiesis

Answer 5

lymphopoeisis, myelopoeisis, erythropoeisis

Question 6

what is hematopoiesis affected by

Answer 6

infection, allergy, hemorrhage, exertion, and drugs

Question 7

where are the stem cells located

Answer 7

bone marrow

Question 8

these are non dividing cells; they transport oxygen and CO2 ; no nucleus, no mitochondria, and have rapid turnover

Answer 8

rbc

Question 9

these cells have adult sites of production ( vertebrae, pelvis, sternum, ribs); lifespan of 120 days; removed by mononuclear phagoctyes system ( spleen, liver, and lymph nodes)

Answer 9

rbc

Question 10

what are the growth requirements for rbc

Answer 10

iron, protein, vitamins ( folate and B12)

Question 11

iron is important for _____

Answer 11

heme pt of hemoglobin molecule

Question 12

protein is important for ____

Answer 12

globin part of hemoglobin

Question 13

folate is good for _____

Answer 13

dna synthesis

Question 14

what are some stimulating factors of rbc

Answer 14

hemorrhage, damage to bone marrow, high altitude, exercise, hemolytic disease, and low hemoglobin levels

Question 15

this is regulated by oxygen levels in the blood; stimulated by hypoxia

Answer 15

erythropoeisis

Question 16

what produces erythropoeitin

Answer 16

peritubular cells of the kidney

Question 17

what induces RBC production in the bone marrow

Answer 17

erythropoietin- takes 4 days

Question 18

what is the general rbc circulation

Answer 18

rbc produced -> incorporated into hemoglobin-> Hb broken down into heme and globin > heme broken down into iron and bilirubin > bilirubin stored in liver > iron stored in spleen> some iron reused in the synthesis of new Hb

Question 19

% of blood that is RBCsl convenient way to determine if rbc count is normal ; women have less due to menstrual cycle

Answer 19

hematocrit

Question 20

what is reduced oxygen carrying capacity

Answer 20

anemia

Question 21

what is an important cause of anemia

Answer 21

iron deficiency and end stage renal failure

Question 22

what are some symptoms of anemia

Answer 22

overall weakness, tachycardia, fatigue, dyspnea, pallor

Question 23

what are 4 diff ways to get anemia

Answer 23

production failure of rbcs, hemorrhage, hemolysis, and hypersplenism ( overly active spleen)

Question 24

what are the etiologies of anemia

Answer 24

hypoproliferatie and hemolytic

Question 25

what are the diff size classifications of anemia

Answer 25

macrocytic, microcytic, and normocytic

Question 26

what is the Hb content of anemia

Answer 26

normochromic and hypochromic

Question 27

what are large, abnormally shaped rbcs; normal Hb concentration

Answer 27

macrocytic normochromic anemia

Question 28

which type of anemia is due to lack of vitamin B12; abnormal dna synthesis in the rbc ; premature cell death ; can be congenital or acquired def. of IF or genetic disorder of DNA synthesis; mean pt age 60 YO

Answer 28

pernicious anemia ; more common than folate def )

Question 29

which type of anemia is due to lack of folate; abnormal dna synthesis and premature cell death ; caused by dietary folate def.

Answer 29

folate def. anemia

Question 30

causes of this anemia include autoimmune and malabsorption disorder ( Crohns, etc); H pylori infection, ETOH abuse, PPI use, diet ( vegetarians ; treat with B12 injections

Answer 30

pernicious anemia

Question 31

how do we obtain the B vitamin

Answer 31

through the diet; malabsorption can lead to folate def. ; B vitamin is a coenzyme involved with DNA synthesis in RBCs; this def. associ with neural tube defects in fetuses

Question 32

what are the causes of folate def.anemia

Answer 32

autoimmune and malabsorption disorders, ETOH abuse, diet ; tx with oral supplements and /or diet changes

Question 33

which type of anemia has small , abnormally shaped RBCs; reduced Hb concentration

Answer 33

microcytic hypochromic anemia

Question 34

what are the diff types of macrocytic anemias

Answer 34

pernicious anemia and folate def. anemia

Question 35

what are the diff types of microcytic anemias

Answer 35

iron def. anemia, and sideroblastic anemia and lead poisoning

Question 36

which type of micro anemia deals with lack of iron for Hb; insuff Hb ; caused by chronic blood loss, dietary Fe def. and disruption of iron metabolism or iron cycle

Answer 36

iron def. anemia

Question 37

which type of micro anemia deals with dysfunctional iron uptake by erythroblasts ; defective porphyrin and heme synthesis; caused by congenital dysfunction of iron metabolism in rbc ; acquired dysfunction of iron metabolism as a result of drugs or toxins

Answer 37

sideroblastic anemia

Question 38

this type of micro anemia deals with the inhibition of heme ad globin ; synthesis of rbc; caused by excessive lead exposure

Answer 38

lead poisoning

Question 39

this is the most common type of anemia worldwide; risk groups are poor, women, and children

Answer 39

iron def. anemia ( affects 20 %)

Question 40

what are the main causes of iron def. anemia in the US

Answer 40

pregnancy and heavy menstruation, chronic GI bleeds

Question 41

how is iron def. anemia dx'd

Answer 41

blood test and hematocrit

Question 42

how is iron def. anemia tx'd

Answer 42

address bleeding and iron supplementation

Question 43

this type of anemia cannot incorporate iron into Hb in RBC; ringed nuclei in bone marrow and hemochromatosis ( brown skin)

Answer 43

sideroblastic anemia

Question 44

what are some causes of sideroblastic anemia

Answer 44

congenital, myelodysplastic syndrome, meds, toxins, and ETOH Abuse

Question 45

how do we Dx sideroblastic anemia

Answer 45

bone marrow sample containing sideroblasts

Question 46

how do we tx B6 supplementation and bloodletting

Answer 46

sideroblastic anemia

Question 47

the MOA of this anemia inhibits heme and globin synthesis of RBCs; children are high risk

Answer 47

lead poisoning

Question 48

what are some early signs and symptoms of lead poisoning

Answer 48

pallor, ab pains, irritability

Question 49

what are late signs of lead poisoning

Answer 49

lethargy, anorexia, ataxia, slurred speech, and convulsions

Question 50

what is tx of lead poisoning

Answer 50

remove lead source and/or chelation

Question 51

what is anemia that deals with normal size and normal Hb concentration

Answer 51

normocytic/normochromic anemia

Question 52

what are diff types of normochromic anemia

Answer 52

aplastic anemia, posthemorrhagic anemia, hemolytic anemia, and anemia of chronic inflammation

Question 53

this type of normo. anemia is when bone marrow is replaced with fibrous, fatty tissue ; abrupt onset of low blood cell counts; increased incidence of infections and hemorrhages; occurs in healthy young adults

Answer 53

aplastic anemia

Question 54

etiology of this anemia is idiopathic ( 75%); secondary > chloramphenicol ; tx of this anemia includes a bone marrow transplant

Answer 54

aplastic anemia

Question 55

this type of anemia is due to premature destruction of RBCs; signs include fatigue, jaundice, and red-brown urine

Answer 55

hemolytic anemias

Question 56

causes of this anemia include inherited def. of RBC membranes, enzyme defects, Hb; toxic or Ab damage to the circulating RBC ( autoimmune/medications)

Answer 56

hemolytic anemias

Question 57

what is 2nd to IDA in incidence; usually occurs in adults ; causes are AIDS, RA, SLE

Answer 57

Anemia of chronic disease

Question 58

this type of anemia is assoc with decreased RBC lifespan, suppressed production of EPO; ineffective bone marrow erythroid progenitor response to EPO; altered iron metabolism and iron sequestration in macrophages

Answer 58

anemia of chronic disease