Hematology Flashcards
(100 cards)
1
Q
This occurs when the red cell life span is reduced
A
Hemolytic anemia
2
Q
Increased number of red blood cells
A
Polcythemia
3
Q
Cells derived from erythroblast in the bone marriow
A
Red blood cell
4
Q
Cell does not have a nucleus with a life span of 120 days
A
RBC
5
Q
Symptoms of anemia include:
A
- tiredness
- shortness of breath
- poor concentration
- palpitations
- pallor
6
Q
Anemia is classified by the:
A
- Red cell volume
7
Q
MCV < 80 is considered what type of anemia
A
Microcytic sub class Fe Deficiency and Thalassemia
8
Q
MCV 80-95 is classified as:
A
Normocytic anemia: Chronic infection, renal disease, marrow disease
9
Q
MCV > 85 is classified as:
A
Macrocytic anemia: Vitamin B12 or folate deficiency
10
Q
how many grams of iron are in the body
A
4-5 grams
11
Q
Intake of iron through food is:
A
10-20 mg
12
Q
Heme iron is eaten in what kinds of food?
A
Meat and vegetables
13
Q
Which form of iron is most readily absorbed by the intestinal cells?
A
Ferrous
14
Q
What is the amino-acid involved in the synthesis of iron
A
Glycine
15
Q
What is the second major cause of microcytic anemia?
A
Thalassemia
16
Q
Thalassemia gets its name because it was common where?
A
In the Mediterranean
17
Q
Thalassemia is due to an imbalance in what?
A
Alpha or beta globin
18
Q
α-thalassemia results from deficiency where?
A
α-thalassemia is a result of a deficiency in the α-chains
19
Q
b-thalassemia results from a deficiency where?
A
b-thalassemia is a result of a deficiency in b-chain
20
Q
What causes the hemopoietic tissue to expand in people with B-thalassemia?
A
inadequately treated anemia makes the bone marrow expand
21
Q
Expansion within the bone marrow gives what type of appearance on an x ray?
A
Hair on end appearance
22
Q
When there is inflammation in the body, what effect does this have on iron?
A
When there is inflammation in the body, they sequesters iron within macrophages
23
Q
When the body sequesters iron within the macrophages what happens to the iron levels?
A
reduced iron levels with no increase in iron binding capacity
24
Q
A decrease in red cell production may be a result of a bone marrow disorder, some of those disorders are?
A
- Leukemia
- Proliferative disease
- infiltration
- Aplasia
25
the iron-binding storage protein. Its purpose is to store iron in a non-toxic form. Bone marrow macrophages are one of the storage
Ferritin
26
: Iron that is bound to transferrin; transferrin is the binding protein for iron in the blood and is synthesized in the
Serum iron
27
This is the concentration of transferrin.
Total iron binding capacity
28
Percentage of available binding sites on transferrin
Iron saturation
29
During inflammatory disease the liver produces a protein called?
Hepcidin
30
What does Hepcidin do?
It works to stop iron absorption in the duodenum and prevents iron recycling by inhibiting the breakdown of old RBCs.
31
An anemia that occurs due to the abnormalities in the synthesis of protoporphyrin
Sideroblastic anemia
32
This type of anemia the mean corpuscular volume is greater than 96 nm
Megaloblastic anemia
33
What is the most common form of macrocytic anemia
Megaloblastic anemia
34
what causes the red blood cells to be large with megaloblastic anemia
The vitamin deficiency limits the ability of the cell to divide and replicate due to a deficiency of B12 or folate
35
What is a pernicious anemia
an autoimmune disease in which antibodies are made against gastric parietal cells and intrinsic factor
36
Where is B12 absorbed
in the terminal ileum
37
What numbness disorder can B12 deficiency lead to
neuropathy
38
How is vitamin B12 deficiency treated
B12 injections
39
Why does Folate and a B12 Deficiency cause the same effect of megaloblastic anemia
Folate and B12 use the same pathways
40
If there is hemolysis of red blood cells what does the bone marrow do in response?
1. increase reticulocyte production
41
What causes the mean corpuscular volume to increase with hemolytic anemia?
Reticulocytes are larger that red blood cells
42
How long can the bone marrow keep up with a shortened RBC life span?
15 days
43
Why are patients with hemolytic anemia jaundiced?
Protoporphin as a result of a break down and destruction of RBC's
44
What are the two groups of hemolytic anemia?
1. Inherited
| 2. Acquired
45
Hereditary spherocytosis is treated how
Splenectomy
| or folic acid
46
Glucose 6 phosphate dehydrogenase (G6PD) is a what type of linked disease?
X linked
47
Where is G6PD most common?
The Mediterranean
| Africa
48
G6PD is what type of red blood cell disorder
Red Cell Enzyme Disorder
49
What are the three inherited hemolytic anemia's?
1. G6PD
2. Pyruvate Kinase Deficiency
3. Sickle Cell
50
How is sickle cell treated?
RBC transfusions
| hydroxycarbamide
51
What are acquired hemolytic anemia's
IgG
| IgM
52
What type of bilirubin will be increased in the blood of a patient with hemolytic anemia?
Unconjugated and total bilirubin
53
What is the name of the molecules that anchor the spectrin molecule
Band 3 protein Band 4.1 Ankyrin
54
What is the etiology of hemolytic crisis in G6PD deficiency?
1. Increased oxidative stress
55
What are complications of polycythemia?
Blood clots
lethargy
pruritus
56
Primary polycythemia can be related to?
Myeloproliferative disorder
57
Secondary polycythemia can be caused by?
Secondary to an increase in erythropoietin due to lung disease, smoking, altitude due to a tumor that is secreting EPO (rare)
58
Secondary polycythemia is treated how
By correcting the underlying condition
59
In a patient with polycythemia, the red cell mass is _____ and the plasma volume is___?
1. Red cell mass increased
| 2. Plasma volume is normal
60
What is anemia?
Decrease in total number of RBC's, HGB or circulating RBC mass
61
Anemias are classified as?
1. Microcytic (MCV < 80) 80-99
2. Macrocytic (MCV >100)
3. Normocytic (MCV 80-100)
62
Microcytic anemia is a RBC count of
less than 80 m
63
Normocytic anemia range is
80-100
64
Disease that cause non megoblastic anemia?
Liver Disease
Alcoholism
Reticulocytosis
Drugs
65
Immature blood cell
Blast
66
Macrocytic anemia ranges are
>100
67
Where is the grave site for a RBC
The spleen
68
If you can't make red blood cells how do you destroy RBC's?
You can't non hemolytic anemia
69
Diseases that are non hemolytic anemia specific are?
1. Blood loss < 1 week
2. Early stage Fe deficiency
3. Early stage anemia of chronic disease
4. Aplastic anemia
5. Renal disease
6. Malignancy
70
What is aplastic anemia?
A condition in which the body stops producing RBC's
71
What is an immature RBC called
Reticulocyte
72
Do you do iron studies with macrocytic and microcytic anemias
yes
73
Iron in it's primary form is stored in the cells as?
1. Ferritn
74
Increased serum iron results in a decreased?
TIBC
75
The average volume of red blood cells and is reflective of RBC size
Mean Corpuscular Volume
76
The bio-chemical component of RBC's that is responsible for binding with oxygen?
1. Hemoglobin
77
The measure of the total volume of % of RBC's in the blood?
Hematocrit
78
Normal HCT value for men is?
45%
79
Normal HCT for women is?
40&
80
A metalloprotein with iron being the metal attached to the globular protein?
HGB
81
Normal MCV is?
80-96
82
Accodring to the WHO anemia in non-pregnant women and otherwise healthy people is characterized by a HGB lower than?
12.5
83
lack of iron results in a decreased synthesis of____which results in a reduction in_____?
HBG
| The size of RBC's
84
Why can infants less than 6 months develop anemia
Lack of iron in breast milk
85
What is anemia from increased iron demand in the body?
During rapid growth phases and pregnancy due to increase in blood volume and the need to produce more Hgb
86
Blood loss in males resulting in anemia is usually the result of what disease?
Peptic ulcer
87
This type of anemia is strongly associated with inflammatory diseases?
Anemia of chronic disease
88
This type of anemia occurs due to abnormalities in the synthesis protoporphyrin, which results in decreased synthesis of hemoglobin?
Sideroblastic anemia
89
Iron along with protoporphyrin makes what?
heme
90
In sideroblastic anemia iron accumulates in the cells because its not being utilized to make heme due to the absence of protoporphyrin, which gives RBC's a__ around the cell?
Ring
91
In sideroblastic anemia the serum ferritin level is (1), serum iron is (2) and saturation is (3), the total iron binding capacity is (4).
1. Increased
2. Increased
3. Increased
4. decreased
92
Why does alpha thalassemia occur?
Because of gene deletion
93
non-megaloblastic anemia is less common cause of macrocytic anemia. Diseases associated with non-megaloblastic anemia are:
ETHOH abuse and drugs like 5-fluorouracil
94
If the reticulocyte count is more than 3% it is indicative of?
1. Bone marrow functioning normally, therefore in this case anemia is not due to underproduction of RBC's
95
If the reticulocyte is less than 3% is indicative of?
1. Abnormality in the bone marrow, therefore there is an underproduction of RBC's leading to anemia
96
What are the 3 conditions normocytic anemia occurs under?
1. Acute blood loss: Reticulocyte count <3%
2. Intrinsic defect of RBC: Retic count <3%
3. Extrinsic defect of RBC: Retic count >3%
97
IgG or IgM mediated destruction of RBC's, direct and indirect Combs test are used for diagnostic purposes?
Immune hemolytic anemias
98
RBC's getting damaged due to micro or macro thrombi, resulting in schistocytes, diseases include thrombotic thrombocytopenic purpura, hemolytic uremic syndrome DIC?
Micro/macroangiopathic hemolytic anemias
99
Destruction of RBC's by plasmodium species transmitted by the female anopheles mosquito?
Malaria
100
What are clinical findings of extrinsic defect in RBC's
1. Anemia
2. Jaundice due to increased destruction of RBC's by the spleen
3. Splenomegaly due to increased burden on the spleen to destroy so many abnormal RBC's
