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Laboratory Diagnostics > Hematology - Anemias > Flashcards

Hematology - Anemias Flashcards

1
Q

What is the Hematocrit ?

A

the proportion of red blood cells ,by volume, in the whole blood.
The Reference ranges is 26-50%

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2
Q

What a hematocrit may be used to ?

A
  • evaluate the severity of anemia
  • evaluate the severity of polycythemia
  • Monitor the response to treatment of anemia or polycythemia
  • Help make decisions about blood transfusions
  • Evaluate dehydration
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3
Q

What is MCV ?

A

It is a measurement of the average size of a single red blood cell
Reference ranges is 80-96 fL (depends on age)

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4
Q

What is MCH ?

A

the average amount of hemoglobin inside a single red blood cell
Reference ranges is 26-38 pg

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5
Q

What is MCHC ?

A

concentration of hemoglobin inside a single red blood cell Reference ranges is 31-37 g/dL

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6
Q

What does High MCHC indicate ?

A

Spherocytosis

  • is an auto-hemolytic anemia
  • characterized by the production of spherocytes (RBCs that are sphere-shaped rather than bi-concave disk shaped)
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7
Q

What is RDW ?

A

calculation of the variation in the size of RBCs

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8
Q

What is ANISOCYTOSIS ?

A

Variable size of red blood cells

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9
Q

What is Poikilocytosis ?

A

variable shapes of red blood cells

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10
Q

What are Reticulocytes ?

A

Immature red blood cel with network of ribosomes and endoplasmic reticulum
Reference ranges is 0.5-1.5%

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11
Q

What is ESR (Erythrocytes sedimentation rate) ?

A

the rate at which red blood cells sediment in a period of one hour

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12
Q

What maybe the cause of elevated ESR ?

A

two types of proteins, globulins or fibrinogen

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13
Q

What are the drugs affecting ESR ?

A
  • increase ESR : dextran, methyldopa, oral contraceptives, penicillamine, procainamide, theophylline, and vitamin A
  • decrease ESR : aspirin, cortisone, and quinine
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14
Q

What are the markers of hemolysis ?

A 
↑ LDH
↑ unconjugated Bilirubin
↑ plasma hemoglobin 
↓ haptoglobin
Hemoglobin in urine 
Hemosiderin in urine
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15
Q

What are the symptoms of hemolytic anemia ?

A

Jaundince, fatigue, tachycardia, pigmented gallstones, back pain, dark urine, splenomegaly

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16
Q

What is the difference between cold and warm autoimmune hemolytic anemia ?

A
  • Warm autoimmune hemolytic anemia IgG antibodies that bind RBC in 37°C
  • Cold autoimmune hemolytic anemia IgM antibodies that bind RBC in 0-22°C
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17
Q

What are the causes of Hereditary spherocytosis ?

A
  • genetic defects of spectrin, ankiryn, band 3 protein, protein 4.2 and/or others erythrocytes plasma membrane proteins.
  • Deficiency of cytoskeleton proteins results in characteristic red blood cell’s shape
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18
Q

How can we diagnose the Hereditary spherocytosis ?

A
  • high MCHC
  • high RDW
  • spherocytes in blood film
  • EMA test
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19
Q

What is the thalassemia ?

A

Mutation that leads to reduced production of a structurally normal globin chains

20
Q

How can we diagnose thalassemia ?

A
  • Low Hgb
  • Very low MCV
  • Highw RBC
  • High HbA2 and HbF in hemoglobin electrophoresis
21
Q

What is the Sickle cell anemia ?

A

Mutation that leads to production of structurally abnormal globin chains

22
Q

How much does the Sickle cell disease episode last ?

A

only 10 to 20 days

23
Q

What the Sickle cell disease patients are resistant to ?

A

To Plasmodium falciparum

24
Q

What is the cause of G6PD (Glucose-6-phosphate dehydrogenase deficiency) ?

A

Red cell enzyme defect

25
Q

How can we diagnose G6PD ?

A
  • Heinz bodies
  • bite cells
  • low G6PD activity
26
Q

What is DAT test ? For what is it used ?

A
  • DAT : Antihuman globulin binds IgG on RBC and agluttinate RBCs
  • positive in AIHA (autoimmune hemolytic anemia)
  • positive in HDN (hemolytic disease of newborns)
27
Q

When EMA (eosin-5’-maleimide) test is used ?

A

Usually in Hereditary spherocytosis

28
Q

What is osmotic fragility test ?

A

The measurement of erythrocyte resistance to hemolysis while being exposed to varying levels of dilution of a saline solution

29
Q

What does osmotic fragility increase indicate ?

A
  • Hereditary spherocytosis
  • Autoimmune spherocytosis
  • Poisoning, Severe burns
30
Q

What does osmotic fragility decrease indicate ?

A
  • Thalassemias
  • Iron deficiency anemia
  • Sickle cell anemia
31
Q

What are the indications of Hemoglobin electrophoresis ?

A
  • Thalassemia : elevated Hb-A2 and very high Hb-F

- Sickle cell anemia : absence of Hb-A and presence of Hb-S

32
Q

What is the first stage of IDA (Iron Deficiency Anemia) ?

A

Iron store depletion :

  • Decreased Serum ferritin
  • Stainable marrow iron
33
Q

What is the second stage of IDA (Iron Deficiency Anemia) ?

A

Impaired ertythropoiesis :

  • First stage events
  • Increased RDW and
  • Increased TIBC (Total iron binding capacity)
  • Decreased serum iron
34
Q

What is the third stage of IDA (Iron Deficiency Anemia) ?

A

Iron deficiency anemia

  • First and second stage events
  • Microcytosis (RBCs are unusually small)
  • Hypochromic anemia (RBCs are paler)
  • Presented clinically with fatigue and pallor
35
Q

How can we diagnose IDA ?

A

Decreased RBC, MCV and MCHC

Increased RDW

36
Q

What is the normal TIBC ? What is abnormal ?

A
  • 30% transferrin saturation is normal
  • 10% transferrin saturation is Iron deficiency
  • 60% transferrin saturation is hemochromatosis
37
Q

How can we differentiate between IDA and ACD (Anemia of chronic diseases) ?

A
  • the ferritin is decreased in IDA and increased in ACD
  • the hepcidin is decreased in IDA and increased in ACD
  • the transferrin is increased in IDA and decreased in ACD
  • the RDW is increased in IDA and remains normal in ACD
38
Q

What are the effects of vitamin B12 deficiency ?

A
  • Megaloblastic anemia

- Degenerative neurologic syndrome

39
Q

What are the effects of folate deficiency ?

A
  • Megaloblastic anemia
  • Nuclear maturation of bone marrow precursors
  • Impairment of DNA synthesis
40
Q

How can we diagnose Megaloblastic anemia ?

A
  • MCV is more than 115 fL
  • Oval macrocytosis
  • Decreased folate or vitamin B12
  • Hypersegmented neutrophils
  • Large platelets
41
Q

What is aplastic anemia ?

A

Complete absence of hematopoiesis

42
Q

What is Erythrocytosis ?

A

Persistent elevation in the RBC mass

43
Q

What are the two kinds of Erythrocytosis ?

A 
- Primarily : 
>myeloproliferative neoplasm 
- Secondary : 
> low PaO2 states, 
> abnormal Hemoglobin variants, 
> neoplasms that produce EPO (erythropoietin)
44
Q

How to differentiate between primary and secondary erythrocytosis ?

A
  • leukocytes elevated in prim and normal in sec
  • vitamin B12 elevated in prim and normal in sec
  • Splenomegaly in prim and normal spleen in sec
  • EPO decreased in prim and elevated in sec
  • PaO2 normal in prim and decreased in sec
45
Q

What is Polycythemia vera ?

A

Clonal neoplastic proliferation of erythroid precursors

Laboratory Diagnostics (2 decks)

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