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RRPA Pathophysiology II > Hematopathology - Schoenwald > Flashcards

Hematopathology - Schoenwald Flashcards

(54 cards)

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1
Q

Anemia is a ______ in RBC count and erythrocytosis is a ________ in RBC count. (Not going into super detail on this lecture because we did a lot of this in clin med, feel free to add stuff)

A

decrease increase

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2
Q

Name 3 mechanisms of anemia.

A
  • Blood loss
  • Decreased RBC production
  • Increased RBC destruction
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3
Q

What is a reticulocyte?

A

Immature RBC

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4
Q

What are schistocytes?

A

RBC fragments

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5
Q

What is erythroblastosis fetalis?

A

It is an Rh factor incompatibility between mother and fetus leading to anemia due to increased destruction of RBCs.

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6
Q

People with paroxysmal nocturnal hemoglobinuria have acquired a defect in what gene?

A

Phosphatidylinositol class A (PIG-A)

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7
Q

What two organs remove RBCs from circulation?

A

Spleen and liver

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8
Q

An increase in unconjugated bilirubin levels is associated with what clinical findings?

A

Jaundice and gallstones

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9
Q

Name 2 conditions associated with spherocytes

A

hereditary spherocytosis

immune hemolysis

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10
Q

Name 2 conditions associated with schistocytes

A

TTP

HUS

(also, having a mechanical valve)

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11
Q

What type of conditions should be associated with target cells?

A

Hemoglobinopathies (thalassemia)

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12
Q

What condition is associated with teardrops?

A

Myelofibrosis

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13
Q

What is a rouleaux and what is one condition they are commonly seen in?

A

“stacking of coins” - RBCs are stacked together.

Common in multiple myeloma

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14
Q

Which thalassemia is more worrisome, alpha or beta thalassemia?

A

Beta

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15
Q

A patient with alpha thalassemia, with a loss of 3 copies of the alpha globulin chain gene will have which of the following?

a) the patient will be stillborn
b) the patient will have marked anemia
c) the patient will be a carrier for alpha thalassemia
d) the patient with be asymptomatic with a low MCV

A

b)the patient will have marked anemia

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16
Q

What patient population is most commonly diagnosed with beta thalassemia?

A

Patients of Mediterranean descent

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17
Q

T/F? Patients with beta thalassemia minor usually require blood transfusions

A

False - patients with beta thalassemia major usually require blood transfusions.

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18
Q

There are ____ copies of alpha globulin and ____ copies of beta globulin. This is important for classifying thalassemias

A

4 alpha, 2 beta

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19
Q

you have a patient who is asymptomatic but their labs exhibited a low MCV. Upon further investigation they have a loss of 2 of the alpha globulin chains. this is characteristic of what disease

A

alpha thalassemia

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20
Q

a complete loss of the hemoglobin protein is what disease?

A

Beta thalassemia

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21
Q

Beta thalassemia major is usually seen at 6 months of age due to the loss of _____ which transitions into ____

A

Hgb F (fetal) and it transitions into Hgb A (adult)

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22
Q

a characteristic lab finding of thalassemia minor is a disproportionate _____ and _____

a. MCV/ MHC
b. MCHC/ MCH
c. Hgb/ MCV
d. Hgb/ MCH

Study These Flashcards
A

c. Hgb/ MCV (10/55)

23
Q

labs of thalassemia: ____MCV ____Hgb anisocytosis Poikilocytosis

Study These Flashcards
A

decreased MCV Decreased hgb

24
Q

what is hepcidin and how does it play a role in anemia of chronic disease

Study These Flashcards
A

it is a protein that is key regulator of the entry of iron into circulation. it impairs the release of iron from storage. therefor there will be elevated levels of iron in storage and decrease levels of iron in the serum.

25
Levels of ferratin, iron, TIBC, transferrin in IDA a. increased, increased, decreased, decreased b. decreased, decreased, increased, increased c. decreased, increased, increased, increased d. decreased, decreased, increased, decreased
d. decreased, decreased, increased, decreased
26
Transferrin is usually _____ related to TIBC a. inversely b. directly c. not d. the two are the same
a. TIBC and transferrin are inversely related
27
one way to differentiate between B12 deficiency and folate deficiency is\_\_\_\_\_\_\_
Elevated homocysteine and methyl-malonic acid with B12 deficiency. Also B12 deficiency has neuro deficits that you don't get with folate deficiency.
28
you have a patient that has some paralysis in their left arm. You've done every workup you can think of for a stroke and they are negative. Finally you get the blood work back and they are deficient in an important substance that causes an anemia. This substance is\_\_\_\_ A. folate B. B12 C. Copper D. iron
b. B12. folate will not cause iron deficiencies. This paralysis is from spinal cord lesions caused by b12 deficiency
29
your patient who has B12 deficiency has a condition that creates antibodies against the parietal cells in the stomach. This is called\_\_\_\_\_
pernicious anemia
30
its a strange day in the ER and you have yet another case of B12 deficiency. This patient really likes sushi and eats it often. You suspect that his B12 deficiency is from \_\_\_\_\_\_\_\_.
Diphyllobathrium latum infection (fish tapeworm)
31
alcoholics are prone to ____ deficiency
folate
32
aplastic anemia is due to absence of ____ in bone marrow a. reticulocytes b. leukocytes c. Hemoglobin d. RBCs
d. RBCs
33
Labs: Haptoglobin: decreased Unconjugated bilirubin: increased LDH: markedly increased urine is brown (due to hemosiderin and hemoglobin)
Intravascular hemolysis
34
in extravascular hemolysis the RBC are broken down in: a. spleen b. Liver c. blood vessels d. A and B
d. the RBCs are broken down in the liver and the spleen.
35
what is haptoglobin
glycoproteins produced by the liver. They are very powerful free hemoglobin binding proteins. Haptoglobin decreases with hemolytic anemia because liver is unable to rapidly compensate to make more haptoglobin.
36
Indirect coombs testing tests the ______ for antibodies where in direct coombs the \_\_\_\_\_is tested for antibodies
serum, RBC
37
ABO tranfusion reaction is mediated by which antibodiy? a. IgA b. IgM c. IgG d. IgE
b. IgM causes acute renal failure
38
Blood type O has which antigens? a. A b. B c. none d. A,B
c. none
39
None ABO tranfusion reaction is mediated by which antibody? a. IgA b. IgM c. IgG d. IgE
c. IgG causes jaundice
40
Mothers with a ____ RH factor have to get Rhogam injections throughout pregnancy, every pregnancy
negative
41
In warm auto immune anemia, direct coombs will be \_\_\_\_
postive
42
In cold autoimmune anemia direct coombs will be \_\_\_\_\_\_
negative
43
In hereditary spherocytosis there is a defect in the cytoskeleton of the RBC. The RBC gets caught in the spleen. A cure fo rthe disease is \_\_\_\_\_ a. transfusion b. spleenectomy c. no cure d. iron supplimentation
b. spleenectomy
44
In paroxysmal nocturnal hemoglobinuria, red cells are more prone to lysis by \_\_\_\_\_\_\_\_\_\_\_.
In paroxysmal nocturnal hemoglobinuria, red cells are more prone to lysis by **_complement_** (because complement-regulating proteins CD55 and CD59 are deficient).
45
Paroxysmal nocturnal hemoglobinuria can result in \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Paroxysmal nocturnal hemoglobinuria can result in **_venous thrombosis in hepatic portal, mesenteric, and cerebral veins._**
46
T/F: Vitamin B12 deficiency causes hypersegmented neutrophils on CBC due to incorrect maturation of DNA.
True
47
T/F: Pts with aplastic anemia will often have splenomegaly
False. No splenomegaly.
48
Indirect bilirubin, AKA \_\_\_\_\_\_\_\_\_\_
Unconjugated bilirubin
49
Direct bilirubin, AKA \_\_\_\_\_\_\_\_\_\_
Conjugated bilirubin
50
ABO transfucion reaction has _(intravascular/extravascular)_ hemolysis, whereas non-ABO transfusion reaction has _(intravascular/extravascular)_ hemolysis.
ABO transfucion reaction has **_intravascular_** hemolysis, whereas non-ABO transfusion reaction has **_extravascular_** hemolysis.
51
Pts with sickle cell anemia have "sticky" hemoglobin due to _______ substitution for _________ in Beta globin chain.
Pts with sickle cell anemia have "sticky" hemoglobin due to **_valine_** substitution for **_glutamic acid_** in Beta globin chain.
52
G6PD: microscopy will show _______ and \_\_\_\_\_\_\_\_
Heinz bodies and Bite cells
53
Which type of anemia is this describing: RBC unable to regenerate glutathione, which normally helps to reduce oxidized substances
G6PD deficiency
54
Clinical findings of red faces, headaches, and hgb \>60%, indicative of....
Polycythemia

RRPA Pathophysiology II (16 decks)

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