hemopoesis pt 2 Flashcards

Question

Terminology for Reduction in the Number of Cells Erythrocytes (Leukocytes (Thrombocytes )

Answer 1

Erythrocytes – anemia, erythropenia (Leukocytes – leukopenia) (Thrombocytes - thrombocytopenia)

Answer 2

cell size and hb content (chromic)

Answer 3

Normocytic Macrocytic – B12, Folate deficiency Microcytic – Iron deficiency

Answer 4

Normochromic Hypochromic

Answer 5

Fe def- microcytic hypochromic

Answer 6

 A reduction in the erythron – a reduction in the total red cell mass below normal limits  Reduction in the oxygen carrying capacity of the blood leading to tissue hypoxia

Answer 7

 Usually diagnosed based on: Inadequate numbers of erythrocytes (low hematocrit - the ratio of packed red cells to total blood volume) Inadequate level of hemoglobin – the hemoglobin concentration of the blood

Answer 8

RBC production and destruction

Answer 9

Increased RBC destruction Decreased RBC production Blood loss

Answer 10

Pallor – pale skin and mucosa Lethargy – lack of energy, fatigue, weakness Dyspnea – labored breathing, SOB Tachycardia, arrhythmia, chest pain Koilonychia - spoon-shaped nails Atrophic glossitis Cognitive problems, dizziness Cold extremities Headache

Answer 11

a person with a low hematocrit cannot carry enough oxygen in the blood to meet energy demands. Weakness, malaise, and easy fatigability.

Answer 12

Increased heart rate - compensates for the low oxygen carrying capacity of the blood

Answer 13

 Shortness of breath / increased respiratory rate – compensates for the poor delivery of oxygen to the tissues. Dyspnea on mild exertion.

Answer 14

 Low blood pressure – a decrease in blood viscosity directly lowers total peripheral resistance to the flow of blood, thus lowering mean arterial blood pressure

Answer 15

- hemoglobin is bright red when oxygenated and less red when deoxygenated. Because the redness of skin is due to the redness of blood, the skin of an anemic person (who has less oxygen in the blood) will be less red (paler) than the average person

Answer 16

Central nervous system - hypoxia can cause headache, dimness of vision, and faintness

Answer 17

Cardiac failure can develop and compound the tissue hypoxia caused by the deficiency of O2 in the blood

Answer 18

Sickle cell anemia Thalassemia Erythroblastosis fetalis G6PD deficiency Malaria

Answer 19

 A hemoglobinopathy  Inherited, mis-sense mutation of beta chain  A single AA substitution of valine for glutamic acid  Forms a new, abnormal hemoglobin, Hemoglobin S - HbS  Sickle cell disease – homozygous HbS  Sickle cell trait - heterozygous, a less serious condition

Answer 20

 Individuals with sickle cell trait (heterozygous for HbS) have a survival advantage in malaria-endemic areas  Homozygous normal – increased mortality due to malaria  Heterozygous HbS – survival advantage  Homozygous HbS – increased mortality due to sickle cell disease  About 8% of African Americans are heterozygous (sickle cell trait)  1 in 600 African Americans are homozygous (sickle cell disease)

Answer 21

 HbS molecules polymerize when deoxygenated, forming HbS aggregates  Cytosol changes from a freely-flowing liquid to a viscous gel  With continued deoxygenation, HbS aggregates form long, needle-like fibers that distort the red cell shape  Sickle cell trait – HbA interferes with HbS polymerization in the heterozygous condition  Red cells do not sickle except under conditions of profound hypoxia

Answer 22

 Hemolytic anemia - chronic hemolysis leading to jaundice and phagocytosis in spleen  Microvascular occlusions - sickle cells becone arrested during transit through the microvasculature  Vaso-occlusive crises (pain crises)-episodes of hypoxic injury and infarction that cause severe pain in the affected region: Commonly involved sites: bone, lung, liver, brain, spleen  Autosplenectomy

Answer 23

Increased susceptibility to infection with encapsulated organisms Pneumococcus pneumoniae and Hemophilus influenzae

Answer 24

hair on end radiograph, can be seen with sickle cell anemia and beta thalassemia major

Answer 25

hair in end and step ladder trabeculae

Answer 26

Group of inherited diseases Quantitative problem - too few globins synthesized, A or B could be affected Underproduction of normal globin proteins due to mutations in regulatory genes

Answer 27

Regular transfusions – iron overload – organ damage

Answer 28

 Bone deformities – expansion of marrow space  Splenomegaly - splenectomy  Impaired growth  Bone marrow transplantation

Answer 29

Two genes involved in making beta chain (one from each parent) Severity depends on number of affected beta chain genes One gene – beta-thalassemia minor - beta-thalassemia trait= Mild disease Two genes – beta-thalassemia major (Cooley’s anemia)= Severe disease

Answer 30

 Four genes involved in making alpha chain (two from each parent)  Severity depends on number of affected alpha chain genes  One gene – asymptomatic carrier  Two genes – alpha-thalassemia minor - alpha-thalassemia trait= Mild disease  Three genes – hemoglobin H disease= Moderate to severe disease  Four genes – alpha-thalassemia major – (lethal)

Answer 31

compensatory hyperplasia

Answer 32

hair on end like SCA

Answer 33

ABO mismatch leads to intravascular hemolysis Antibody-coated erythrocytes destroyed by both complement-mediated lysis and by phagocytosis in spleen

Answer 34

Type O – 45% Type A – 42% Type B – 10% Type AB – 3%

Answer 35

Positive - 85% Negative - 15%

Answer 36

Hemolytic Blood Rh-Mediated Hemolytic Disease of the Newborn

Answer 37

 Rh- mom  Rh+ fetus  Fetal RBCs cross the placenta and enter the maternal circulation during birth trauma  Prophylactic anti-Rh (D) immune globulin (Rhogam) within 72 hours of delivery  Rhogam lyses fetal RBCs in the maternal circulation – effectively removing any available antigen, so the mom doesn’t develop anti- Rh antibodies baby not harmed

Answer 38

 Rh- mom, with anti-Rh from prior pregnancy  Rh+ fetus  Anamnestic response rapidly produces anti-Rh (IgG)  Anti-Rh IgG crosses placenta and lyses fetal RBCs  Rh-mediated hemolytic disease

Answer 39

Rhogam: Rhesus Immune Globulin - RhIg Immunoglobulin Administered to Rh-negative women after pregnancies in which they carried Rh-positive fetuses Anti-D antibodies

Answer 40

 Hemolytic anemia in utero  Rh-negative mother develops antibodies against Rh-positive erythrocytes of fetus  Antibodies cross placenta and hemolyze fetal erythrocytes  High levels of bilirubin and biliverdin  Deposition in developing teeth  Only primary teeth affected

Answer 41

 Erythroblasts in peripheral blood  Hyperbilirubinemia  Kernicterus (bilirubin encephalopathy) if bilirubin reaches a high levels  Developmental dental defects reported- enamel hypo and staining

Answer 42

 X-linked disease; most common human enzyme defect (African-American male population)  Most are asymptomatic; at risk for non-immune hemolytic anemia upon exposure to oxidative stress  Oxidative stress: infections, drugs (aspirin)

Answer 43

 G6PD / NADPH / Glutathione pathway - maintains supply of reduced glutathione to scavenge free radicals (anti-oxidant)  Red cells sustain damage from oxidizing free radicals (phagocytosed in spleen), decreased RBC

Answer 44

All individuals with Favism (hemolysis due to Broad Beans(fava)) are G6PD deficient

Answer 45

endemic malaria environments

Answer 46

Malaria Protozoal disease – primarily Plasmodium falciparum Female Anopheles mosquito vector, human reservoir Reproduction in red cells – showers of organisms produce shaking, chills and fever Hemolytic anemia High morbidity, mortality

Answer 47

Iron deficiency anemia -microcytic, hypochromic Pernicious anemia (B12 deficiency) - macrocytic Folic acid deficiency anemia - macrocytic Aplastic anemia

Answer 48

microcytic and hypochromic

Answer 49

 Most common anemia in US  Lack of Fe most common nutritional deficiency in the world  Microcytic, hypochromic  Seen most often in females – more iron lost in menses than replaced by nutrition  Treated with iron supplements  When in males, suspect internal bleeding

Answer 50

middle aged female with profound anemia

Answer 51

Dietary lack Impaired absorption Increased requirement Chronic blood loss

Answer 52

breat feeding

Answer 53

Males - peptic ulcer disease Females - menorrhagia or pregnancy

Answer 54

Colonic polyps / colon adenocarcinoma in Western world Hookworm infection in developing world

Answer 55

Serum ferritin Total iron binding capacity (TIBC) % saturation Serum iron

Answer 56

Serum ferritin – reflects iron stores in bone marrow macrophages and liver

Answer 57

measure of transferrin molecules in blood

Answer 58

percent of transferrin molecules bound by iron (nl = 33%)

Answer 59

Serum iron – measure of iron in the blood

Answer 60

Scandinavian, Northern European women Severe Fe-deficiency anemia Mucosal atrophy - atrophic glossitis Esophageal webs - dysphagia Increased risk for squamous cell carcinoma: Esophagus, Oropharynx, Posterior Oral Cavity

Answer 61

Pernicious anemia (B12 deficiency) - macrocytic Folic acid deficiency anemia - macrocytic

Answer 62

Absorption of vitamin B12 requires intrinsic factor, which is secreted by the parietal cells of the stomach Cobalamin – Intrinsic Factor complex absorbed in the ileum

Answer 63

Autoimmune disease Not due to dietary deficiency of B12 A form of megaloblastic anemia caused by autoimmune gastritis and failure of intrinsic factor production leading to vitamin B12 deficiency Loss of ability to absorb Vitamin B12 Vitamin B12 (cobalamin) required for normal folate metabolism and DNA synthesis

Answer 64

milk, poultry, eggs, meat, shellfish

Answer 65

maintenence CNS and RBC production

Answer 66

atrophic and ulcerative

Answer 67

Megaloblastic anemia Dietary deficiency of folic acid Folate required for DNA synthesis

Answer 68

 Marrow aplasia secondary to supression of multipotent myeloid stem cells (erythrocyte, leukocyte and thrombocyte series), resulting in pancytopenia

Answer 69

 May be caused by known myelotoxic agents (eg. whole body radiation)  Antineoplastic drugs (alkylating agents, antimetabolites)  Benzene  Chloramphenicol

Answer 70

T cell attack on myeloid stem cells

Answer 71

unpredictable

Answer 72

bone marrow transplant and transfusions

Answer 73

Gastrointestinal bleeding Hemoptysis (coughing up blood) Epistaxis (nosebleed) Hematuria (blood in urine) Menstrual blood loss

Answer 74

Hematemasis (vomiting blood) Melena (black stool) Hematochezia (red blood in feces).

Answer 75

Menorrhagia (excessive bleeding) Metrorrhagia (irregular bleeding).

Answer 76

Screening test for occult bleeding in GI tract

Answer 77

 An increase in the RBC mass can be relative or absolute

Answer 78

dehydration – decreased plasma volume with normal red cell mass

Answer 79

a true increase in red cell mass can be primary or secondary

Answer 80

 Erythropoietin-independent  Acquired, clonal stem cell disorder (a chronic myeloproliferative disorder)

Answer 81

 Erythropoietin-dependent  Compensatory response to tissue hypoxia: Chronic lung disease, Cigarette smoking, Residence at high altitude, Paraneoplastic syndromes

hemopoesis pt 2 Flashcards

(111 cards)