LEC 2

Question 1

What is the cause of floods acid deficiency?

Answer 1

Poor intake
Malabsorption such as celiac disease
Drugs (phenytoin, methotrexate, thrimethoprime , isoniazid, phenobarbitone )
Increased demand or requirements such as pregnancy

Question 2

What is tha cause of B12 deficiency?

Answer 2

Pernicious anemia
Poor B12 intake
Malabsorption such as crhon disease

Question 3

What is the pernicious anemia ?

Answer 3

Autoimmune disease which attack partial cell that production IF which prevent B12 from destruction in stomach

Question 4

Which one cause memylination ?

Answer 4

Deficiency in B12

Question 5

What is tha cause of chronic disease anemia ?

Answer 5

1-systemic inflammation (increased in IL-6 lead to increased hepcidin which increased iron stored)
2-chronic disease decreased in erythropoietin hormone

Question 6

What is the change on ferritin and transferrin occurs in anemia chronic disease?

Answer 6

Increased in ferritin (so increased in iron stored) , decreased in iron level in blood , decreased in TIBC

Question 7

What is the aplastic anemia ?

Answer 7

Anemia come from bone marrow failure due to suppression of multipotent steam cell which lead to pancytopnea

Question 8

What is the causes of aplastic anemia?

Answer 8

Acquired: idiopathic, myelotoxic agent , viral infection
Inherited: defect in telomerase , disorder of DNA repair mechanisms (fanconi anemia)

Question 9

What is the change occurs in aplastic anemia?

Answer 9

Hypocellular anemia , 90% of the interabecular space occupied by fat , thrombocytopenia which lead to petechiae of patient get trauma, granulocytopdnia so there are increased in infections , no splenomegaly

Question 10

What is the type of hemolytic?

Answer 10

Intrinsic (inside blood vessel) & extrinsic (outside blood vessel (inside macrophages))

Question 11

What is the feature of hemolytic anemia ?

Answer 11

Shortness of RBCs survival , elevated in erythropoietin to compensate decreased in RBCs or called erythyroid hyperplasia (so reticulocyte will be increased) , juandice and increased in LDH

Question 12

What is the features of intrinsic hemolytic anemia?

Answer 12

Hemoglobinuria , hemoglobinemia , hemosiderinuria , hyperbilirubinemia , juandice , increases LDH , decreased haptoglobin

Question 13

What is the feature of extrinsic hemolytic anemia ?

Answer 13

Hyperbilirubinemia , juandice , LDH increased , splenomegaly

Question 14

What is the cause of spherocytosis?

Answer 14

Mutation in spectrin , ankyrin and band 3

Question 15

What is the features of hereditary spherocytosis?

Answer 15

Hyperchromic (increased MCHC) , hight reticulocyte, hight osmotic fragility, splenomegaly, destruction of the spleen

Question 16

Does spherocytosis intrinsic or extrinsic hemolytic?

Answer 16

Intrinsic because defect occurs in membrane of RBCs

Question 17

Does RBCs in spherocytosis destruction intrinsic or extrinsic?

Answer 17

Extrinsic by macrophages

Question 18

What is the complication of spherocytosis?

Answer 18

Gallbladder stone , aplastic crisis of patient get parvovirus B19

Question 19

What is aplastic crisis?

Answer 19

Patient with spherocytosis, and get effected by parvovirus B19 which lead to bone marrow failure

Question 20

Why hemolysis occurs if patient have G6PD deficiency?

Answer 20

Because oxidant agent will accumulation in RBCs

Question 21

Give examples about some oxidant that lead to hemolytic anemia if G6PD deficiency found ?

Answer 21

Drugs : anti malaria, sulfonamide, furantoins
Favism
Free radicle

Question 22

In G6PD deficiency, hemolytic occurs intrinsic or extrinsic?

Answer 22

Mainly intrinsic but if occurs extrinsic the bite cell will found

Question 23

What is Heinz body ?

Answer 23

Accumulation of hemoglobin within RBCs due to oxidation

Question 24

What is the causes of immune hemolytic anemia?

Answer 24

Antibodies

Question 25

What is the test we used to detect immune hemolytic anemia ?

Answer 25

Coombs test

Question 26

What is the cause of PNH

Answer 26

Mutation in PIGS gene which lead to decreased in GPI and GPI linked protein, so there are increased in complement mediated hemolysis such as c3 convertase

Question 27

In PNH what is the count of hemoglobin and the size of RBCs?

Answer 27

Normochromic normocytic

Question 28

What is the morphology of PNH

Answer 28

There are poikilocytosis : helmet cell , triangle cell , burr cell , schistocytes