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PBHD - FINAL EXAM > Lecture 10 > Flashcards

Lecture 10 Flashcards

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1
Q

components of blood

A

erythrocytes RBC (non-nucleated), leukocytes (nucleus), platelets (non-nucleated).

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2
Q

What is the primary function of erythrocytes?

A

Erythrocytes (red blood cells) transport oxygen due to their high hemoglobin content.

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3
Q

Describe the shape and deformability of erythrocytes.

A

Erythrocytes are biconcave and deformable, allowing them to navigate through narrow capillaries.

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4
Q

What percentage of blood volume do erythrocytes make up?

A

Erythrocytes make up 45% of total blood volume.

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5
Q

What maintains the shape of erythrocytes?

A

The shape is maintained by the cytoskeletal protein spectrin.

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6
Q

Why can erythrocytes not perform new protein synthesis?

A

Erythrocytes lack a nucleus, which means they cannot synthesize new proteins.

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7
Q

What advantage does the biconcave shape of erythrocytes provide?

A

The biconcave shape increases the surface area, enhancing oxygen diffusion.

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8
Q

What does it mean if more than 1% of RBCs appear purple (polychromatic) in a blood sample?

A

It indicates increased RBC production due to conditions like hemorrhage or hemolytic anemia.

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9
Q

What is the lifespan of an erythrocyte?

A

The lifespan of an erythrocyte is approximately 100 days.

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10
Q

Why do immature erythrocytes appear purple (polychromatic) under a microscope?

A

They contain RNA, which stains purple, indicating they are still maturing.

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11
Q

How is Mean Corpuscular Volume (MCV) calculated, and what does it represent?

A

MCV = (Hematocrit value × 10) / Erythrocyte count; it represents the average volume or size of red blood cells, with a normal range of 80-96 fL in adults.

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12
Q

What does Mean Corpuscular Hemoglobin (MCH) measure, and how is it calculated?

A

MCH = (Hemoglobin in L × 10) / Erythrocyte count; it measures the average amount of hemoglobin per red blood cell, with a normal range of 27-33 picograms per cell in adults.

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13
Q

What is the normal range for Mean Corpuscular Hemoglobin Concentration (MCHC) in adults?

A

The normal MCHC range in adults is 33-36 g/dL.

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14
Q

What are the diagnostic criteria for anemia based on hemoglobin concentration?

A

Anemia is defined as hemoglobin concentration <13 g/dL in men or <11.5 g/dL in women, or a hematocrit of <40% in men and <37% in women.

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15
Q

What are the characteristics of polycythemia in terms of erythrocyte parameters?

A

Polycythemia is characterized by an increase in red blood cell concentration, hemoglobin levels, and hematocrit.

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16
Q

What does a low MCV indicate in erythrocyte diagnostics?

A

A low MCV suggests microcytic anemia, often related to iron deficiency.

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17
Q

What does a high MCH indicate in erythrocyte diagnostics?

A

A high MCH may indicate macrocytic anemia, often associated with vitamin B12 or folate deficiency.

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18
Q

What is anemia?

A

Anemia is a reduction of hemoglobin in the blood, affecting approximately 7% of the population.

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19
Q

What can cause anemia?

A

Anemia can be caused by a decrease in Mean Corpuscular Volume (MCV) or Mean Corpuscular Hemoglobin (MCH).

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20
Q

What are anisocytosis and poikilocytosis in the context of anemia?

A

Anisocytosis is a variation in red blood cell size, and poikilocytosis is an abnormal shape of red blood cells.

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21
Q

What condition may be indicated by both anisocytosis and poikilocytosis?

A

Aniso-poikilocytosis can indicate spleen dysfunction or destruction.

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22
Q

What are the characteristics of microcytic/hypochromic anemia, and what conditions cause it?

A

Microcytic/hypochromic anemia has MCV <78 and MCH <26, commonly caused by iron deficiency and thalassemia.

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23
Q

What defines macrocytic anemia, and what condition is it associated with?

A

Macrocytic anemia has an MCV >98 and is often associated with megaloblastic anemias, such as those caused by vitamin B12 or folate deficiency.

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24
Q

What is normocytic/normochromic anemia, and what are common causes?

A

Normocytic/normochromic anemia has normal MCV and MCH values and can be caused by acute blood loss, hemolytic anemias, and bone marrow failure.

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25
What does Mean Corpuscular Volume (MCV) indicate in RBC analysis?
MCV measures the average size of RBCs, with normal values between 80-100 fL. It categorizes RBCs as microcytic, normocytic, or macrocytic.
26
What are the three MCV classifications for RBCs?
Microcytic (small size), Normocytic (normal size), and Macrocytic (large size).
27
What does Mean Corpuscular Hemoglobin Concentration (MCHC) measure?
MCHC measures the concentration of hemoglobin in RBCs, with normal values between 32-36 g/dL. It classifies RBCs as hypochromic, normochromic, or hyperchromic.
28
What are the classifications based on MCHC values?
Hypochromic (low hemoglobin concentration), Normochromic (normal hemoglobin concentration), and Hyperchromic (high hemoglobin concentration).
29
What type of anemia is characterized by hypochromic, microcytic RBCs?
Iron deficiency anemia, which shows small RBCs with low hemoglobin concentration.
30
How does iron deficiency affect RBC morphology?
It leads to hypochromic (pale) and microcytic (small) RBCs due to insufficient hemoglobin.
31
What is a common effect of all types of anemia?
All types of anemia cause a reduction in the blood’s oxygen-carrying capacity.
32
How does the clinical presentation of anemia vary?
The clinical presentation is similar across types, with differences mainly in the speed of disease progression.
33
What happens if anemia progresses slowly?
If anemia progresses slowly, the body often adapts to the reduced oxygen levels, even in severe cases.
34
List some typical clinical observations in patients with anemia.
Increased heart rate, fatigue, weakness, feebleness, headaches, pallor of skin, mild fever, and pica (craving for non-food items).
35
What are the three main classifications of anemia?
Dys-haemopoietic (production failure), Haemorrhagic (excessive loss), and Haemolytic (excessive destruction of RBCs).
36
What is pica, and how is it related to anemia?
Pica is the craving for non-food items and is sometimes observed in patients with anemia.
37
What is the most common cause of dyshaemopoietic anemia?
Iron deficiency anemia, which causes microcytic hypochromic blood cells.
38
What factors can lead to iron deficiency anemia?
Increased requirements, malabsorption, and malnutrition.
39
Which vitamin deficiencies cause macrocytic anemia in dyshaemopoietic anemias?
Vitamin B12 and folate deficiencies.
40
What are some conditions that can lead to vitamin B12 deficiency anemia?
Gastrectomy, congenital lack of intrinsic factor, Crohn’s disease, and malnutrition.
41
What is a distinguishing feature of blood smears in vitamin B12 deficiency anemia?
The presence of hypersegmented neutrophils.
42
What is pernicious anemia?
A type of B12 deficiency anemia caused by a severe or total lack of intrinsic factor, necessary for B12 absorption.
43
What is the prognosis and treatment for pernicious anemia?
It has a poor prognosis without treatment and requires lifelong B12 replacement therapy.
44
Name other types of dyshaemopoietic anemias.
Folate deficiency anemia, aplastic anemia, toxic dyshaemopoietic anemia, and leucoerythroblastic anemia.
45
What is leucoerythroblastic anemia, and what causes it?
It is caused by space-occupying lesions in the bone marrow, leading to abnormal red and white blood cell production.
46
What are the two classifications of aplastic anemia?
Primary (very rare) and secondary aplastic anemia.
47
What causes hemorrhagic anemia?
Hemorrhagic anemia is caused by excessive blood loss.
48
What are the effects of losing 600 mL of blood in acute hemorrhagic anemia?
Loss of 600 mL of blood generally has little impact on the body.
49
What symptoms might occur with a 1200 mL blood loss in acute hemorrhagic anemia?
A loss of 1200 mL can lead to weakness and fainting.
50
How severe is a 1500 mL blood loss in acute hemorrhagic anemia?
A 1500 mL blood loss can be catastrophic and potentially life-threatening.
51
What are common causes of chronic hemorrhagic anemia?
Chronic hemorrhagic anemia can be caused by peptic ulcers, hemorrhoids, ulcerative colitis, malignant tumors, or bleeding disorders.
52
What causes sickle cell anemia?
It is caused by a homozygous inherited gene for a hemoglobin variant that crystallizes at low oxygen tensions, leading to sickle-shaped cells.
53
What are some complications associated with sickle cell anemia?
Microvascular occlusion, hyperplastic bone marrow, and splenomegaly in childhood, with spleen shrinkage over time due to vascular occlusion.
54
How does thalassemia affect hemoglobin?
Thalassemia is due to abnormalities in alpha or beta globin chain synthesis, often resulting in hypochromic, microcytic anemia.
55
What is a severe form of thalassemia, and what are its effects?
Beta-thalassemia major, which can lead to severe anemia, growth retardation, and failure of sexual development due to ineffective erythropoiesis.
56
What is hereditary spherocytosis?
It is a hemolytic anemia caused by erythrocyte membrane protein abnormalities, leading to fragile, spherical RBCs that are prematurely destroyed in the spleen.
57
How can hereditary spherocytosis be managed?
Splenectomy is often used to resolve symptoms, but it is delayed until adulthood or when absolutely necessary in childhood.
58
What are target cells, and in which conditions might they appear?
Target cells have a bullseye appearance and may appear in liver disease, thalassemias, and hemoglobinopathies.
59
How does beta-thalassemia major affect the bone marrow?
It causes erythroid hyperplasia, leading to bone marrow expansion, cortical bone thinning, and extramedullary erythropoiesis in the spleen and liver.
60
What are spherocytes, and why are they problematic in hereditary spherocytosis?
Spherocytes are RBCs with reduced deformability, which impedes their passage through the spleen and leads to premature destruction.
61
What are the three main types of acquired hemolytic anemias?
Malaria, autoimmune anemias, and toxic anemias
62
What is malaria, and in which regions is it commonly found?
Malaria is a parasitic disease prevalent in tropical and subtropical areas.
63
How many people are affected by malaria annually?
Malaria affects approximately 10 million people each year and is a major cause of death worldwide.
64
How does malaria contribute to anemia?
Malaria causes damaged, sticky RBCs, leading to anemia and the formation of microthrombi.
65
What are common symptoms of malaria?
Cyclic bouts of fever and chills, hepatosplenomegaly (enlarged liver and spleen), jaundice, hemoglobinuria, and kidney damage.
66
Why does malaria cause hepatosplenomegaly?
The massive immune response to malaria causes enlargement of the liver and spleen.
67
What happens to RBCs in malaria, and what are the potential complications?
RBCs become damaged and sticky, leading to microthrombi formation, jaundice, kidney damage, and hemoglobinuria.
68
What is polycythemia, and what are the hematocrit levels in this condition?
Polycythemia is an increase in red blood cell mass, with hematocrit levels reaching 60-80%.
69
Differentiate between primary and secondary polycythemia.
Primary polycythemia may be due to a neoplasm or increased erythropoietin sensitivity, while secondary polycythemia is often a response to high altitudes, cardiovascular disease, or COPD.
70
What are some symptoms and complications of polycythemia?
Increased blood viscosity, congested and red skin, nosebleeds, hypertension, splenomegaly, and thrombosis.
71
What are leukocytes, and what is their primary function?
Leukocytes, or white blood cells (WBCs), are involved in the body’s defense against infections and foreign substances.
72
Name the five types of leukocytes.
Neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
73
Which type of leukocyte is the most abundant?
Neutrophils are the most abundant type of white blood cell
74
Describe the main characteristics of neutrophils.
Neutrophils are granulated, containing enzymes and lysozymes, and they spend 14 days maturing in the bone marrow.
75
What is the half-life of neutrophils, and what percentage of them are in peripheral circulation?
The half-life of neutrophils is 6-9 hours, and only about 10% are found in peripheral circulation.
76
What are the characteristics of monocytes?
Monocytes are the largest type of leukocyte, have a curved single-lobed nucleus, and function similarly to neutrophils by entering tissues, forming macrophages, and phagocytosing pathogens.
77
What is the primary function of eosinophils?
Eosinophils play a role in mediating allergic responses and defending against parasites.
78
Describe the appearance of eosinophils.
Eosinophils have large red granules and a lobulated nucleus.
79
What are basophils, and what substances do they contain?
Basophils are the least abundant leukocyte, containing large blue/black granules that obscure the nucleus, and they store heparin and histamine.
80
What role do basophils play in the immune system?
Basophils are involved in hypersensitivity reactions and act similarly to mast cells.
81
What is the appearance of lymphocytes?
Lymphocytes have a large round nucleus.
82
What are the two main forms of lymphocytes?
T cells and B cells.
83
What is the primary function of lymphocytes?
They stimulate and regulate the immune system.
84
What are the two main types of changes in leukocyte disorders?
Quantitative changes (number of leukocytes) and qualitative changes (function and appearance of leukocytes).
85
What is leukocytosis?
An increase in the number of leukocytes, which can occur in conditions like sepsis, trauma, infarct, and malignant neoplasms.
86
What is leukopenia, and what are some causes?
A decrease in the number of leukocytes, often due to bone marrow failure or hypersplenism. Hypersplenism can be caused by sepsis, autoimmune diseases, and certain drugs.
87
What are some examples of qualitative leukocyte disorders?
Changes in phagocyte cell function, such as hypersegmented neutrophils and toxic granulation.
88
What conditions can lead to toxic granulation in neutrophils?
Toxic granulation often occurs in response to severe infections or inflammatory conditions.
89
What is leukemia?
Leukemia is a neoplastic proliferation of white blood cell (WBC) progenitors, leading to abnormal cells in the blood and infiltration of organs like the spleen, liver, lymph nodes, meninges, and gonads.
90
What are some consequences of bone marrow failure in leukemia?
Bone marrow failure can cause hemorrhage, infection, hyperviscosity of blood, and lead to death without treatment.
91
What are the main treatments for leukemia?
Treatments include marrow transplants, chemotherapy, and tailor-made therapies.
92
What is acute myeloblastic leukemia and its features?
Acute myeloblastic leukemia (AML) is more common in adults, with about half of the cases showing increased WBC count and primitive-appearing lymphocytes with large nuclei.
93
What is acute lymphoblastic leukemia, and in whom is it more common?
Acute lymphoblastic leukemia (ALL) is more common in children and typically shows increased WBC count due to neoplastic lymphoblasts.
94
What is chronic myelocytic leukemia, and what are its characteristics?
Chronic myelocytic leukemia (CML) is characterized by a severe increase in leukocyte count with various abnormal circulating cells.
95
What are common symptoms of leukemia?
Symptoms include fever, chills, persistent fatigue, weakness, frequent infections, weight loss, swollen lymph nodes, enlarged liver or spleen, and easy bruising or bleeding.
96
What is chronic lymphocytic leukemia (CLL)?
Chronic lymphocytic leukemia is a type of chronic leukemia with a severe increase in leukocyte count, commonly affecting lymphocytes.
97
What are platelets and their primary functions?
Platelets are non-nucleated fragments of cytoplasm, about 1/5 the size of red blood cells, that help maintain vascular integrity and function as contractile adhesive cells.
98
Where are platelets made?
Platelets are produced in the bone marrow.
99
What substances are found in platelet granules?
Platelet granules contain Von Willebrand factor, clotting factors, and growth hormones.
100
What is thrombocytopenia?
Thrombocytopenia is a deficiency in platelets, leading to an increased risk of spontaneous bleeding.
101
What is thrombocytosis, and what can cause it?
Thrombocytosis is an increase in platelet count, which can be due to blood loss, iron deficiency, trauma, or inflammatory conditions.
102

PBHD - FINAL EXAM (7 decks)

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