Pathology 1

Question 1

RBC morphology associated with liver disease, abetalipoproteinemia

Answer 1

Acanthocyte (spur cell)

Question 2

Basophilic stippling of RBC

Answer 2

Anemia of Chronic Disease, Alcohol Abuse, Leading Poisoning, Thalassemias

Question 3

Bite cell

Answer 3

G6PD deficiency

Question 4

Hereditary elliptocytosis

Answer 4

Abnormal cell membrane proteins, Elliptocytes

Question 5

Excess iron in mitochondria

Answer 5

Ringed sideroblast

Question 6

Schistocyte, helmet cell

Answer 6

DIC, TTP/HUS, traumatic hemolysis (mechanical heart valve prosthesis)

Question 7

Stomatocyte

Answer 7

due to expansion of inner leaflet of lipid bilayer, liver disease or alcoholism or stomatocytosis

Question 8

Sickle Cell

Answer 8

Point Mutation beta-globin chain of HbA

Valine to glutamic acid in position 6

Question 9

Spherocyte

Answer 9

Hereditary spherocytosis, autoimmune hemolysis

Question 10

Dakryocyte

Answer 10

teardrop cell, extramedullary hematopoiesis, BM infiltration (RBC been forced out)

Question 11

Target Cell

Answer 11

HbC disease, Asplenia, Liver Dx, Thalassemia

Question 12

Pencil Cell

Answer 12

Iron Deficiency

Question 13

Heinz Bodies

Answer 13

Seen in G6PD deficiency, oxidized Hb sulhydryl groups causing denatured Hb precipitation

Question 14

Howell-Jolly Bodies

Answer 14

Basophilic nuclear remnants found in RBCs

Seen in patients with functional hyposplenia or asplenia

Question 15

Methemoglobinemia

Answer 15

oxidized Iron (3+) therefor can't pick up oxygen
if hereditary deficiency of metahemaglobin reductase deficiency or structurally abnormal HbM

Question 16

MCV <80fL

Answer 16

Microcytic Anemia: Late iron deficiency, anemia of chronic dx, thalassemia, Lead poisoning, Sideroblastic anemia

Question 17

MCV 80-100fL Non-hemolytic

Answer 17

Start of anemia of chronic disease, aplastic anemia, chronic kidney disease, iron deficiency (early)

Question 18

MCV 80-100fL Intrinsic Hemolysis

Answer 18

RBC membrane defect (hereditary spherocytosis), G6PD or PK deficiency, HbC defect, Paroxysmal Nocturnal Hemoglobinuria, Sickle Cell

Question 19

MCV 80-100fL Extrinsic Hemolysis

Answer 19

Autoimmune, Microangiopathic, Macroangiopathic, Infections

Question 20

MCV >100fL megaloblastic

Answer 20

folate and B12 deficiency, orotic aciduria

Question 21

MCV >100fL non-megaloblastic

Answer 21

Liver disease, Alcoholism, Reticulocytosis

Question 22

Decreased Iron & ferritin, Increased TIBC

Answer 22

Iron deficiency

Question 23

Iron deficiency anemia, esophageal webs, beefy red tongue and atrophic glossitis

Answer 23

Plummer-Vinson Syndrome

Question 24

Alpha-globulin gene deletion

Answer 24

alpha-thalassemia

Question 25

Cis deletion of alpha-globulin

Answer 25

Asian Population

Question 26

Trans deletion of alpha-globulin

Answer 26

African Population

Question 27

4-alpha allele deletion

Answer 27

Hb Barts, excess gamma-globin. Causes Hydrops Fetalis

Question 28

3-alpha allele deletion

Answer 28

HbH disease, Excess beta-globin forms Beta4

Question 29

Koilonychias

Answer 29

Spooned nails seen with iron deficiency

Question 30

Beta Thalassemia Minor

Answer 30

heterozygote, beta chain is under produced, usually asymptomatic, increased HbA2 >3.5% on electrophoresis

Question 31

Beta Thalassemia Major

Answer 31

homozygote, beta chain is absent, req blood transfusions, increase in HbF, HbF is protective in the infant for 6months. Chr 11

Question 32

Crew-cut on skull X-ray

Answer 32

Marrow expansion associated with Beta-Thalassemia

Question 33

Chipmunk facies

Answer 33

Associated with Beta-Thalassemia Major

Question 34

HbS/Beta-thalassemia heterozygote

Answer 34

mild to moderate sickle cell disease depending on amount of beta-globin production

Question 35

Inhibits Ferrochelatase and ALA dehydratase

Answer 35

Lead poisoning

Question 36

Romanosysky Stain

Answer 36

Lead Poisoning, basophilic stippling of RBCs

Question 37

Burton Lines

Answer 37

Lead lines on gingivae and on metaphyses of long bones

Question 38

1st line of tx for lead poisoning

Answer 38

Dimercaprol and ADTA

Question 39

Wrist drop and foot drop

Answer 39

Lead poisoning

Question 40

Encephalopathy, erythrocyte stippling, abdominal colic and sideroblastic anemia

Answer 40

Lead Poisoning

Question 41

X-linked decfect in delta-ALA synthase

Answer 41

Sideroblastic Anemia

Question 42

Tx for Sideroblastic Anemia

Answer 42

Pyridoxine (B6, cofactor for delta-ALA synthase)

Question 43

Primary Acquired form of Sideroblastic Anemia

Answer 43

myelofibrosis, myeloid leukemia or myeloma or drugs like Isoniazid + Cycloserine

Question 44

Impaired DNA synthesis in RBCs

Answer 44

Megaloblastic anemia

Question 45

Diphyllobothrium latum

Answer 45

B12 deficiency

Question 46

Subacute combined degeneration

Answer 46

``` B12 deficiency, affecting dorsal columns (vibration/proprioception) Lateral Corticospinal (spasticity) ```

Question 47

Increased homocysteine, increased methylmalonic acid

Answer 47

B12 deficiency

Question 48

Pernicious Anemia

Answer 48

Parietal cell antibodies inhibiting Intrinsic factor binding

Question 49

Inhibits Fatty Acid Pathways and Myelin Synthesis

Answer 49

B12 deficiency

Question 50

Defect in UMP synthase

Answer 50

Orotic Aciduria, autosomal recessive

Question 51

Children w/ megaloblastic anemia that cannot be cured with folate or Vit B12

Answer 51

Orotic Aciduria, autosomal recessive

Question 52

Tx of Orotic Aciduria

Answer 52

Uridine Monophosphate

Question 53

Defect in de novo pyrimidine synthesis pathway

Answer 53

Orotic aciduria

Question 54

What is broke in my Kitchen

Answer 54

Clock