Quiz #3 RBC anemias

Question 1

Reticulocyte:

Answer 1

-Estimates rate of RBC production

Increased: bleeding or hemolytic anemia

Decreased: bone marrow not working well

Question 2

Mean corpuscular volume (MCV)

Answer 2

§ The average measure of red cell volume

§ Normal Range: 80-100 fL

▪ 100 = macrocytic

Question 3

Mean corpuscular hemoglobin (MCH)

Answer 3

§ The average amount of hemoglobin per red cell

§ Ref 28-34 pg/cell

Question 4

Mean corpuscular hemoglobin concentration (MCHC)

Answer 4

§ Average concentration of hemoglobin in a given volume of red cells

§ Ref: 32-36 g/dL

▪ Decreased: microcytic anemia

▪ Increased: hereditary spherocytosis and sickle cell disease

Question 5

Red cell distribution width (RDW)

Answer 5

§ Measures the range of sizes of red blood cells in a
blood sample

▪ Iron Deficiency Anemia (high RDW with low MCV)

▪ Folate & Vitamin B12 Deficiency (high RDW and high MCV)

▪ Recent hemorrhage (high RDW with normal MCV)

Question 6

General Diseases:

Answer 6

1. Anemia – too few
2. Polycythemia – too many
3. Abnormal – sickle-cell, thalassemia

Question 7

Anemia definition:

Answer 7

decreased Hgb/Hct

Question 8

Absolute anemia definition:

Answer 8

Physiologic causes: stem cell disorders, DNA disorders, heme and globin disorders, RBC survival disorders

Question 9

Relative anemia:

Answer 9

Dilutional – 3rd trimester

Question 10

Microcytic:

Answer 10

small RBC

MCV

Question 11

Macrocytic:

Answer 11

large RBC

MCV > 100

Question 12

Normocytic:

Answer 12

normal RBC

MCV within normal range

Question 13

MCH

Answer 13

hypochromic anemia

Question 14

MCH within normal range:

Answer 14

normochromic anemia

Question 15

MCH > upper limit of normal:

Answer 15

hyperchromic anemia

Question 16

Ferritin:

Answer 16

Iron storing protein (major)

Question 17

Transferrin:

Answer 17

Iron-binding (reversible) blood plasma glycoproteins

Increased in iron deficiency anemia

Question 18

Serum Iron:

Answer 18

Measures the amount of circulating iron that is bound to transferrin

Question 19

Total iron-binding capacity (TIBC):

Answer 19

Measures the blood’s capacity to bind iron with
transferrin

Increased in Iron Deficiency Anemia

Question 20

Sideroblastic Anemia:

Answer 20

disorder of excess iron

Question 21

Lead Poisoning (Plumbism):

Answer 21

§ Microcytic, hypochromic anemia

§ Basophilic stippling

Question 22

Megaloblastic anemias:

Answer 22

Results from inhibition of DNA synthesis during
RBC production

Vitamin B 12 Deficiency (Schilling test)

Folate Deficiency

Question 23

Normocytic anemia:

Answer 23

Anemia with MCV 80-100 fl

Chronic conditions: inflammatory, infectious, and malignant disease

Acute blood loss

Question 24

Erythrocytosis/Polycythemias:

Answer 24

Elevated Hct (> 55%)

Absolute Polycythemia (increase number of RBC)

Polycythemia vera

Question 25

Heme of hemoglobin:

Answer 25

Each heme group contains one iron (Fe++) atom held in a porphyrin ring

Question 26

Globin of hemoglobin:

Answer 26

Protein subunits

Question 27

Hemoglobin A:

Answer 27

most common 2 alpha and 2 beta

Question 28

Hemoglobin A2:

Answer 28

2 alpha and 2 delta

Question 29

Hemoglobin F:

Answer 29

Fetal hemoglobin Consists of 2 alpha and 2 gamma subunits

Question 30

Heme diseases:

Answer 30

Iron Deficiency Anemia

Question 31

Globin diseases (hemoglobinopathy):

Answer 31

Thalassemia Hemoglobin S – Sickle cell disease

Question 32

Carboxyhemoglobin (HgbCO):

Answer 32

Carbon monoxide (CO) variant of Hgb (normal

Question 33

Sulfhemoglobin:

Answer 33

Hgb variant due to addition of sulfur atom

Question 34

Glycosylated hemoglobin (HgbA1C):

Answer 34

Hgb with a glucose irreversibly attached

Question 35

Lab findings of sickle cell disease:

Answer 35

Sickled RBC Anemia -- short RBC lifespan of 30 days

Question 36

Alpha thalassemia:

Answer 36

defect in alpha chain

Question 37

Beta thalassemia:

Answer 37

defect in beta chain

Question 38

Lab findings of thalassemia:

Answer 38

Microcytic anemia Looking for "target" cells

Question 39

Intrinsic hemolytic anemia:

Answer 39

Usually hereditary disorders

Question 40

Extrinsic hemolytic anemia:

Answer 40

Acquired RBC survival disorders

Question 41

Hemolytic deficiency:

Answer 41

G6PD deficiency African & Mediterranean cultures, fava beans

Question 42

Pyruvate kinase (PK) deficiency:

Answer 42

Mild to moderate hemolytic anemia

Question 43

Haptoglobin:

Answer 43

In hemolytic anemias associated with hemolysis of RBCs, the released hemoglobin is quickly bound to haptoglobin

Question 44

Hemolysis labs:

Answer 44

CBC - anemia Peripheral smear - Schistocytes, increased reticulocytes Serum haptoglobin -- decreased Indirect bilirubin -- increased Serum Lactate dehydrogenase (LDH) -- increased

Question 45

Erythrocyte Sedimentation Rate (ESR):

Answer 45

Increased -- inflammation

Question 46

ESR normal range:

Answer 46

0-20 mm/hr