RBC AND ANEMIA Flashcards
1
Q
process of blood formation
A
hematopoiesis
2
Q
process of RBC formation
where does it take place?
A
erythropoiesis
bone marrow
3
Q
process of WBC formation
A
leukopoiesis
4
Q
process of PLT formation
A
thrombopoiesis
5
Q
total population of RBC inside the body
A
erythron
6
Q
total population of RBC in circulation only
A
RBC mass
7
Q
dynamics of RBC creation and destruction
A
erythrokinetics
8
Q
graveyard of RBC
A
spleen
9
Q
production of defective erythroid precursors
A
ineffective erythropoiesis
10
Q
how does RBC die in effective erythropoiesis?
A
defective RBC precursors often undergo apoptosis
11
Q
examples of ineffective erythropoiesis (4)
vfts
A
vitamin B12 deficiency
folate deficiency
thalassemia
sideroblastic anemia
12
Q
type of anemia for vitamin B12 deficiency and folate deficiency
A
macrocytic, normochromic anemia
13
Q
type of anemia for thalassemia and sideroblastic anemia
A
microcytic, hypochromic anemia
14
Q
decrease in the number of erythroid precursors in the BM
A
insufficient erythropoiesis
15
Q
examples of insufficient erythropoiesis (3)
A
IDA
renal disease
acute leukemia
16
Q
type of anemia for IDA
A
microcytic, hypochromic anemia
17
Q
type of anemia for renal disease and acute leukemia
A
normocytic, normochromic anemia
18
Q
immature hematopoietic cell that is committed to a cell line but cannot be identified morphology
A
progenitor cells
19
Q
examples of progenitor cells
A
BFU-E (bust forming unit)
CFU-E (colony forming unit)
20
Q
immature hematopoietic cell that is morphologically identifiable as belonging to a given cell line
A
precursor cells
21
Q
examples of precursor cells
A
rubriblast, prorubricyte
22
Q
earliest marker of erythroid differentiation; transferrin receptor
A
CD71
23
Q
meaning of CD
A
clusters of differentiation
24
Q
transport protein of iron in the plasma
A
transferrin
25
chief stimulatory cytokine for RBC; major hormone that stimulates the production of erythrocytes
erythropoietin (EPO)
26
primary organ and cell source of EPO
kidney
| peritubular interstitial cells
27
primary target cells of EPO
BFU-E and CFU-E
28
3 major effects of EPO
1. early release of retics from BM
2. reduce the time needed for cells to mature in BM
3. preventing apoptosis
29
artificial way to induce RBC production using EPO
blood doping
30
hormone produced by pituitary gland that directly stimulates erythropoiesis
growth hormone
| prolactin
31
hormone produced by testes/ovaries that indirectly stimulates erythropoiesis
testosterone
| estrogen
32
the hormone that suppresses production of EPO
estrogen
33
T or F.
it takes about 21 to 30 days for the BFU-E to mature to an erythrocyte, of which approximately 7 days are spent as recognizable precursors in the bone marrow
18-20 days
| 6 days
34
RBC precursors (all stages)
```
rubriblast
prorubricyte
rubricyte
metarubricyte
reticulocyte
```
35
3 RBC naming
rubriblast, normoblast, erythroblast
36
1st RBC stage
rubriblast/ pronormoblast/ proerythroblast
37
2nd RBC stage
prorubricyte/ basophilic normoblast/erythroblast
38
3rd RBC stage
rubricyte/ polychromatophilic normoblast/erythroblast
39
4th RBC stage
metarubricyte/ orthochromatic normoblast/erythroblast
40
5th RBC stage
reticulocyte
41
6th RBC stage
mature erythrocyte
42
supravital stains for retics:
brilliant cresyl blue
| new methylene blue
43
t or f. if you use wright stain, the reticulocyte will change its name
true
polychromatophilic erythrocyte
diffusely basophilic erythrocyte
44
rubriblast characteristics
nucleoli: 1-2
cytoplasm: basophilic
N:C ratio: 8:1
45
RBC basophilia (color) correlation
cytoplasmic basophilia = ribosomal RNA
46
RBC eosinophilia (color) correlation
cytoplasmic eosinophilia = hemoglobin
47
last RBC stage with nucleolus
prorubricyte
48
this is where hemoglobinization starts
prorubricyte
49
prorubricyte gives rise to:
4 rubricytes
50
prorubricyte characteristics
nucleoli: 0-1
coarser chromatin
absence of nucleoli
N:C ratio: 6:1
51
rubriblast gives rise to:
2 prorubricytes
52
rubricyte gives rise to:
2 metarubricytes
53
last RBC stage capable of mitosis
rubricyte
54
first RBC stage in which cytoplasm becomes pink
rubricyte
55
lymphocyte vs rubricyte
lympho
nucleus: crushed velvet
cytoplasm: sky blue
rubri
nucleus: checkerboard
cytoplasm: muddy/gray
56
rubricyte N:C ratio
4:1
57
RBC precursor that has the same color with mature RBC
metarubricyte
58
last RBC stage with nucleus
metarubricyte
59
other names of metarubricyte
nucleated RBC
pyknotic erythroblast
acidophilic normoblast
60
enveloped extruded nucleus of RBC
pyrenocyte
61
which WBC engulfs the extruded nucleus of metarubricyte
macrophage
62
small fragment of the extruded nucleus left in the RBC
howell-jolly bodies
63
who removes howell-jolly bodies?
splenic macrophages
64
in which RBC stage hemoglobin is first synthesized?
prorubricyte
65
last immature RBC stage
reticulocyte
66
what do reticulocytes contain?
residual RNA
67
t or f. spends 2 to 3 days in the bone marrow and 1 day in the peripheral blood before developing into a mature RBC
true
68
last stage of hemoglobin synthesis
reticulocyte
69
type of retic:
| polychromatic macrocyte, seen in increased RBC production
shift cells
70
type of retic:
| macroreticulocyte, seen in severe conditions (hemolytic anemia)
stress reticulocytes
71
metarubricyte N:C ratio:
1:2
72
mature RBC characteristics
shape: biconcave
color: salmon pink
life span: 120 days
73
number of RBC produced from each rubriblast:
16
74
normal ratio of RBC to WBC
600:1
75
normal ratio of RBC to PLT
15:1
76
is not a disease; a consequence of having a disease
anemia
77
3 factors to dx anemia
low number of RBCs
low hemoglobin
low hct
78
first consideration for anemia
hemorrhage
79
common site for clinically significant bleeding
GIT bleeding
80
2nd consideration for anemia
hemolysis
81
3 mechanism of hemolysis
1. shortened RBC survival not explained by bleeding
2. destruction of RBC before 120th day
3. can occur intravascularly or extravascularly
82
3rd consideration for anemia
decreased RBC production
83
disease associated with insufficient erythropoiesis
kidney disease, nutritional deficiencies
84
two methods of classifying anemia
1. morphological
| 2. pathological
85
which blood parameters do we base on for morphological classification?
1. mean corpuscular volume
| 2. mean corpuscular hemoglobin concentration
86
normal or decreased retics, normocytic, normochromic anemia examples (2)
aplastic anemia
| renal disease
87
increased retics, normocytic, normochromic examples (5)
| ppseo
```
PNH
PCH
sickle cell disease
enzyme deficiencies
other hemolytic anemias
```
88
rare, potentially deadly bone marrow failure syndrome
aplastic anemia
89
characteristics of aplastic anemia (4)
| prbd
1. pancytopenia
2. reticulocytopenia
3. bone marrow hypocellularity
4. depletion of HSC
90
2 classification of aplastic anemia:
acquired
| inherited
91
most common aplastic anemia
acquired aplastic anemia (AAA)
| idiopathic or secondary
92
secondary acquired aplastic anemia causes
```
chemicals
insecticides
benzene
EBV
chloramphenicol*
```
93
most common inherited aplastic anemia
fanconi anemia
94
fanconi anemia characteristics (6)
| cam ssa
1. chromosome instability disorder
2. aplastic anemia, cancer susceptibility
3. macrocytic
4. skeletal abnormalities
5. skin pigmentation
6. abnormalities of the eyes, kidneys, and genitals
95
paroxysmal nocturnal hemoglobinuria other name:
marchiafava-micheli syndrome
96
cause of PNH (2)
1. decay-accelerating factor or CD55
| 2. membrane inhibitor of reactive lysis or CD59
97
tests for PNH (3)
1. ham's acidified serum test
2. sugar water test/ sucrose hemolysis test
3. flow cytometry (confirmatory)
98
disease associated with microcytic, hypochromic anemia (5)
```
thalassemia
anemia of chronic infection
iron deficiency anemia
lead poisoning
sideroblastic anemia
```
99
microcytic, hypochromic anemia characteristics (lab)
mcv and mchc are low
100
most common anemia among hospitalized patients
anemia of chronic inflammation/disease
101
central feature of anemia of chronic inflammation
sideropenia
- decreased serum iron despite having high iron stores
- macrophages hog iron because of inflammation
102
acute phase reactants that contribute to anemia of chronic inflammation
(3)
flh
ferritin
lactoferrin
hepcidin
103
master regulatory for systemic iron metabolism
hepcidin
104
what does hepcidin inactivates?
ferroportin
105
protein that transports iron from tissue to blood
ferroportin
106
most common anemia
iron deficiency anemia
107
possible causes of IDA (5)
```
blood loss
nutritional deficiency
increased iron demand
GIT malignancy
hookworms
```
108
IDA clinical features (5)
| fkgpp
```
fatigue, weakness, pallor
koilonychia
glossitis
pica
pagophagia
```
109
most sensitive test for IDA
serum ferritin test
110
develop when the production of protoporphyrin or the incorporation of iron into protoporphyrin is prevented
sideroblastic anemia
111
nucleated RBC precursor with cytoplasmic iron granules
sideroblast
112
anucleated RBC with iron granules
siderocyte
113
hallmark of sideroblastic anemia
ring sideroblasts
114
indirect measure of transferrin concentration in the plasma
total iron binding capacity
115
amount of protoporphyrin rings not bound to urine
free erythrocyte protoporphyrin
116
heme is made up of?
protoporphyrin ring + iron
117
mechanism of lead poisoning
inhibits:
ferrochelatase (heme synthetase)
pyrimidine-5'-nucleotidase (RNA catabolizer in retics) > basophilic stippling
118
```
megaloblastic anemia (3)
vfa
```
vitamin B12 deficiency
folate deficiency
acute erythroleukemia
119
non megaloblastic anemia (3)
| labm
liver disease
alcoholism
BM failure
120
hypersegmented neutrophils are only seen in?
megaloblastic anemia
121
macrocyte shapes in megaloblastic and non megaloblastic anemia
megaloblastic = oval
| non megaloblastic = round
122
vitamin B12 deficiency may be caused by (4)
1. inadequate intake
2. pregnancy
3. D. latum infection
4. lack of intrinsic factor
123
causes of lack of intrinsic factor (3)
1. gastrectomy > removes parietal cells
2. H. pylori infection > destroys parietal cells
3. pernicious anemia > autoantibodies against parietal cells and intrinsic factors
124
folate deficiency may be caused by (3)
1. inadequate intake
2. pregnancy
3. renal dialysis
125
differentiate folate vs B12 deficiency
folate holoTC assay: normal
| B12 holoTC assay: decreased
