Session 13

Question 1

what are the three main functions of the lymphatic system?

Answer 1

1. removal of excess tissue fluid 2. absorption and transport of fat to the circulatory system and 3. production of immune cells

Question 2

how does lymph originate?

Answer 2

as blood plasma from the capillaries that becomes the fluid that fills the spaces between the cells and tissues

Question 3

what re the 4 major parts of the lymphatic system?

Answer 3

thymus, spleen, lymph nodes and bone marrow

Question 4

what are the two distinct type of multipotential stem cells?

Answer 4

1. lymphopoietic (lymphoid) stem cells which migrate to lymphoid organs for immune system and 2. multipotential hemopoietic (myeloid) stem cells which remain in the marrow

Question 5

what is known as a reduction in circulating erythrocyte mass?

Answer 5

anemia

Question 6

a demonstrated reduction in HCT, hemoglobin or RBC count is diagnostic for what?

Answer 6

anemia

Question 7

what is the ultimate end game for anemia?

Answer 7

leads to decreased oxygen delivery which leads to tissue hypoxia

Question 8

how is RBC size reflected?

Answer 8

in mean corpuscular volume (MCV)

Question 9

what is the difference btwn normoochromic and hypochromic anemia?

Answer 9

normo has normal content of hemoglobin while hypo has reduced content hemoglobin

Question 10

what is the term for abnormally shaped RBCs? what is the combination of both irregular size and shape? what is defined as irregular size?

Answer 10

poikilocytosis; anisopoikilocytosis; anisocytosis

Question 11

what is the major disturbance with megaloblastic anemia?

Answer 11

disturbance of dna synthesis

Question 12

what is the major disturbance of iron deficiency?

Answer 12

disturbance in hemoglobin synthesis; lack of iron

Question 13

what is the major disturbance for hereditary spherocytosis anemia?

Answer 13

membrane defect

Question 14

what is the major disturbance in hereditary elliptocytosis ?

Answer 14

membrane defect

Question 15

what is the major disturbance in hemoglobin c disease anemia?

Answer 15

abnormal globin chain

Question 16

what is the major disturbance in acanthocytosis?

Answer 16

membrane lipid defect

Question 17

i say abetalipoproteinemia, you say?

Answer 17

acanthocytosis

Question 18

mechanical damage to erythrocytes caused by such things as DIC, TTP, and heart valve prosthesis sequela will all lead to what kind of RBCs?

Answer 18

schistocytes

Question 19

what is the major disturbance in sickle cell anemia?

Answer 19

abnormal globin chain which produces sickle cells

Question 20

what is the major disturbance that is the cause of thalassemia?

Answer 20

disturbance in hemoglobin synthesis

Question 21

i say oval macrocytes with hypersegmented neutrophils, you say?

Answer 21

megaloblastic anemia

Question 22

what is the shape to look for with megaloblastic anemia?

Answer 22

teardrop poikilocytosis

Question 23

what is the type or RBCs you are looking for in iron deficiency anemia? (2)

Answer 23

hypochromic and microcytic

Question 24

what are the cells of thalassemia described as? (3)

Answer 24

hypochromic, microcytic cells with basophilic stippling

Question 25

which pathophysiologic classification of anemia is associated with increased numbers of circulating reticulocytes (reticulocytosis)?

Answer 25

anemias associated with increased destruction or loss of RBCs

Question 26

what is the most common anemia worldwide?

Answer 26

iron deficiency

Question 27

T or F: iron requirements increases during pregnancy?

Answer 27

TRUE

Question 28

iron deficiency in adults is most commonly a result of what?

Answer 28

blood loss (chronic); in young women (reproductive years) it is most commonly assoc with blood loss rom menstruation

Question 29

in post menopausal women, unexplained iron deficiency should prompt a study of what type?

Answer 29

GI tract tumor or vascular lesions

Question 30

what happens to the bone marrow in iron deficiency anemia?

Answer 30

bone marrow displays erythroid hyperplasia and decreased or absent stored iron

Question 31

what happens to the levels of serum iron, ferritin levels, and total iron biding capacity? and what about the serum transferrin

Answer 31

decreased, decreased and increased (due to increased serum transferrin)

Question 32

what happens to the saturation of transferrin in iron deficiency anemia?

Answer 32

it is lowered

Question 33

chronic anemia does what to the body's iron store?

Answer 33

they are normal or even slightly increased

Question 34

hypocelllular bone marrow and pancytopenia is indicative of what?

Answer 34

aplastic anemia

Question 35

which anemia is really the result of injury to bone marrow stem cells?

Answer 35

aplastic anemia

Question 36

what are the two types of aplastic anemia?

Answer 36

does dependent )predictable) and dose independent (idiopathic)

Question 37

the bone marrow in aplastic anemia shows increased or decreased cellularity? what happens to the corresponding fat levels?

Answer 37

reduced cellularity with increased in fat

Question 38

anemia of chronic renal insufficiency is reflected by a decreased producing of what?

Answer 38

EPO (erythorpoietin)

Question 39

T or F: the anemia of chronic renal disease is hyperchromic and normocytic

Answer 39

FALSE: normocytic and normochromic

Question 40

in some cases of anemia due to chronic renal disease you will find RBC's with scalloped cell membranes - what are these RBCs called?

Answer 40

Burr cells

Question 41

how doe lead poising result in anemia?

Answer 41

interferes with the enzymes involved in heme synthesis

Question 42

what is the difference between ineffective hematopoiesis and stem cell or precursor cell disorders?

Answer 42

the bone marrow erythrocyte precursor pool is expanded with ineffective hematopoiesis

Question 43

true or false: megaloblastic anemia results in the formation of large nucleated erythrocyte precursors (megaloblasts), most of which do not mature enough to be released into the blood but rather undergo intramedullary destruction.

Answer 43

true