Term
| What does ESR Stand for? What is the Function of ESR? |
|
Definition
| Erythrocyte Sedimentation Rate; Provides a means of detecting and following the chemical course or therapy of inflammatory conditions |
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Term
| Changes in ESR are the results of changes in __________. |
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Definition
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Term
| Normally Red Cells tend to _________. |
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Definition
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Term
| ________ Following an acute inflammatory response or Acute tissue injury, protein levels increase (acute phase Reaction) |
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Definition
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Term
| The increased protein levels _________ the tendency or RBC's to repel each other and enhance _______ formation. |
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Definition
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Term
| Rouleaux formation ________ ESR as clumped RBC's settle faster then single RBC's |
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Definition
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Term
| What diseases are associated with Increased ESR? |
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Definition
| Acute and chronic infections; Tissue necrosis and infection; Malignancies; Rheumatoid Collagen diseases; Chronic renal diseases |
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Term
| What is the Function of Osmotic Fragility? |
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Definition
| Measures how much water Red Blood Cells can absorb before lysing. |
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Term
| The ability of RBC's to take up water without lysing is determined by the cells ________. |
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Definition
| Surface area to volume ratio of the cell |
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Term
| The normal biconcave disc shape of Red Blood Cells gives them a _______ surface area to ________ ratio. |
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Definition
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Term
| Hereditary Spherocytosis, Immune Hemolytic Anemias and Hereditary Elliptocytosis all _________ osmotic fragility. |
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Definition
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Term
| Decreased Osmotic fragility may be due to the presence of _______ or _______. |
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Definition
| Target cells; hypochromasia |
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Term
| _______ and _______ are causes for Target cells. |
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Definition
| Hemoglobin C disease; Thalassemias |
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Term
| Hypochromic cells can be caused by _______ and _______. |
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Definition
| Iron deficiency Anemia; Thalassemias |
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Term
| What is the function testing for G6PD? |
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Definition
| Functions to detect decreased G6PD activity |
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|
Term
| What is G6PD and its function? |
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Definition
| G6PD is part of the hexose monophosphate shunt and helps protect hemoglogin from the affect of oxidizing agents. |
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Term
| Older RBC's will be ________ affected by G6PD deficiency than younger cells. |
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Definition
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Term
| In which ethnic group are the most severe variants of G6PD deficiency found? |
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Definition
| Mediterranean Peoples (Greek, Italian, and some Jewish populations) |
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Term
| What is the Function of the Acidified Serum (Ham's) Test? |
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Definition
| Identifies Red Blood Cells that are susceptible to hemolysis by activated complement when in an acidic environment. |
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Term
| The Acidified Serum (Ham's) Test provides confirmation for ___________. |
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Definition
| Paroxysmal Nocturnal Hemoglobinuria |
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Term
| What is Paroxysmal Nocturnal Hemoglobinuria? |
|
Definition
| A rare acquired blood cell membrane defect in which RBC's WBC's and platelets demonstrate abnormal sensitivity to the effect of activated serum complement. |
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Term
| What is the function of the Leukocyte Alkaline Phosphatase (LAP)? |
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Definition
| Used to differentiate Chronic Myelogenous leukemia from Leukemoid reactions and other myeloproliferative disorders |
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Term
| Leukemoid Reactions, Myelofibrosis, and Polycythemia Vera all cause _______ LAP Scores. |
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Definition
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Term
| Chronic Myelogenous Leukemia and Paroxysmal Nocturnal Hemoglobinuria both cause _______ LAP Scores. |
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Definition
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Term
| What is the normal range for total body Iron? Where is iron located in the body? |
|
Definition
| approximately 3.5 g; 2/3 in hemoglobin in RBC's and 1/3 as tissue iron (stored) |
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Term
| Daily Iron intake is typically 10-20mg, of which normally about _______ is absorbed. |
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Definition
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Term
| Dietary HEME iron is found in _______ and is readily absorbed by the ________. |
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Definition
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Term
| Inorganic iron salts, primarily in the _______ state must be reduced before absorbtion can occur. |
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Definition
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Term
| The acidic pH of the stomach reduces dietary _______ iron to _________ iron. _______ also helps in reducing iron to the _______ state. |
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Definition
| Ferric (3+) iron; Ferrous (2+) iron; Vitamin C; Ferrous |
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Term
| Iron absorption occurs primarily in the _______ and the _______. |
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Definition
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Term
| The Remainder of dietary iron is excreted in _______ (usually greater then 10mg/day) |
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Definition
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|
Term
| Total Iron is controlled at the _______ level. |
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Definition
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|
Term
| Iron not released into circulation remains in the mucosal cell and is lost through _______. |
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Definition
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|
Term
| Normally _______ of iron per day enter the circulation from the mucosal cell. |
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Definition
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|
Term
| Iron is stored in the body as ______ which is _______. |
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Definition
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|
Term
| Carrier Protein _______ is a beta-globulin protein produced by the liver. |
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Definition
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Term
| Normally only about _______ of transferrin's total binding sites contain iron. |
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Definition
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|
Term
| The Transferrin-Iron complex travels to sites of _______ or to _______. |
|
Definition
| erythropoiesis; sites of storage |
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Term
| Sites of Iron storage include _______, _______ and _______. |
|
Definition
| The liver, Spleen and Kidneys |
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|
Term
| Storage forms of Iron include _______ and _______. |
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Definition
| Ferritin (soluble); Hemosiderin (insoluble) |
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|
Term
| Ferritin found in the blood is in _______ with ferritin stored in Reticuloendothelial cells. |
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Definition
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|
Term
| Normally the primary sites of storage are _______ found in the red bone marrow, liver and spleen (reticuloendothelial) |
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Definition
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|
Term
| At the end of Red Blood Cells life span the cells are broken down in the ________. Here iron is liberated and bound to _______ and recycled |
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Definition
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|
Term
| The average Life span of Red Blood Cells is ______. |
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Definition
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Term
| Men and non-menstrating women generally lose on average of _______ of body iron each day. |
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Definition
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|
Term
| In what ways does the body lose iron? |
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Definition
| Intestinal epithelium sloughing, Excretion in urine and sweat |
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Term
| Menstruating women typically lose on average _______ of iron a day. |
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Definition
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Term
| _______ are metal free tetrapyrroles found in virtually all cells, but in greatest quantities in ________ and the _______. |
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Definition
| Porphyrins; bone marrow; liver |
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Term
| Porphyrins serve as _______ in the synthesis of HEME. |
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Definition
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|
Term
| Composed of 4 pyrrole rings, with an arrangement of 4 nitrogen atoms in the center of the ring which enable chelation of Metal ion. |
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Definition
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|
Term
| Protoporphyrin IX that contains iron is called ________. |
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Definition
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|
Term
| HEME synthesis takes place _______ and mostly in the _______ and _______. |
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Definition
| aerobically; bone marrow; liver |
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Term
| Synthesis of HEME is a ________ Pathway. Deficiency in _____ enzyme stops the process. |
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Definition
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Term
| HEME Synthesis produces a _______ system. Once enough is made the process _______ or _______. |
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Definition
| Negative Feedback; slows down; Stops |
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Term
| HEME Synthesis begins in the _______ and moves to ________ and then back to the _______. |
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Definition
| Mitochondrion; cytoplasm; mitochondrion |
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Term
| Hemoglobin A (normal) is composed of _______ and _______ chains. |
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Definition
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|
Term
| Different hemoglobins have different _______. |
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Definition
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Term
| Globin Chain synthesis is _______. |
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Definition
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Term
| Deficiency in synthesis of one globin chain results in _______ of the other type. |
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Definition
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Term
| _______ synthesis also affects the rate of synthesis of globin chains. |
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Definition
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|
Term
| _______ in HEME synthesis results in a _______ in globin chain synthesis |
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Definition
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Term
| Normal Hemoglobin production is dependent on: _______, _______, and _______. |
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Definition
| Adequate iron delivery and supply; Adequate synthesis of Protoporphyrin IX (HEME); Adequate globin chain synthesis |
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Term
| Functions of Hemoglobin include _______ and _______. |
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Definition
| Uptake and delivery of Oxygen |
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Term
| Hemoglobin holds onto oxygen until the oxygen tension of the surrounding tissues is reduced to about _______, it then ________. |
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Definition
| 40 mmHg; Releases oxygen rapidly |
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Term
| Hemoglobin aids in controlling accumulation of _______ in the Red Blood Cell. |
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Definition
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Term
| Organs involved in Hemoglobin catabolism are the _______, _______, _______. |
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Definition
| Liver, Spleen, Bone Marrow |
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Term
| As Hemoglobin unloads Oxygen in the tissues, it binds _______ generated by the dissociation of H2CO3 inside the Red Cell. |
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Definition
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Term
| Globin chains are brokendown, and the Amino Acids are ________. _______ is also recycled for new _______. |
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Definition
| recycled into new protein synthesis; Iron; hemoglobin synthesis |
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Term
| The Protoporphyrin ring is cleaved to _______. |
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Definition
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|
Term
| Biliverdin is reduced to _______. |
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Definition
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|
Term
| Unconjugated bilrubin enters the circulation and is bound by _______ and transported to _______. |
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Definition
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Term
| In the liver unconjugated bilirubin is _______ with _______ and _______ in the bile as bilirubin. |
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Definition
| conjugated; glucoronic acid;excreted |
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|
Term
| Hydrolysis by _______ reduce conjugated bilirubin to _______. |
|
Definition
| intestinal bacterial enzymes; urobilinogen. |
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Term
| Urobilinogen is largely excreted in the stool as _______. |
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Definition
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|
Term
| Red cell destruction within the blood vessels results in _______ release into the circulation. |
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Definition
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|
Term
| The free hemoglobin released by red cell destruction in the blood vessels is bound by _______. |
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Definition
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|
Term
| The _______ is rapidly cleared by the liver and catabolized. |
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Definition
| Hemoglobin-Haptoglobin complex |
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Term
| If free Hemoglobin levels exceed _______, Hemoglobin will be _______. |
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Definition
| 5 g/day; excreted in the urine (hemoglobinuria) |
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Term
| Hemoglobin is processed by the _______, where it is ______ and converted to _______. |
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Definition
| Kidneys; reabsorbed; Hemosiderin |
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Term
| Free Hemoglobin is _______ by the kidneys,it is oxidized to _______. |
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Definition
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Term
| Metheme groups are released and bound up by _______. |
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Definition
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Term
| Any Metheme exceeding Hemopexin level is bound by _______. |
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Definition
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Term
| Metheme-hemopexin is cleard by the _______ and _______. |
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Definition
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Term
| Iron Deficiency Anemia is defined as _______ total body iron. As body iron _______ severity of anemia _______. |
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Definition
| Diminished; Decreases; Increases |
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Term
| What are the causes of Iron Deficiency Anemia? |
|
Definition
| Inadequate dietary intake of iron; Chronic blood loss; GI Bleeding; Heavy menstration; Increased demands; Pregnancy; Lactation; Chronic Hemoglobinuria. |
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|
Term
| If the iron needs of the body are not met, body stores of iron are _______ and anemia of _______ severity develops. |
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Definition
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|
Term
| What is the treatment for Iron deficiciency Anemia? |
|
Definition
| Ferrous Sulfate, 325 mg, TID, for 6 months |
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|
Term
| Sideoblastic Anemias are a group of disorders which cause ________. |
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Definition
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Term
| The causes of sideroblastic Anemias include _______, _______, _______ and _______. |
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Definition
| inherited rare sex-linked disorder; Alcohol Abuse; Exposure to certain drugs which inhibit Vitamin B6 (isoniazid) and Lead Poisoning (Inhibits ALD dehydrase on porphyrin cycle) |
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Term
| The body responds to deficient HEME synthesis by _______ intestinal absorption of iron with _______ iron transport to red bone marrow. |
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Definition
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Term
| Interfering with normal HEME Synthesis _______ iron's insertion into the porphyrin structure with subsequent ________ of iron in mitochondria of RBC Precursors. |
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Definition
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Term
| Ringed Sideroblasts are an indication of _______. |
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Definition
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Term
| Causes of Anemia of Chronic Disease include _______ or _______, _______, _______ and _______ |
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Definition
| Chronic Infection or inflammation; Cancer; Liver Disease; Renal Disease |
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Term
| Underlying systemic disease causes a _______ in RBC's, _______ amount of iron stored as Ferritin and _______ amount of iron available for Hemoglobin production. |
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Definition
| Trapping; increasing; decreasing |
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Term
|
Definition
| An inherited autosomal recessive disorder causing idiopathic excess intestinal iron absorption. |
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|
Term
| In Hemochromatosis, increased amounts of absorbed iron are _______ matched by increased excretion. |
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Definition
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Term
| Slow chronic build up of iron results in _______ of iron _______ the reticuloendothelial system causing Injury to Parenchymal cells of many organs. |
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Definition
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|
Term
| Organs involved in the Chronic build up of iron include _______, _______, ______, ______, _______, _______ and _______. |
|
Definition
| Liver, Heart, Pancreas, Testes, Adrenals, Kidneys, and Pituitary |
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|
Term
| Abrnormal _______ in iron absorption by the GI Tract results in iron storage outside normal Reticuloendothelial Cell Stores. |
|
Definition
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|
Term
| What is the cause of Hemosiderosis? |
|
Definition
| Frequent blood transfusions; Blood transfusions add 200-250 mg of iron to the body per transfusion. |
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|
Term
| What is the cause of Hemochromatosis? |
|
Definition
| Lacking a normal physiological route to excrete excess iron leading to abnormal iron accumulation |
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|
Term
| Iron deficiency causes _______ Serum Iron, _______ Serum Transferrin, _______ Serum Ferritin, _______ TIBC and _______ in % Saturation. |
|
Definition
| Decreased; increased; decreased; increased; decreased |
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|
Term
| Sideroblastic Anemia Causes _______ Serum Iron, _______ Serum Transferrin, _______ Serum Ferritin, _______TIBC and _______ % Saturation. |
|
Definition
Increased; Normal; Increased; Normal; Normal to elevated
*Defective HEME Synthesis |
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|
Term
| Anemia of Chronic Disase causes _______ Serum Iron, _______ Serum Transferrin, _______ Serum Ferritin, _______ TIBC and _______ % Saturation. |
|
Definition
Decreased; Decreased; Increased; Decreased; Decreased
*Iron is trapped and can not be released |
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|
Term
| Hemochromatosis causes _______ Serum Iron, _______ Serum Transferrin, _______ Serum Ferritin, _______ TIBC and _______ % Saturation. |
|
Definition
Increased; Decreased; Increased; Decreased; Increased
*Problem with overabsorption |
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|
Term
| Hemosiderosis causes _______ Serum Iron, _______ Serum Transferrin, _______ Serum Ferritin, _______ TIBC, and _______ % Saturation. |
|
Definition
Increased; Decreased; Increased; Decreased; Increased
*Same as Hemochromatosis |
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|
Term
| _______ chain abnormalities create most clnically significant structrual Hemoglobinopathies. |
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Definition
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|
Term
| Structural Globin chain abnormalities _______ affect the amount of hemoglobin produced. |
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Definition
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|
Term
| Hemoglobin S is found most commonly in _______ populations. |
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Definition
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|
Term
| Abnormal Hemoglobin S is prone to _______ when Oxygen tension is low in the Red Blood Cell. |
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Definition
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|
Term
| Sickled cells are _______ to circulate through small capillaries resulting in _______, _______, _______ and Finally _______. |
|
Definition
| Unable; Blockage (Vasoconstriction), Tissue Hypoxia; Extreme pain in area of blockage and Tissue Death. |
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Term
| Repeated sickling causes _______ membrane damage and the cells are _______ from circulation by the Spleen (Hemolytic Anemia) |
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Definition
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|
Term
| Sickle cells only last _______, causing overload of the bone marrow and spleen. |
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Definition
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Term
| _______ of the Spleen are common with necrosis and scarring leading to a nonfunctional spleen, termed _______. |
|
Definition
| Infarctions; Autosplenectomy |
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Term
| It is postulated that sickle cell Train offers protection from parasites, particularily those causeing malaria, due to the fact that infected Red Cells are _______ sickled, and thereby destroyed by the body. |
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Definition
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Term
| Hemoglobin C is most commonly found in _______ and _______ populations. The crystalloid form of Hemoglobin forms a _______ structure. |
|
Definition
| West African;American Black; Cigar-like |
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Term
| Hemoglobin E is found most commonly in _______ populations. |
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Definition
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Term
| Hemoglobin S is _______ compared to other forms of Hemoglobin and forms the basis for simple screening tests. |
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Definition
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|
Term
| _______ globin synthesis causes _______ hemoglobin synthesis eventually producing Hypochromic, microcytic anemia. |
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Definition
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|
Term
| Alpha Thallassemia is a _______ disorder characterized by _______ production of Alpha globin chains due to deletion of alpha-globin genes. |
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Definition
| Autosomal Dominant; decreaseed |
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Term
| Alpha Thalassemias have a high frequency in _______, and less commonly in _______ populations. |
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Definition
| Asian populations; Black populations |
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Term
| Silent Alpha-Thalassemias are the result of _______. |
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Definition
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|
Term
| Alpha-Thalassemia trait involves _______. |
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Definition
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|
Term
| Hemoglobin H Disease is caused by deletion of _______. |
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Definition
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Term
| Excess Beta chains may form Hemoglobin H which is composed of _______. Which has _______ affinity and _______ Oxygen delivery. |
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Definition
| 4 beta chains; increased; poor |
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Term
| Hemoglobin H is composed of _______ and does not release Oxygen to tissues. |
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Definition
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|
Term
| Deletion of all 4 Beta genes is _______. |
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Definition
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|
Term
| Beta-Thalassemias affect persons of _______ origin and to a lesser extent Chinese other Asian populations and _______ populations. |
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Definition
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|
Term
| Hemoglobin Bart, which has very high Oxygen affinity is composed of _______. |
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Definition
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|
Term
| Mutations in Beta genes result in _______ or in problems with transcription of RNA, resulting in _______ or _______ beta-globin synthesis. |
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Definition
| premature chain termination; decreased; absent |
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Term
| Defects that result in absent globin chain expression are termed _______. |
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Definition
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|
Term
| Defects causing decreased Beta chain synthesis are termed _______. |
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Definition
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|
Term
| Beta-Thalassemia Minor is present with _______. |
|
Definition
| Heterozygous Beta Null or Beta Plus |
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|
Term
| Beta-Thalassemia Majour is present with _______. |
|
Definition
| Homozygous Beta Null or Beta Plus |
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Term
| IN both minor and Majour beta-thalassemias, _______ beta chain synthesis results in _______ amounts of Hemoglobins A2 and F |
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Definition
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Term
| Hemoglobin _______ is used to detect and confirm abnormal Hemoglobin levels and types. |
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Definition
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Term
| Screening for increased levels of hemoglobin _______ and _______ may help in detecting Beta-Thalassemias. |
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Definition
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|
Term
| The _______, tests for Hemoglobin F. |
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Definition
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|
Term
| Resistance to Denaturation by acid or alkali assay provide a measure of _______. |
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Definition
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