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Hematology 1 Reynolds Exam 2
System Exam 2
118
Medical
Graduate
02/27/2011

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Cards

Term
What is the lifespan of a RBC?
Definition
3-4 months
Term
What is the lifespan of a WBC?
Definition
7 hours
Term
What is the lifespan of a platelet?
Definition
7 days
Term
What are thrombocytes?
Definition
Platelets
Term
What are the primary constituents of plasma?
Definition
water, fibrinogen, albumin
Term
In an embryo, where does hematopoiesis occur?
Definition
yolk, then liver/spleen, then in bone marrow
Term
Are hematologic stem cells pluripotent?
Definition
Yes
Term
Are hematologic stem cells self reproducing?
Definition
Yes
Term
Where are hematologic stem cells found?
Definition
Bone marrow
Term
in an embryo, where does hematopoiesis occur?
Definition
hemopoietic growth factors, colony stimulating factors, erythropoietin, thrombopoietin and cytokines (interleukins, TNF)
Term
What % of RBC's is hemoglobin?
Definition
95.00000%
Term
What is the structure of hemoglobin?
Definition
4 hemes; each consisting of 2 alpha and 2 beta globin strands
Term
What is a reticulocyte?
Definition
immature RBC's, about 1% of RBC in body. The nucleus has already been ejected.
Term
What is the MCV?
Definition
MCV = mean cell (corpuscular) volume
Term
What is the MCH?
Definition
MCH = mean cell (corpuscular) hemoglobin, average content (mass) of hemoglobin/cell
Term
What is erythropenia?
Definition
Too few RBC's or enough RBC's but with reduced function
Term
What is polycythemia?
Definition
Too many RBC's. Also called erythrocytosis
Term
What is hemolysis?
Definition
An elevated rate of RBC destruction
Term
What are the 3 types of anemia morphology
Definition
microcytic, macrocytic, normocytic
Term
Where is hypochromicity found?
Definition
In microcytic anemia
Term
Where is normochromicity found?
Definition
In normocytic anemia
Term
What is a sideroblast?
Definition
A ringed, abnormal RBC
Term
Sideroblastic anemia is a subset of what type of anemia?
Definition
microcytic-hypochromic
Term
Folic acid deficiency can be seen in what dx?
Definition
Macrocytic anemia
Term
B12 deficiency can be seen in what disease?
Definition
Macrocytic anemia
Term
Pernicious anemia is seen in what kind of anemia?
Definition
Macrocytic anemia
Term
What is thalassemia?
Definition
abnormal hemoglobin production due to genetic disorder
Term
How is thalassemia passed?
Definition
Genetically, automsomal recessively
Term
What anemia has thalassemia as a sign?
Definition
microcytic-hypochromic anemia
Term
If you have anemia due to iron deficiencey, what type is it?
Definition
microcytic-hypochromic anemia
Term
What is deficient in hemolytic anemia?
Definition
G-6-PD
Term
What form of anemia has sickle cell as a subset?
Definition
hemolytic anemia
Term
What is hereditary spherocystosis?
Definition
Abnornal RBC morphology, spherical instead of biconcave disk
Term
What kind of anemia can present spherocytosis
Definition
hemolytic anemia
Term
What are the types of normocytic anemia?
Definition
anemia due to chronic disease, acute blood loss, or aplastic anemia
Term
What is aplastic anemia?
Definition
A lack of bone marrow RBC production
Term
What is a pale conjunctiva an early sign of?
Definition
anemia
Term
What is pica?
Definition
compulsive eating often seen with anemia
Term
What is microcytosis?
Definition
Abnormally small cells
Term
what is hypochromia?
Definition
decreased hemoglobin
Term
What is sideroblastic anemia?
Definition
Abnormal hemoglobin production due to inability to use iron, iron present systemically in normal amounts
Term
If iron is seen accumulating in the mitochondria of RBC precursors, what disease is this?
Definition
Sideroblastic anemia
Term
Can thalassemia present with varying degrees of symptoms?
Definition
Yes.
Term
What anemia is mild and has normal lifespans?
Definition
beta-thalassemia
Term
What is the treatment for thalassemia?
Definition
Transfusion
Term
What is the most common anemia?
Definition
iron deficient microcytic-hypochromic; both in U.S. and worldwide
Term
What does normochromic mean?
Definition
Hemoglobin/RBC are within normal range
Term
What is hypochromicity?
Definition
Low amount of hemoglobin/RBC
Term
What dx can be seen in 20% of U.S. women?
Definition
iron deficient anemia (microcytic-hypochromic)
Term
What can cause iron deficiency?
Definition
blood loss (gastrointestinal or menstrual); dietary deficiency, hookworms
Term
What is the #1 cause of iron deficiency worldwide?
Definition
Hookworms
Term
What is the ferritin level?
Definition
The measure of iron/protein complexes that store iron in intestinal cells
Term
What does a low ferritin level mean?
Definition
iron deficiency
Term
How do you treat iron deficiency?
Definition
Stop the blood loss, then replace the iron
Term
What are two signs of a good response to iron replacemtn therapy?
Definition
An increase in reticulocytes at 1 week; hemoglobin back to normal by week 6
Term
What does it mean if reticulocytes are normal?
Definition
bone marrow is functional
Term
When are reticulocyte levels increased?
Definition
acute blood loss or iron therapy
Term
What is a subset of macrocytic anemia?
Definition

Large celled (megaloblastic) anemia

 

Non-megaloblastic anemia

Term
What abnormal biologic process causes macrocytic anemia?
Definition
impaired DNA synthesis
Term
What causes nonmegaloblastic macrocytic anemia?
Definition
alcoholism, hypothyroidism, chronic liver disease
Term
How long does the body's folic acid supply last?
Definition
4-5 months
Term
What 4 things can cause folic acid deficiency?
Definition
pregnancy, diet, alcoholism*, inflammatory bowel disease
Term
How long do B12 supplies last?
Definition
3-5 years
Term
What can cause B12 malabsporption?
Definition
Diet, veganism, being elderly, alcoholism
Term
What is the most common side affect of Vit B12 malabsorption?
Definition
Pernicious anemia
Term
What are basic B12 deficiency symptoms?
Definition
neurologic problems, atrophic glossitis (tongue inflammation)
Term
What is the cascade of events that cause pernicious anemia?
Definition
autoimmune attack of gastric parietal cells leads to loss of intrinsic factor which leads to B12 malabsorption
Term
A lack of intrinsic factor is a hallmark of what disease?
Definition
Pernicious anemia
Term
What disease presents anti-parietal cell antibodies?
Definition
Pernicious anemia
Term
What disease presents anti-Intrinsic Factor antibodies
Definition
Only pernicious anemia
Term
What are treatments for macrocytic anemia (3)?
Definition
remove/treat the cause if you can, B12 supplementation, Folate
Term
What is anemia of chronic disease?
Definition
anemia caused by chronic inflammation
Term
What 2 diseases often cause anemia of chronic disease?
Definition
rheumatoid arthritis and renal disease
Term
How to you treat anemia of chronic disease?
Definition
Erythropoietin (EPO)
Term
What is the primary mechanism of anemia of chronic disease?
Definition
inability to metabolize iron in the bone marrow
Term
What is erythropoietin?
Definition
a glycoprotein that causes RBC synthesis
Term
Where is EPO produced?
Definition
Kidneys
Term
What induces EPO production?
Definition
Hypoxia
Term
What drug is often used in end-stage renal failure?
Definition
Erythropoietin (EPO)
Term
What causes aplastic anemia?
Definition
Hematopoietic stem cell failure
Term
What is pancytopenia?
Definition
A reduction of WBC, RBC, and platelet production
Term
What is thrombocytopenia?
Definition
Low platelet levels
Term
What is leukopenia?
Definition
Low levels of WBC
Term
What is erythropenia?
Definition
low levels of RBC
Term
What is the etiology of primary aplastic anemia?
Definition
unknown, idiopathic
Term
What are 2 common causes of secondary aplastic anemia?
Definition
chemotherapy, infections
Term
What are signs/symptoms of leukopenia?
Definition
increased infections
Term
What are signs/symptoms of thrombocytopenia?
Definition
bleeding, petechiae, purpura, ecchymosis
Term
What is ecchymosis?
Definition

bruises greater than 1cm in size

 

Subcutaneous

Term
What are petechiae?
Definition
hemorrhagic bleeding less than 3mm in size
Term
What are purpura?
Definition
hemorrhages between 3mm and 1cm in size
Term
What are 4 ways to treat aplastic anemia?
Definition
RBC transfusion, antibiotics if infection present, platelet transfusions, bone marrow transplant
Term
What Is the survival of aplastic anemia if untreated?
Definition
2-6 months
Term
What type of anemia is blood loss anemia?
Definition
normocytic, normochromic
Term
Is reticulosytosis seen with acute blood loss anemia?
Definition
yes
Term
What are two signs of acute blood loss anemia?
Definition
low blood pressure, tachycardia
Term
What are the 4 treatments for acute blood loss anemia?
Definition
Prevent shock, give fluids,control bleeding, blood transfusions
Term
What is hypovolemia?
Definition
Shock due to low blood volume
Term
What is the prevalance of the sickle cell gene in blacks?
Definition
25.00000%
Term
What is the prevalence of sickle cell anemia in blacks?
Definition
1.00000%
Term
What is abnormal in sickle cell anemia?
Definition
hemoglobin S
Term
What hemoglobin protects against malaria?
Definition
hemoglobin S (affected in sickle cell anemia)
Term
What are the 3 main characteristics of sickle cell anemia?
Definition
chronic hemolysis, acute vaso-occlusive crises, increased susceptibility to infection
Term
What causes the sickling of RBC's in sickle cell crisis?
Definition
Hypoxia
Term
What triggers sickle cell crisis?
Definition
cold exposure, pregnancy, infections, gallbladder disease, stimulant drugs (cocaine, meth, nicotine)
Term
What is the mechanism of jaundice?
Definition
heme breakdown produces bilirubin
Term
What can present jaundice as a symptom?
Definition
sickle cell crisis and hereditary spherocytosis
Term
What can cause splenomegaly?
Definition
sickle cell crisis
Term
What are the 4 ocular signs of sickle cell?
Definition
retinopathy, vitreous hemorrhage, retinal detachments, neovascularization
Term
What is the most important treatment for sickle cell anemia?
Definition
oxygen
Term
What are treatments for sickle cell anemia
Definition
Oxygen, Fluids and transfusions, treat infections, hydroxyurea
Term
What is hydroxyurea?
Definition
a sickle cell anemia med that increases Hb F which inhibits the sickling effect
Term
What disease presents with fragile, less pliable cells?
Definition
hereditary spherocytosis
Term
What diseases can present with splenomegaly?
Definition
 Sickle Cell Crisis and hereditary spherocytosis
Term
How do you treat hereditary spherocytosis?
Definition
splenectomy
Term
What is a G-6-PD deficiency?
Definition
deficiency of G-6-P dehydrogenase; an antioxidant that protects RBC's
Term
What is the primary demographic w/ G-6-PD deficiency?
Definition
black males
Term
What are meds that can trigger G-6-PD deficiency (3)
Definition
sulfa, aspirin, antimalarials
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