Term
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Definition
| RBCs, Hgb, and Hct below established normal values. A decrease in the oxygen carrying capacity of the blood. Low Hgb or nonfunctional Hgb causes reduced oxygen capacity. |
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Term
| What are the clinical signs and symptoms of anemia? |
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Definition
| Fatigue, Skin Pallor, Jaundice, petechiae, headaches, low blood pressure, tachycardia (increased heartbeat). |
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Term
| What are the three classifications of anemias in relation to RBC size? |
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Definition
Microcytic - < 80 MCV
Macrocytic - > 100 MCV
Normocytic - 80 - 100 MCV |
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Term
| What are the causitive factors which are also used to for classification of anemias? |
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Definition
| Acute or chronic blood loss. Decreased or impared RBC production. (defective Hgb synthesis, DNA synthesis) Increased RBC destruction or loss from membrane defects, metabolic defects (enzyme deficiencies), immune and non-immune destruction. |
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Term
| What are the MCV and MCHC values seen in microcytic, hypochromic anemia? |
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Definition
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Term
| Microcytic, hypochromic anemia conditions result in _______ Hgb synthesis and the ________ to use iron. |
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Definition
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Term
| Microcytic, hypochromic anemia is seen in what conditions? |
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Definition
| Iron Deficiency Anemia, Sideroblastic Anemia, Thalassemia, and Lead Poisoning. |
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Term
| What are the MCV and MCHC values associated with macrocytic, normochromic anemias? |
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Definition
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Term
| Macrocytic, normochromic anemias are seen in what type of conditions? |
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Definition
| Megaloblastic anemias such as vitamin B12 deficiency and folate deficiency. |
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Term
| What are the MCV and MCHC values associated with Normocytic, normochromic anemia? |
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Definition
MCV - 80-100
MCHC - 32-36 |
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Term
| What are the conditions seen with normocytic, normochromic anemia? |
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Definition
Conditions resulting in increased plasma volume,
- acute blood loss,
- hemolytic anemias,
- aplastic anemias,
- splenomegaly,
- Anemia of chronic disorders (Rheumatoid arthristis, chronic infection, malignancy)
- Anemia of chronic renal problems
- Anemia of endocrine diseases (disease associated with thyroid, pituitary, adrenals, and gonads)
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Term
| What is the Red Cell Distribution Width (RDW) test, and how is it calculated? |
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Definition
| Indicates the degree of anisocytosis, calculated using the MCV and RBC count (automated analyzers) |
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Term
| What conditions cause a increased RDW value? |
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Definition
| Iron deficiency anemia, vitamin B12 and folic acid deficiencies. |
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Term
| Normal RDW values are seen in which type of anemia? |
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Definition
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Term
| What is the reticulocyte count test? |
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Definition
| Indicates shortened RBC survival and the subsequent appropriate response by the bone marrow to increase RBC production. |
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Term
| Retic counts are elevated in what type of anemia? |
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Definition
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Term
| Retic counts are often decreased in anemias resulting from _______ ________ production. |
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Definition
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Term
| Blood smear examinations serve as a quality control to verify the results of _________ __________. |
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Definition
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Term
| True of False? Examinations of bone marrow smears are performed when the cause cannot be determined or the differential diagnosis remains broad. |
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Definition
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Term
| Anemia caused by acute blood loss. |
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Definition
| Usually associated with traumatic conditions such as an accident or severe injury. Presents as a normocytic/normochromic anemia. |
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Term
| In anemia caused by acute blood loss, after blood loss the anemia occurs as follows... |
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Definition
| For the first few hours, vassoconstriction delays the onset of anemia (no change in hematocrit and hemoglobin). Severe hemorrhage reduces an individual's total blood volume and produces a condition of shock. The body adjusts itself by expanding the circulatory volume (fluid from the extravascular spaces enters the blood circulation). This has a diluting effect on the remaining cells, which produces the subsequent anemia. |
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Term
| Anemia caused by chronic blood loss is frequently associated with... |
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Definition
| Disorders of the gastrointestinal tract (bleeding ulcer), extremely heavy menstrul flow. |
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Term
| Instead of a dilution problem as seen with acute blood loss, chronic blood loss results in an ______ _______ _________. |
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Definition
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Term
| Anemia caused by chronic blood loss begins as _____________ anemia, until iron stores are depleted, then develops into _______________ anemia. |
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Definition
| normocytic/normochromic... microcytic/hypochromic |
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Term
| What are three types of anemias caused by defective hemoglobin synthesis? |
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Definition
| Iron deficiency anemia, sideroblastic aemia, and thalassemia. |
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Term
| True or false? Anemias caused by defective Hgb synthesis are usually Microcytic. |
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Definition
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Term
| What is the etiology of Iron deficiency anemia? |
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Definition
| Develops from inadequate levels of iron, and usually occurs in infancy, pregnancy, women in child bearing years, and chronic blood loss. |
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Term
| What causes iron deficiency anemia? |
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Definition
| inadequate iron intake, increased iron need, and chronic loss of Hgb. |
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Term
| With iron deficiency anemia, what are the CBC findings? |
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Definition
Microcytic/Hypochromic anemia
Low RBC count, Hgb, Hct, MCV, MCH, & MCHC Increased RDW |
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Term
| With iron deficiency anemia, what are the RBC morphology findings? |
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Definition
Small RBCs deficient in Hgb
Occasional target cells and elliptocytes |
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Term
| With iron deficiency anemia, what are the iron studies findings? |
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Definition
Decreased serum iron
Increased TIBC
Decreased serum ferritin |
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Term
| Sideroblastic Anemia: Etiology |
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Definition
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Related to iron overload conditions.
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Body has adequate iron but is unable to incorporate it into heme synthesis.
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Iron enters the developing RBC but accumulates in the mitochondria.
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Iron accumulation leads to presence of iron deposits around the nucleus of normoblasts (ringed sideroblasts).
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Prussian blue stain of bone marrow will show ringed sideroblasts.
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Term
| What are three types of sideroblastic anemia? |
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Definition
- Hereditary sideroblastic anemia
- Secondary sideroblastic anemia
- Idiopathic acquired sideroblastic anemia
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Term
| What are the causes of Hereditary Sideroblastic Anemia? |
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Definition
- Result of inherited abnormal genes
- Sex-linked recessive trait
- Seen mostly in men
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Term
| What are the causes of Secondary Sideroblastic Anemia? |
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Definition
- Typically caused by toxins or drugs
- Lead poisoning
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Term
| What are the causes of Idiopathic Acquired Sideroblastic Anemia? |
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Definition
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Term
| What are the RBC morphology findings for hereditary & idiopathic acquired sideroblastic anemia? |
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Definition
- Dimorphic
- Microcytes and some normal cells
- Hypochromic and some normochromic cells
- Anisopoikilocytosis
- Target cells
- Pappenheimer bodies
- Basophilic stippling (classic finding of lead toxicity)
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Term
| What are the RBC values for Hereditary and Acquired Idiopathic sideroblastic anemias? |
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Definition
- Decreased hematocrit and reticulocytes
- Increased RDW
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Term
| What are the iron study values for Hereditary and Acquired idiopathic sideroblastic anemias? |
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Definition
- Increased serum iron
- Decrease in TIBC
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Term
| What are the causes of Hemochromotosis? |
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Definition
- Excess accumulation of iron
- Body's rate of iron exceeds the rate of loss (1mg/day)
- Iron excess is toxic to the liver
- Condition may be acquired or hereditary
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Term
| What type of hemochromatosis is caused as a result of mutations that affect proteins directly related to iron metabolism, and may lead to iron overload? |
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Definition
| Hereditary Hemochromatosis |
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Term
| Which type of hemochromatosis develops excess iron due to repeated transfusion of red blood cells, and iron in the donor RBCs overloads the patient's liver? |
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Definition
| Transfusion-related Hemochromatosis (acquired) |
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Term
| What are the lab findings for hemochromatosis? |
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Definition
- Elevated transferrin saturation: common screening test
- Elevated liver function test (ALT)
- Elevated serum ferritin (assesses degree of iron overload)
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Term
| What is the name given to anemias that are caused by DNA synthesis? |
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Definition
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Term
| What causes megaloblastic anemias? |
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Definition
| Vitamin b12 and folate deficiencies. |
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Term
| How does a Folate deficiency and a B12 deficiency affect DNA synthesis? (directly/indirectly) |
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Definition
Folate - directly
B12 - indirectly |
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Term
Findings to diagnose Megaloblastic Anemia
CBC |
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Definition
- Decreased WBC, RBC, and platelets
- Decreased Hgb, and Hct
- Increased MCH, MCV, and RDW
- Normal MCHC
- Low absolute reticulocyte count
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Term
Findings to diagnose Megaloblastic Anemia
RBC morphology |
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Definition
- Oval macrocytes
- Slight TD
- Moderate to marked anisocytosis/pokilocytosis
- RBC Inclusions Include
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Term
Findings to diagnose megaloblastic anemia
Neutrophil lobe count |
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Definition
Larger h-segs seen in 98% of the cases
significant find:
five 5-lobed or one 6-lobed neutrophil per 100 WBC count. |
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Term
Findings to diagnose megaloblastic anemia
Blood serum |
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Definition
| Elevated bilirubin and lactate dehydrogenase. |
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Term
| What type of anemia is caused by malabsorption of vitamin b12 due to lack of intrinsic factor? |
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Definition
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Term
| What test is the diagnostic test for pernicious anemia, detects the loss of intrinsic factor and is diagnostic for the disease, and does not pinpoint cause of B12 malabsorption? |
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Definition
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Term
| Both of these anemias are caused by decreased production of RBCs and classified as normochromic. |
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Definition
| Aplastic Anemia and Pure Red Cell Aplasia |
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