Term
| what are two microcytic anemia? |
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Definition
| Iron deficiency and anemia of chronic disease |
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Term
| what are two normocytic normochronic anemia |
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Definition
| aplastic and chronic disease |
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Term
| two megaloblastic macrocytic anemia |
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Definition
vit B 12 deficiency
folate deficiency |
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Term
| give 6 condition anemia caused by defective Hgb synthesis (hemoglobiinopathies) |
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Definition
Sickle cell disease
Sideroblastic
Thalassemia
Porphyria
Lead Poisoning
G6PD |
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Term
| what is iron overload anemia called? |
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Definition
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Term
| myeloproliferative disorders --- hint PCV |
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Definition
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Term
Episodic or continuous destruction of RBCs
--- due to intracorpuscular defects causes 4 conditions? |
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Definition
G6PD deficiency*
sickle cell syndromes*
methemoglobinemia
spherocytosis |
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Term
Episodic or continuous destruction of RBCs
due to Extracorpuscular causes: |
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Definition
drug toxicity autoimmune diseases*
TTP* lymphoproliferative diseases
HUS* valve hemolysis
DIC* metastatic adenoCa
vasculitides burns |
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Term
megakaryoblast would become_______
myeloid stem cells would become _____ |
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Definition
thrombocyte
neutrophil, eosinophil, basophile-mast cell |
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Term
what are young erythrocytes called?
Destruction of stem cells is called?
Norm maturation depends on vit B12 & folate deficiencies is called? |
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Definition
reticulocyte
aplastic anemia
Megaloblastic anemia |
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Term
inability to produce globin chain is what condition?
inability to incorporate stored Fe to make heme --- ________________ |
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Definition
thalassemias
Anemia of chronic disease - |
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Term
give name
cells with ↓ conc of Hb-->
abnormal cell shape -->
crescent shaped cell-->
dark center & periphery with a clear ring in between (bullseye)-->
fragmented, irregularly contracted --> |
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Definition
Microcytosis: cell size < 6µm
Macrocytosis: cell size > 8µm
Hypochromia: cells with ↓ conc of Hb
Poikilocytosis: abnormal cell shape
Spherocytosis: spherical, w/o pale centers
Sickle cells: crescent shaped cells
Target cells: dark center & periphery with a clear
ring in between (bullseye)
Schistocytes: fragmented, irregularly contracted |
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Term
| normal Hgb and Hct for Female and male |
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Definition
Hgb – measure of total amt Hgb in peripheral blood. Reflects # RBCs in blood
norm: males 14-18 g/dl
females 12-16 g/dl
Hct – (AKA packed cell vol) measure of % of the total blood vol that is made up of RBCs
norm: males 42-52%
females 37-47% |
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Term
| normale reticulocyte count |
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Definition
Reticulocyte count – to determine bone marrow function
norm: adult/child 0.5-2% of RBCs |
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Term
| Reticulocyte index determines What? |
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Definition
RI – reticulocyte index. Determines if retic count indicates an appropriate erythropoietic response from RBC marrow.
normal RI : 1.0 |
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Term
| iron is absorbed where in GI and when is absorption increased or decreased |
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Definition
Is absorbed primarily in duodenum
Balance is tightly regulated by the body
↑ absorption: anemia
hypoxia
↑ erythropoiesis
↓ iron stores
↓ absorption: inflammation
↑ iron stores |
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Term
most common causes of microcytic anemia?
what stores the iron in liver, spleen and bone marrow? |
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Definition
Iron deficiency anemia
Ferritin. Once absorbed, iron is transported to tissues by transferrin. |
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Term
| serum iron measures what ? |
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Definition
↓ serum iron – measures amt of iron bound to transferrin. Evaluates total body iron.
50 – 150 µg/dL |
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Term
this are example of what disease
Ex: ABO incompatibility, transfusion rxn, thermal burns, snake bites, malaria, bacterial infections, Mycoplasma pneumonia, drugs |
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Definition
Auto Immune Hemolytic Anemia
From coating of RBC membrane with antibodies &/or complement.
Mediated by: IgG “warm” antibodies
IgM “cold” antibodies |
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Term
| Auto immune hemolytic Anemia coomb's test--- explain direct |
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Definition
Direct (antiglobulin test)
To ID hemolysis or a hemolytic transfusion rxn
Direct: aids in evaluating suspected transfusion rxn by detecting antibodies that coat transfused RBCs
Uses pt’s blood
Antibodies can develop:
from drugs (levodopa, methyldopa). Antigens develop on the RBC
with some diseases (autoimmune disease, lymphoma)
idiopathic
+ = agglutination |
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Term
| indirect coomb test detect antibody circulating in the blood or the one that coats transfused RBCs |
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Definition
Indirect: (Indirect antiglobin test)
Detects circulating antibodies against RBCs
To detect minor serum antibodies (other than ABO/Rh system) to RBCs that will be given in a future blood transfusion |
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Term
| type and screen is done in direct or indirect ...when is it done |
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Definition
| indirect and it is done b4 surgery |
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Term
| with autoimmune or lymphoproliferative disorders what kind of antibody? is it warm or cold |
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Definition
| Warm. IgA antibodies react @ body temp |
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Term
cold Abs
Immune Hemolytic anemia occurs in what group of pt? what kind of abs? |
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Definition
elderly
Occurs post infection (EBV, Mycoplasma pneumonia)
IgM antibodies bind @ lower temps, usually in distal circulation & bind complement |
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Term
| hallmark for Aplastic anemia. what are the causes of aplastic anemia? |
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Definition
Pluripotent stem cells in bone marrow are injured → ***pancytopenia*** (hallmark)
Causes: Cause: inherited (Fanconi’s anemia)
radiation
toxins (benzene, carbon tetrachloride)
drugs (chloramphenicol,dilantin, chemo drugs,
acetazolomide, carbamazapine)
insecticides, fungicides
idiopathic |
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Term
| what happens in graft vs host disease ? |
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Definition
Occurs with grafting of immunocompetent lymphocytes from bone marrow transplant to an immunocompromised host
These lymphocytes divide spontaneously
only takes a small number
Prevention: irradiate all blood products for these pts |
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Term
| what is the tx for aplastic anemia? |
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Definition
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Term
| anemia of chronic disease could happen form what other chronic disease |
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Definition
From chronic renal failure, malignancies, liver,
endocrine or thyroid failure |
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Term
| Anemia of chronic disease --what happens to kidney? |
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Definition
| CRF: as renal endocrine function declines, erythropoietin production is impaired. As kidneys fail to excrete, hemolysis and bone marrow depression occur. |
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Term
| cause and S&S of anemia of chronic disease |
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Definition
Cause: ↓ EPO production
S&S: fatigue, pallor
tachypnea, tachycardia
pericardial effusions |
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Term
| Anemia of CRF would show what kind of RBCs? what is the tx? |
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Definition
| Burr cells. recombinant human erythropoietin |
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Term
lack of intrinsic factor with gastric atrophy would causes what kind of anemia?
what kind of pt would get it? what kind of cancer has increased risk? |
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Definition
B12 Deficiency anemia.
in: strict vegetarians*
elderly
post gastrectomy*
surg resection of distal ileum
Crohn’s disease*
Tropical Sprue
alcoholics
gastric cancer |
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Term
| this anemia is dx by doing schilling test (radioisotopes of B12). S & S are sore tongue and angular stomatitis. symmetric paresthesias of feet and hands |
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Definition
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Term
| what is the tx for pernicious anemia? |
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Definition
Rx: B12 (cyanocobalamin) 1mg/day in doses till Hct is norm, then 1mg/mo IM for life
monitor serum K+ levels* (po K+ ) |
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Term
| ______________ are associated with neural tube defects, abnormalities of heart, urinary tract and limbs in neonates |
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Definition
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Term
| what two types causes need for folate needs to increase? |
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Definition
| pregnancy and exfoliative skin disease |
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Term
| what does alcohol do to folate --increase level or dec level in body |
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Definition
| dec -- Usually associated with alcoholism. Alcohol interferes with intestinal absorption of folic acid & ↓ hepatic storage |
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Term
| s & S of folate deficiency anemia |
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Definition
S&S: memory changes
irritability
personality changes |
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Term
| very important what would see on blood smear which will dx folate deficiency anemia ---- two things |
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Definition
macro-ovalocytes & hypersegmented PMNs are pathognomonic*
Howell-Jolly bodies* (small remnants of
nuclear material in RBCs)
Folate level <150 ng/ml*
Serum B12 levels are normal |
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Term
| x-linked recessive disorder which affects black males and sephardic jews. |
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Definition
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Term
| what kind of cells and bodies would you see in G6PD that would confirm the dx? |
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Definition
G6PD level during the illness
bite cells
Heinz bodies
retic count
serum indirect bilirubin |
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Term
| what are some causes of G6PD? |
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Definition
| Fava beans, primaquine, quinidine, sulfonamides ASA, soy products, anti-malarials durgs. |
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Term
what is HbSS?
and What is HbAs |
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Definition
HbS is defective gene for sickle cell. HbSS is when all of the HbA (normal gene) is replaced by HbS (Defective one). they are positive for sickle cell disease
HbAs: is when they have both. --Sickle cell trait |
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Term
| causes of sickle cells anemia? |
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Definition
Cause: fever/infection
cold weather
high altitudes
dehydration
acidosis
hypoxemia |
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Term
| what could be long term sequela? |
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Definition
splenomegaly/asplenia
renal failure
avascular necrosis of femoral head(osteomyelitis)
strokes
priapism
retinopathies→ blindness |
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Term
| what would you notice on lab work to Dx sickle cell? |
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Definition
Anisocytosis/ poikilocytosis
howell-jolly bodies
sickle cells/target cells
serum bilirubin, urobilinogen,urobilin
hemoglobinuria
WBCs
thrombocytopenia/DIC can develop |
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Term
| what is the rx of choice for sickle cell? |
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Definition
stem cell transplant.
other tx: analgesics (acetaminophen)
supportive – fluids, O2
hydroxyurea
clotrimazole
possible exchange transfusions
Hydroxyurea – switches fetal Hgb gene back on
HbF does NOT sickle |
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Term
this Anemia is Genetically transmitted.
Decreased or absent synthesis of the α- or β-globin chains→ abnorm cells with ↓ survival rates→ anemia.
BQ-----**Prominent feature is microcytosis out of proportion to the degree of anemia.** |
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Definition
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Term
| Deficiencies of globin chain synthesis produce inadequate hemogoblin which then produce what kind of RBCs |
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Definition
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Term
| why does spleen further causes worsening anemia in thalassemia trait? |
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Definition
When there is a deficiency in alpha-globin synthesis, unused beta-globin chains accumulate in the RBC injuring the cell membrane.
These abnormal RBC’s are then removed from the circulation prematurely by the spleen – further worsening the anemia. |
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Term
| what ethnicity is affected ? |
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Definition
| Asian Mediterranean, and African |
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Term
| what other disease could thalassemia would be confused by due to dec MCV? |
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Definition
Iron deficiency. however, RDW would be decreased in iron def.
thalassemia has normal RDW.
also order iron level in serum to r/o iron deficiency. |
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Term
| what shape cells for thalassemia? |
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Definition
| Tear shaped, oval cells, microcytic |
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Term
this anemia is Caused by defects in the incorporation of iron into the heme molecule?
it is a rare anemia. and refractory to Fe therapy |
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Definition
| Sideroblastic anemia--- Sidero means iron |
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Term
| how would you Dx sideroblastic anemia? |
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Definition
Bone marrow bx.
demonstrate abnormalities in erythropoiesis and the accumulation of iron in erythroblast (ring sideroblasts)
Serum iron is often elevated |
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Term
| what color ring would you see around sideroblasts? |
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Definition
| Blue granules denote ringed sideroblasts (iron) |
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Term
| what causes Sideroblastic anemia? |
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Definition
inherited (rare)
typically it is an acquired disorder caused by exposure to certain drugs & toxins
ethanol, lead, isoniazid, chloramphienicol
secondary to malignancy of chronic inflammatory diseases |
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Term
| pt comes in complaining of Nerve damage, severe photosensitivity, liver disease and anemia. what could it be |
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Definition
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Term
vesiculo/bullous eruptions
plaquelike scar formation
hyperpigmentation
excess hair to face
pt with all this would have what kind of porphyria? |
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Definition
| PCT: porphyria cutanea tarda |
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Term
begins in
childhood
itching, burning, erythema
angioneurotic, edemalike swelling of
exposed skin areas
pt with all this would have what kind of porphyria |
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Definition
| EPP: erythropoietic porphyria |
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Term
| name three enzyme that are inhibited by lead in production of heme? |
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Definition
PBG synthase
Heme Sunthase
Coproporphyrinogen oxidase |
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Term
| what else does lead do to RBCs? |
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Definition
Lead appears to injure the RBC membrane, possibly by inhibiting ATPase → impaired cation exchange
Synthesis of α & ß globin chains appear to be defective |
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Term
| Dx of Lead poisoning is done when what is seen on smear? |
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Definition
normocytic, hypochromic anemia
----RBC stippling
----ringed sideroblasts on peripheral
smear (with severe anemia)
urine, blood lead levels |
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Term
|
Definition
Children: speech & language deficits
learning problems
Adults: GI distress (constipation, vomiting)*
severe, diffuse abd pain with episodes of
paralytic ileus (acute intoxication)*
**** linear blue-black line in gingiva****
motor neuropathies
CNS damage
fatigue (anemia) |
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Term
| normal RBC count in male? Female? |
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Definition
RBC count: males: 4.3 – 5.7 x10³/µL
female: 3.8 – 5.1 x10³/µL |
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Term
| Normal Hgb in male and female |
|
Definition
Hgb: males 14 - 18g/dL
females 12 – 16g/dL |
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Term
| normal Hct in male and female |
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Definition
Hct: males 37 – 47%
females 35 – 45% |
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Term
| MCV MCH and MCHC normal values |
|
Definition
MCV: 82 - 98µm
MCH: 30- 40pg/cell
MCHC: 31 – 37d/dL |
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Term
|
Definition
|
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Term
|
Definition
| WBC count: 5000 – 10,000/mm³ |
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Term
| second most numbered WBC? |
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Definition
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Term
|
Definition
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