Term
| Which two types of deficiencies cause Megaloblastic Macrocytic RBC anemia? |
|
Definition
| Vit B12 & Folate Deficiency |
|
|
Term
| Which two conditions cause Normocytic Normochromic RBC anemia? |
|
Definition
| Aplastic Anemia & Anemia of Chronic Disease |
|
|
Term
| Which two conditions cause Microcytic RBC anemia? |
|
Definition
| Iron Deficiency and Anemia of Chronic Disease |
|
|
Term
| What conditions cause defective Hgb synthesis? |
|
Definition
Sickle Cell Disease
Sideroblastic Anemia
Thalessemia
Porphyria
Lead Poisoning
G6PD deficiency |
|
|
Term
| What is term describes iron overload? |
|
Definition
|
|
Term
| What type of disorder is PCV (Polycythemia Vera)? |
|
Definition
| Myeloproliferative Disorders |
|
|
Term
| What conditions lead to intracorpuscular defects of the RBCs? |
|
Definition
| G6PD deficiency and Sickle Cell syndromes |
|
|
Term
| What main conditions lead to Extracorpuscular defects in the RBCs? |
|
Definition
AI Disease
DIC (Disseminated Intravascular Coagulation)
TTP (Thrombotic Thrombocytopenia Purpura)
HUS (Hemolytic Uremic Syndrome) |
|
|
Term
| What is the precursor cell in hematopoiesis? |
|
Definition
| pluripotent cell (aka stem cell) |
|
|
Term
| Which WBCs are derived from CLP (Lymphoproliferative) Cells? |
|
Definition
|
|
Term
| Which Blood Cells are derived from CMP (Monoproliferative) Cells? |
|
Definition
Erythrocyte
Megakaryocyte/Platelets
Basophil/Mast Cell
Eosinophil
Neutrophil
Monocyte/Macrophage/Kupffer Cell/Langerhans Cell/Dendritic Cell |
|
|
Term
| What term describes excess RBCs? |
|
Definition
|
|
Term
| What term describes a decrease in the number of RBCs or a decrease in RBC function? |
|
Definition
|
|
Term
| What term describes the production of RBCs? |
|
Definition
|
|
Term
| What condition results in the destruction of stem cells? |
|
Definition
|
|
Term
| Where is Erythropoietin produced? What does it do? |
|
Definition
| Produced by the kidney; Stimulates division & maturation of RBC stem cells in bone marrow |
|
|
Term
| What two chemicals does normal maturation of RBCs depend upon? |
|
Definition
|
|
Term
| If there is a deficiency in vitamin B12 or Folate, what anemia develops? |
|
Definition
|
|
Term
| What condition is caused by the inability to produce globin chains in the development of hemoglobin? |
|
Definition
|
|
Term
| What anemia is caused by a deficiency in Fe needed for hemoglobin production? |
|
Definition
|
|
Term
| What anemia is caused by an inability to incorporate stored Fe to make heme? |
|
Definition
| Anemia of Chronic Disease |
|
|
Term
| Which term describes an abnormal variation in size of RBCs? |
|
Definition
|
|
Term
| Which term describes an abnormal cell size < 6 micrometers? |
|
Definition
|
|
Term
| Which term describes the abnormal size of an RBC > 8 micrometers? |
|
Definition
|
|
Term
| Which type of cells have a decreased concentration of Hgb? |
|
Definition
|
|
Term
| Which term describes cells that have an abnormal shape? |
|
Definition
|
|
Term
| What term describes RBCs that are spherical without pale centers? |
|
Definition
|
|
Term
| Which term describes crescent shaped RBCs? |
|
Definition
|
|
Term
| Which term describes RBCs with dark centers & and periphery with a clear ring in between? |
|
Definition
|
|
Term
| Which term describes RBCs that are fragmented, irregularly contracted cells? |
|
Definition
|
|
Term
| What molecule in RBCs binds Oxygen? What molecule binds CO2? |
|
Definition
Heme binds Oxygen
Globin binds CO2 |
|
|
Term
| What is the norm value of Hemoglobin for males and females? |
|
Definition
males = 14 - 18g/dL
females = 12 - 16g/dL |
|
|
Term
| What blood cell evaluation test reflects the number of RBCs in blood? |
|
Definition
|
|
Term
| What blood cell test measures the percent of the total blood volume that is made of RBCs? |
|
Definition
|
|
Term
| What are the normal Hct values for men and women? |
|
Definition
men = 42 - 52%
women = 37 - 47% |
|
|
Term
| What blood test helps to determine the bone marrow function? |
|
Definition
|
|
Term
| What are the normal values for retic counts of adult and children? |
|
Definition
| adult/children = 0.5 - 2% of RBCs |
|
|
Term
| What is the normal value for retic index? |
|
Definition
|
|
Term
| What is the norm value for MCV? |
|
Definition
|
|
Term
| What test value is the best to classify anemias based on size? What are the three different classifications? |
|
Definition
MCV
Normocytic Anemia
Macrocytic Anemia
Microcytic Anemia |
|
|
Term
| What blood test value measures the average concentration of Hgb in RBCs? |
|
Definition
| MCHC - Mean Corpuscular Hgb Concentration |
|
|
Term
| What is the normal value for MCHC? |
|
Definition
|
|
Term
| Which lab value is used to diagnose severe anemia? |
|
Definition
| MCH - Mean Corpuscular Hemoglobin |
|
|
Term
| What is the norm value of MCH? |
|
Definition
|
|
Term
What is the differential percentages for each type of WBC?
Neutrophils?
Lymphocytes?
Monocytes?
Eosinophils?
Basophils? |
|
Definition
Neutrophils = 50 - 70%
Lymphocytes = 20 - 40%
Monocytes = 2 - 8%
Eosinophils = 1 - 4%
Basophils = 0.5 - 1% |
|
|
Term
| What is the norm value for WBC count? |
|
Definition
|
|
Term
| What term describes an increase in WBCs? |
|
Definition
|
|
Term
| What term describes a decrease in WBCs? |
|
Definition
|
|
Term
| What is the major cause of Leukopenia? |
|
Definition
|
|
Term
| What are the causes of Leukocytosis? |
|
Definition
| Infection, Inflammation, Tissue Necrosis, Leukemic Neoplasia |
|
|
Term
| What conditions can lead to macrocytic anemia? |
|
Definition
Vitamin B12 Deficiency
Folic Acid Deficiency
Alcoholism
Hypothyroidism |
|
|
Term
| Where is iron primarily absorbed? Where is iron stored? |
|
Definition
absorbed in the duodenum
Stored in the liver, heart, spleen and bone marrow |
|
|
Term
| What can cause decreased absorption of iron? |
|
Definition
|
|
Term
| What molecule is responsible for transporting iron? What molecule is responsible for storing iron? |
|
Definition
Iron Transport - Transferrin
Iron Storage - Ferritin |
|
|
Term
| What anemia is the most common cause microcytic anemia in children, and women of childbearing years? |
|
Definition
|
|
Term
| At what levels of Hgb are women and men considered to have iron deficient anemia? |
|
Definition
Women = <12g/dL
Men = <14g/dL |
|
|
Term
| What conditions can lead to iron deficient anemia? |
|
Definition
Decreased dietary Iron Intake
Decreased Absorption
Hemorrhage
Pregnancy
Chronic Renal Failure
Hemodialysis |
|
|
Term
| What blood cell measurement is the amount of iron that can be bound by transferrin? |
|
Definition
| Total Iron Binding Capacity |
|
|
Term
| What is the norm level for Total Iron Binding Capacity (TIBC)? |
|
Definition
|
|
Term
| What is the treatment for Iron Deficiency Anemia? |
|
Definition
|
|
Term
| Which type of anemia is described as episodic or continuous destruction of RBCs? |
|
Definition
|
|
Term
|
Definition
| Thrombotic Thrombocytopenic Purpura |
|
|
Term
|
Definition
| Hemolytic Uremic Syndrome |
|
|
Term
|
Definition
| Disseminated Intravascular Coagulation |
|
|
Term
| What type of anemia is the Coomb's test used to identify? |
|
Definition
|
|
Term
| What is the indirect Coomb's test used for? |
|
Definition
| A "type & screen" test for cross-matching blood |
|
|
Term
| What is tested in a Direct Coomb's test? |
|
Definition
|
|
Term
| What is tested in Indirect Coomb's test? |
|
Definition
|
|
Term
| What is the cause of warm hemolytic anemia? What will the result of a Coomb's test be? |
|
Definition
Associated with AI disorders or lymphoproliferative disorders
+ Coomb's test |
|
|
Term
| What is the cause of cold hemolytic anemia? What will be the results of a Coomb's test? In what type of patient's is this condition common? |
|
Definition
Occurs post-infection
- Coomb's test
Common in the Elderly |
|
|
Term
| What is the hallmark of Aplastic Anemia? What is the cause of aplastic anemia? |
|
Definition
Pancytopenia
Aplastic Anemia is caused by damage to the bone marrow |
|
|
Term
| At what level of the platelet count does spontaneous hemorrhage occur? |
|
Definition
| At a platelet count < 20,000 u/L |
|
|
Term
| What condition causes bleeding, ecchymosis, petechiae, spontaneous hemorrhage, infection, fatigue, pallor, lethargy, dyspnea, palpitations, tachycardia, and murmurs as well as a decreased retic count,leukopenia and thrombocytopenia? |
|
Definition
|
|
Term
| What tx will a patient with aplastic anemia die without? |
|
Definition
|
|
Term
| How can graft vs host disease be prevented? |
|
Definition
| Prevented by irradiating all blood products for these pts |
|
|
Term
| What causes anemia associated with CRF (Chronic Renal Failure)? |
|
Definition
| With declining renal endocrine function, erythropoietin is impaired. This causes hemolysis and bone marrow depression. |
|
|
Term
| Which type of anemia has deformed RBCs (Burr Cells) on peripheral smear? |
|
Definition
| Anemia of Chronic disease |
|
|
Term
| What is the treatment for anemia of chronic disease (CRF)? |
|
Definition
| Recombinant human erythropoietin |
|
|
Term
| Which type of anemia is caused by a lack of intrinsic factor causing B12 dficiency? |
|
Definition
|
|
Term
| What type of patients are at risk for developing pernicious anemia? |
|
Definition
strict vegetarians
post gastrectomy
Chrohn's disease
Alcoholics |
|
|
Term
| How is pernicious anemia diagnosed? |
|
Definition
| Schilling Test (radioisotopes of B12) |
|
|
Term
| If a patient presents with angular stomatitis, sore tongue, symmetric paresthesias of feet and hands, irritability, decreased memory as well as labs showing decreased retic count, thrombocytopenia, increased LDH (Lactate Dehydrogenase), and decreased folic acid? |
|
Definition
|
|
Term
| What is the treatment for Pernicious anemia? What must you monitor when giving this treatment? |
|
Definition
B12 (cyanocobalamin) 1mg/day
Monitor patient's serum K levels |
|
|
Term
| During what conditions is there an increased physiological demand for folic acid? |
|
Definition
Pregnancy
Exfoliative Skin Diseases |
|
|
Term
| What anemia has characteristic macro-ovalocytes, hypersegmented Nuetrophils, and Howell-Jolly bodies on peripheral smear? |
|
Definition
|
|
Term
| What is a low folate level? With folate deficiency anemia what is the findings with B12 levels? |
|
Definition
folate <150ng/mL
B12 will be normal |
|
|
Term
| What are the 6 different types of anemia that are caused by defective Hgb synthesis (Hemoglobinopathies)? |
|
Definition
Sickle Cell Disease
Sideroblastic Anemia
Thalessemia
Porphyria
Lead Poisoning
G6PD Deficiency |
|
|
Term
| Which type of hemoglobinopathies has bite cells, heinz bodies and an increased retic count? |
|
Definition
|
|
Term
| Where is the gene for G6PD deficiency located? |
|
Definition
| X-linked recessive disorder |
|
|
Term
| What does the G6PD deficiency cause in the RBCs? |
|
Definition
| Causes the RBCs to be more sensitive to oxidative stress (ie: infection, acidosis, drugs) |
|
|
Term
| What are some long term sequela of sickle cell anemia? |
|
Definition
splenomegaly
renal failure
avascular necrosis of femoral head
strokes
priapism (persistent painful reaction)
retinopathy leading to blindness |
|
|
Term
| What are some triggers that can cause cells to sickle, leading to a sickle cell crisis? |
|
Definition
fever/infection
cold weather
high altitude
dehydration
acidosis
hypoxemia |
|
|
Term
| What condition causes decreased Hgb and Hct, aniscytosis, poikilocytosis, Howell-Jolly bodies, sickle cells and target cells, increased serum bilirubin, increased urobilinogen, increased urobilin, hemoglobinuria, and Increased WBCs? |
|
Definition
|
|
Term
| What is the treatment for sickle cell anemia? |
|
Definition
avoid precipitating event
analgesics (acetaminophen)
supportive - fluids, O2
HYDROXYUREA - switches fetal Hgb gene back on (HbF does not sickle)
STEM CELL TRANSPLANT - Rx of Choice as is curative
CLOTRIMAZOLE - decreases sickling by blocking ion channels in RBC membrane, keeping Ions inside
Infection Prophalaxis |
|
|
Term
| What anemic condition has a decreased or absent synthesis or the alpha- or beta-globin chains? |
|
Definition
|
|
Term
| Which anemia's prominent feature is microcystosis out of proportion to the degree of anemia? |
|
Definition
|
|
Term
| Describe the defect of the RBC in Thalessemia Minor. |
|
Definition
| There are 2 alpha-globin and 1-beta globin chain. |
|
|
Term
| Which anemic disease is clinically manifested by mild to moderate microcytic hypochromic anemia? |
|
Definition
|
|
Term
| Which type of thalassemia is associated with increased levels of Hgb F and A2? |
|
Definition
|
|
Term
| Which type of thalassemia is difficult to diagnose due to a normal Hemoglobin electrophoresis? |
|
Definition
|
|
Term
| What anemia condition causes tear shaped, oval, microcytic cells? |
|
Definition
|
|
Term
| Which type of anemia is refractory (resistant) to iron therapy? |
|
Definition
|
|
Term
| How is sideroblastic anemia diagnosed? |
|
Definition
| Bone marrow biopsy (shows abnormalities in erythropoiesis and accumulation of iron in erythroblasts) |
|
|
Term
| Which type of anemia has characteristic ring sideroblasts? |
|
Definition
|
|
Term
| Which type of anemia is caused by defects in the incorporation of iron into the heme molecule? |
|
Definition
|
|
Term
| What is sideroblastic anemia typically caused by? |
|
Definition
| exposure to certain drugs and toxins such as ethanol, lead, isoniazid, chloramphienicol |
|
|
Term
| What disease condition is caused by an excess production of porphyrin precursors? |
|
Definition
|
|
Term
| If a patient presents with nerve damage, severe photosensitivity, liver dz or anemia, what condition should be suspected? |
|
Definition
|
|
Term
| What must porphyria be distinguished from? |
|
Definition
|
|
Term
| Which type of porphyria causes vesiculo/bullous eruptions, plaque-like scar formations, hyperpigmentation, and excess hair to face? |
|
Definition
| PCT - Porphyria Cutanea Tarda |
|
|
Term
| Which type of porphyria begins in childhood and has symptoms including itching, burning, erythema, and angioneurotic, edematous swelling of exposed skin areas? |
|
Definition
| EPP - Erythropoietic Porphyria |
|
|
Term
| How is EPP differentiated from Lead Poisoning? |
|
Definition
EPP - Mild Hemolysis, hypochromia
Lead Poisoning - Prominent stippling of RBCs |
|
|
Term
| How is porphyria diagnosed? |
|
Definition
Stool and Urine analyzed for porphyria precursors
CBC
LFTs (Liver Biopsy may be needed to determine severity of cirrhosis if present.) |
|
|
Term
| How is porphyria treated? |
|
Definition
Low dose Chloroquine
Protection from sunlight
B-carotene
If Cirrhosis or iron loading is present then aggressive phlebotomy is used |
|
|
Term
| At what levels of lead concentration is Lead Poisoning considered in children and adults? |
|
Definition
children > 50 micrograms/dL
adults > 80 - 100 micrograms/dL |
|
|
Term
| Which 3 enzymes in the heme synthesis pathway are inhibited by lead poisoning? |
|
Definition
PBG synthase
Heme synthase
Coproporphyrinogen Oxidase |
|
|
Term
| What are the early symptoms of Lead Poisoning? |
|
Definition
Children: Speech and Language Deficits, Learning Problems
Adults:Linear Blue/Black line on Gingiva, Fatigue, HA, Irritability, Metallic Taste
Uneasy Stomach (other GI symptoms), Poor Appetite, Weight Loss, Reproductive Problems |
|
|
Term
| What conditions has characteristic RBC stippling, ringed sideroblasts and increased urine/blood levels of lead? |
|
Definition
|
|
Term
| How is Lead Poisoning Treated? |
|
Definition
Eradicate exposure
Chelating Agents (Encourage urinary excretion) |
|
|
Term
| What is the normal RBC count value for males and females? |
|
Definition
males = 4.3 - 5.7 x 10^3
females = 3.8 - 5.1 x 10^3 |
|
|
Term
| What is the normal platelet count lab value? |
|
Definition
|
|
