Anemia 1: Acute Blood Loss, Decreased Production, Decreased Hematopoiesis, & Polycythemia Flashcards
Describe the morphology (size and color) of acute blood loss anemia.
Normocytic and normochromic
Describe the morphology (size and color) and pathophysiologic classification of iron-deficiency anemia vs. anemia of chronic disease.
Iron deficiency: microcytic and hypochromic
Chronic disease: normocytic to microcytic and normochromic
Both: from decreased production of RBC precursors
Describe the reticulocyte count, serum iron, serum ferritin, serum transferrin, and TIBC (total iron binding capacity) of iron-deficiency anemia.
No reticulocytosis, low serum iron and ferritin, high serum transferrin and TIBC
Describe the reticulocyte count, serum iron, serum ferritin, serum transferrin, and TIBC (total iron binding capacity) of anemia of chronic disease.
No reticulocytosis, low serum iron and ferritin, low serum transferrin and TIBC
What is the pathophysiologic classification of aplastic anemia and pure red cell aplasia? How are they different?
Both caused by decreased production of precursors; aplastic anemia features pancytopenia (WBC, RBC, platelets) while PRCA features only RBC suppression
Describe the EPO and reticulocyte count in aplastic anemia and pure red cell aplasia.
Same for both: high EPO, no reticulocytosis
Name a common viral cause associated with both aplastic anemia and pure red cell aplasia.
Parvovirus B19
What genetic syndrome is associated with aplastic anemia? With pure red cell aplasia?
Fanconi anemia; Diamond-Blackfan syndrome
What is the pathophysiologic classification of anemia of renal disease? It is characterized by a decrease in what molecule?
Decreased production of RBC precursors; decreased EPO
What is the pathophysiologic classification of myelophthisic anemia? With what process is it associated?
Decreased production of RBC precursors; bone marrow infiltration
What is the pathophysiologic classification of anemia of lead poisoning?
Decreased production of RBC precursors
What is the pathophysiologic classification of megaloblastic anemia? It is associated with low levels of what two molecules?
Ineffective hematopoiesis (due to intramedullary cell death); B12 and folate
What anemia is associated with antibodies against gastric parietal cells?
Pernicious anemia
What molecule transports Vitamin B12 in the blood? Deficiency is usually from lack of what molecule?
Transcobalamin; intrinsic factor
What test measures B12 absorption using radioisotopes?
Shilling test
Megaloblastic anemia is characterized by what 2 kinds of abnormal cells?
Large, nucleated RBC precursors (megaloblasts) and neutrophils with hypersegmented nuclei
What is the pathophysiologic classification of thalassemia?
Ineffective hematopoiesis (due to intramedullary cell death)
Give another name for and describe the morphology (size and color) of homozygous β-thalassemia.
Cooley anemia; microcytic and hypochromic
Describe the morphology (size and color) and major presenting symptoms of heterozygous β-thalassemia.
Microcytic and hypochromic; usually asymptomatic
Names for α-thalassemia with 1 or 2 genes affected; what is their morphology (size and color)?
Silent carrier α-thalassemia and α-thalassemia trait; microcytic and hypochromic
Normal hemoglobin is mostly Hb A with some Hb A2 and Hb F. Give the subunits of these 3 hemoglobins.
Hb A: α2β2
Hb A2: α2δ2
Hb F: α2γ2
What 2 abnormal hemoglobin types can form Heinz bodies? Give their subunits.
Hb H: β4
Hb Bart: γ4
What 2 hemoglobin types are increased in β-thalassemia? Which one has a higher affinity for O2?
Hb A2 and Hb F; Hb F has higher affinity (leads to decreased release in tissue)
Compare the typical genetic mutations in α- and β-thalassemia.
α-thalassemia: gene deletions
β-thalassemia: point mutations
Name for α-thalassemia with 3 gene deletions; what 2 hemoglobin types and what one precipitation are seen?
Hemoglobin H disease; Hb H, Hb Bart’s, and Heinz bodies
Give another name for homozygous α-thalassemia. How many genes are affected, and what hemoglobin dominates in the short-lived fetus, causing increased risk for obstetric complications like eclampsia and postpartum bleeding?
α hydrops fetalis; all 4 α genes are missing; Hb Bart is seen
What is another name for Gaisbock syndrome, and what is its cause?
Relative polycythemia, caused by dehydration
Is polycythemia vera relative or absolute, primary or secondary, and EPO-dependent or independent?
Absolute, primary, EPO-independent
What kind of polycythemia can occur in response to chronic lung disease, cigarette smoking, high altitudes, a R-to-L heart shunt, and Hb with increased O2 affinity? Is it EPO-dependent or independent?
Secondary polycythemia, EPO-dependent
Which polycythemia is considered a primary myelodysplastic syndrome?
Primary polycythemia / polycythemia vera
