Anemia 2

Question 0

pancytopenia
hypersegmented neutrophils
and macrocytosis
indicative of what?

Answer 0

Megaloblastic anemia

Question 1

Megaloblastic anemia characterized by deficiency in _____, results in

Answer 1

vitamin B12 or folate deficiency

impaired DNA synthesis resulting in pancytopenia

Question 2

autoimmune gastritis results in

clinical manifestations

Answer 2

failed production of Intrinsic Factor (needed for B12 absorption) leading to Pernicious Anemia

Achlorhydria (low HCl)
increased incidence of gastric carcinoma
lemon yellow skin color
neurologic abnormalities

Question 3

Neurologic abnormalities associated with megaloblastic anemia

associated with _____ deficiency but not…

Answer 3

ataxia
hyperfelexia
babinski’s sign

associated with B12 deficiency but not Folate deficiency

Question 4

Anti-Intrinsic factor antibodies found in

Answer 4

Pernicious Anemia

Question 5

Intrinsic Factor is produced in the _____

B12/folate is absorbed in the ____

Answer 5

Gastric Fundus

Distal Ileum

Question 6

Non-Pernicious Anemia causes of Macroblastic Anemia

Answer 6

Intestinal malabsorption: Crohn’s disease, giant tapeworm (D. Latum), blind loop syndrome

vegetarianism

Question 7

Folate Deficiency megaloblastic anemia most common causes

Answer 7

severe dietary defieincy
Pregnancy
Folate blocker cancer drug: Methotrexate
Malabsorption: Sprue, Giardia lambila

Question 8

Warm body hemolytic anemia associated with _____ and mediated by what immunoglobulin?

Answer 8

Autoimmune diseases such as SLE, Hodgkin’s lymphoma

Mediated by IgG

Question 9

Positive Coombs test indicative of what

Answer 9

Warm body autoimmune hemolytic anemia

Indicates binding of IgG to RBC surface

Question 10

Erythroblastosis fetalis caused by what

Answer 10

Maternal alloimmunization: mom is d Rh and fetus is D

ABO incompatibility:
Mother O, fetus anything other than O
Mother A, fetus B or AB

Question 11

Kernicterus?

Answer 11

Staining of basal ganglia with bilirubin

From hemolytic disease of newborn

Question 12

Paroxymal nocturnal hemoglobinuria.
What is it?
Why is it nocturnal?

Answer 12

Complement induced red cell lysis causing hemolytic anemia and pancytopenia

Passage of bloody urine upon waking

Question 13

Cause of paroxymal nocturnal hemolytic anemia

Answer 13

Mutation in PIG-A gene, which codes for a protein that anchors other proteins to cell surface, such as CD 55, 59, and 8. This makes the cell vulnerable to attack by complements.

Question 14

erythrocyte osmotic fragility seen in

Answer 14

spherocytosis

Question 15

Spherocytosis

can cause _____ and _____

Answer 15

splenomegaly, increase in MCHC (mean corpuscular hemoglobin concentration)

Question 16

Glucose-6-Phosphate Dehydrogenase deficiency most common seen in what populations?

Answer 16

10% of African Americans
and people of Mediterranean origin

X-linked

Question 17

Bite cells are histologic indicator of

Answer 17

G6PD Deficiency

Question 18

Treatment with Primaquine can cause what?

What is primaquine?

Answer 18

Oxidative stress from drugs can cause G6PD hemolytic anemia

Primaquine is an anti-malarial agent

Question 19

This hemoglobinopathy infers resistance to this parasite

This enzyme deficiency infers the same resistance

Answer 19

Hemoglobin S

plasmodium falciparum

G6PD Defieiency

Question 20

Hemolgobin S genetic etiology

Answer 20

Point mutation at Codon 6 of b-globin gene

valine substituted for Glutamic acid

Question 21

prenatal diagnosis for Hemoglobin S

Answer 21

Hemoglobin S mutation abolishes restriction site Mst II. Thus samples from amniotic cells can be tested using this enzyme.

Question 22

Sickle cell preparation

What is it?

Answer 22

Test for Hemoglobin S.

In vitro sickling of cells upon exposure to reducing agent (ie Soidum Metabisulfate)

Question 23

Sickle cell anemia symptoms

Answer 23

Hemolytic anemia
Leg ulcers
Autosplenectomy
Aplastic chrisis
Infection complications (especially salmonella pneumoniae)