Anemia due to Decreased Red Cell Production

Question 1

Marrow production can increase _____ fold

Answer 1

6-8

Question 2

When hgb is outside RBC it dissociates into a _____

Answer 2

dimer

Question 3

What happens to reticulocytes during stress?

Answer 3

They are released early

Question 4

Red cells develop in the _____ over ______ days

Answer 4

marrow

10-14

Question 5

Reticulocyte stays for 3 days in the _____ and then 1 day in the _______

Answer 5

marrow

peripheral blood

Question 6

Most turnover in the spleen occurs in what way

Answer 6

extravascularly (10% is intravascular)

Question 7

Know the classification of anemia chart

Answer 7

go memorize this tree/table in the handout

Question 8

What four things suggest hemolysis if there is a reticulocyte response to anemia?

Answer 8

increased bilirubin
increased lactic dehydrogenase (LDH)
decreased haptoglobin
hemosiderin in urine

BL Up H Down = (BLUHD– you’ve got hemolysis in your bluhd) also should be considerin hemosiderin

Question 9

What is the hallmark of hereditary spherocytosis?

Answer 9

loss of the plasma membrane and formation of the microspherocyte

Question 10

What are the three types of Hereditary spherocytosis?

Answer 10

1. Spectrin defect
2. Ankyrin Defect
3. Band 3 defect

Question 11

What is the problem with having microspherocytes?

Answer 11

They get stuck in the spleen and die much faster than normal.

Question 12

What are important clinical aspects of HS?

Answer 12

1/3 has hyperbilirubinemia as neonates

25% are autosomal recessive (most are autosomal dominant)

Question 13

What is treatment for HS?

Answer 13

supportive care and sometimes splenectomy

Question 14

What is an important lab feature of HS?

Answer 14

unconjugated hyperbilirubinemia

Question 15

Sometimes when a patient has HS, the patient will also contract a clinical complication called an aplastic crisis. How is this detected?

Answer 15

Reticulocyte count and hematocrit drop like a rock.

Question 16

G6PD deficiency may be associated with a selective resistance to ______

Answer 16

plasmodium vivax.

Question 17

Enzyme disorders, such as G6PD are associated with _______

Answer 17

heinz bodies

Question 18

what is the basic pathway problems in G6PD disease?

Answer 18

inability to replete GSH (glutathione)–> Oxidation of hgb

Question 19

clincically G6PD presents with episodes of acute hemolytic anemia and _______ associated with_______

Answer 19

hyperbilirubinemia

oxidant stress

Question 20

RBC makes energy through the _______

Answer 20

glycolytic pathway

Question 21

in a direct or indirect Coombs test a positive test result is seen as

Answer 21

agglutination

Question 22

The spleen is critical for clearance of _______

Answer 22

intravascular microbes

Question 23

The most common problem with a splenectomy is ______. This is often associated with the bacteria ______

Answer 23

sepsis

S. pneumoniae

Question 24

Is the risk for S. Pneumoniae from splenectomy greatest for children or adults?

Answer 24

children

Question 25

The Spleen is important for the ____ humoral response and is the origin of the ____ agglutinins, especially for ______ organisms.

Answer 25

adaptive
IgM
encapsulated