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Gen Path > Anemia/ RBC disorders - Exam 3 > Flashcards

Anemia/ RBC disorders - Exam 3 Flashcards

1
Q

Low RBC or hemoglobin content

A

Anemia

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2
Q

What is low hemoglobin in men and in women

A

<13 men
<12 women

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3
Q

Polycythemia / erythrocytosis

A

increased RBC
(primary - neoplasm of BM)
(secondary - increased altitude, sleep apnea, cyanotic heart disease)

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4
Q

Anemia occurs due to these 3 things

A

Low erythropoiesis
Increased RBC loss / Decreased RBC like span
Dilutional anemia

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5
Q

Tissue hypoxia is a symptom of anemia - what is a response that occurs due to this

A

Cardiovascular-pulmonary compensatory responses

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6
Q

A hematocrit at 30%
<30%
<20 %

A

asymptomatic
moderate anemia (weakness, headache, tinnitus, vertigo)
Severe anemia (loss of period, libido, GI complaints, heart failure / shock)

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7
Q

Production defect due to heme/ globin synthesis alterations

A

Microcytic-hypochromic RBC
(Iron def. or malabsorption)

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8
Q

Hypoplastic or hypoproliferative mechanism

A

Normochromic-normocytic RB
(Leukemia or metastatic cancer)

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9
Q

Defect in DNA synthesis, defect in Vitamin B12, folate or folic acid

A

Macrocytic (megaloblastic) RBC

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10
Q

Anemias due to reduced or ineffective erythropoiesis (4)

A

Iron deficiency anemia
Anemia of chronic disease
Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency anemia

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11
Q

Most common cause of anemia

A

Iron deficiency anemia

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12
Q

Second most common cause of anemia - most common type in hospitalized patients

A

Anemia of chronic disease

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13
Q

Blood loss
Poor iron intake
poor iron absorption

A

Iron deficiency anemia

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14
Q

Koilonychia
Pica
Dysphagia
Atrophic glossitis
Glossodynia

A

Iron deficiency anemia
Anemia of chronic Disease

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15
Q

Iron deficiency anemia + dysphagia + esophageal webs

A

Plummer-Vinson syndrome

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16
Q

Results in microcytic hypochromic anemia

A

Iron deficiency anemia

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17
Q

Associated with underlying diseases that have sustained inflammation

A

Anemia of chronic disease

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18
Q

Anemia of chronic disease :
Inflammatory cytokines release __ that blocks iron channels so iron is stuck in macrophages =

A

hepcidin
low erythropoietin production

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19
Q

Normocytic, normochromic, mild to moderate anemia

A

anemia of chronic disease

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20
Q

Decreased reticulocyte count

A

anemia of chronic disease

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21
Q

Autoimmune disease and H. pylori infection

A

Vitamin B12 deficiency / pernicious anemia

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22
Q

Hereditary in N. european ancestry : Scandinavia

A

Vitamin B12 deficiency / pernicious anemia

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23
Q

Autoimmune-mediated destruction of gastric mucosa that decreases production of intrinsic factor

A

Vitamin B12 deficiency / pernicious anemia
(intrinsic factor helps absorb B12)

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24
Q

Parietal cell antibodies present (70%)
Intrinsic factor antibodies present (50%)

A

Vitamin B12 deficiency / pernicious anemia

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25
Q

Prevalence in black women

A

Vitamin B12 deficiency / pernicious anemia

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26
Q

Atrophic gastritis

A

Vitamin B12 deficiency / pernicious anemia
(inflammation of stomach lining)
Folate (folic acid) deficiency Anemia

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27
Q

Achlorhydria

A

Vitamin B12 deficiency / pernicious anemia
(stomach doesn’t produce hydrochloric acid)
Folate (folic acid) deficiency Anemia

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28
Q

Atrophy of gastric glands histologically (achlorhydria)
GI symptoms

A

Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency Anemia

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29
Q

Mild jaundice

A

Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency Anemia

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30
Q

Complex neurologic syndrome secondary to methionine deficiency
(Decreased proprioception, bad balance/ hard to walk, impaired memory)

A

Vitamin B12 deficiency / pernicious anemia only!

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31
Q

Glossitis (as well as lips, buccal mucosa, other mucosal sites)

A

Vitamin B12 deficiency / pernicious anemia

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32
Q

Oral mucosal erythema and atrophy (redness)

A

Vitamin B12 deficiency / pernicious anemia

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33
Q

Do NOT use nitrous oxide sedation

A

Vitamin B12 deficiency / pernicious anemia

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34
Q

Megaloblastic macrocytic anemia

A

Vitamin B12 deficiency / pernicious anemia
(macrocytosis is absent in >30% of patients)

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35
Q

Can have non-hematologic signs for months before they develop a detectable anemia (anemia is absent in >20% of patients)

A

Vitamin B12 deficiency / pernicious anemia
(Vit. B12 def does not = anemia)

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36
Q

Comes from green veggies and some fruits

A

Folic acid

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37
Q

If cellular stores of folate fall –> __ is blocked and this leads to __

A

DNA replication
megaloblastic anemia

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38
Q

Does Folate (folic acid) deficiency Anemia involve neurologic abnormalities

A

NO

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39
Q

Megaloblastic, macrocytic anemia

A

Folate (folic acid) deficiency Anemia

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40
Q

CBC and smear are indistinguishable from Vit. B12 deficiency

A

Folate (folic acid) deficiency Anemia

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41
Q

How is Folate (folic acid) deficiency Anemia distinguished from Vit. B12 deficiency

A

Measuring serum and red cell folate and Vit. B12 levels

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42
Q

CBC shows increased platelet count

A

Iron deficiency anemia

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43
Q

CBC shows increased RDW

A

Iron deficiency anemia

44
Q

CBC shows decreased
MCV
MCHC

A

Iron deficiency anemia

45
Q

Blood smear shows microcytic hypochromic RBCs

A

Iron deficiency anemia

46
Q

Blood smear shows poikilocytosis and anisocytosis (abnormal variation in size and abnormal variation in shape)

A

Iron deficiency anemia
Vitamin B12 deficiency / pernicious anemia

47
Q

Decreased Ferritin and serum iron

A

Iron deficiency anemia
(ferritin = iron storage)

48
Q

Increased TIBIC

A

Iron deficiency anemia
(total iron binding capacity)

49
Q

CBC shows Low reticulocyte count

A

Anemia of chronic disease

50
Q

Blood smear shows normocytic normochromic OR microcytic hypochromic RBC

A

Anemia of chronic disease

51
Q

CBC shows increased MCV and MCH

A

Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency anemia

52
Q

CBC shows a normal MCHC

A

Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency anemia

53
Q

CBC shows a decreased platelet count

A

Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency anemia

54
Q

CBC shows a low WBC count

A

Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency anemia

55
Q

Blood smear shows LARGE, macroovalocyte RBCs

A

Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency anemia

56
Q

Blood smear shows hyper-segmented neutrophils

A

Vitamin B12 deficiency / pernicious anemia
Folate (folic acid) deficiency anemia

57
Q

Low serum vitamin B12

A

Vitamin B12 deficiency / pernicious anemia

58
Q

Increased methylmalonic acid and homocysteine

A

Vitamin B12 deficiency / pernicious anemia

59
Q

Low serum and red cell folate

A

Folate (folic acid) deficiency anemia

60
Q

Increased homocysteine

A

Folate (folic acid) deficiency anemia

61
Q

Normal methymalonic acid

A

Folate (folic acid) deficiency anemia

62
Q

Anemias due to hemolysis (RBC destruction of reduced lifespan) can be congenital or acquired

A

Congenital = intrinsic RBC defect
Acquired = abnormal marrow or systemic disease (RBC itself is perfect)

63
Q

Congenital hemolytic anemias can be a congenital defect it __, __, or in __

A

hemoglobin structure
RBC metabolism
hemoglobin synthesis

64
Q

Hemolytic anemia caused by congenital, hereditary abnormality in the hemoglobin molecule

A

Hemoglobinopathies

65
Q

2 anemias due to congenital hemolytic anemias

A

Sickle cell anemia
Thalassemia / Beta-thalassemia

66
Q

Most common hereditary hemolytic anemia

A

Sickle cell anemia

67
Q

Production of an abnormal hemoglobin molecule (hemoglobin S HbS)

A

Sickle cell anemia

68
Q

Hemoglobin S HbS is due to a

A

single AA substitution of valine for glutamic acid

69
Q

HbS is unstable and polymerizes when exposed to hypoxemia and acidosis =

A

RBDs deform into a sickle shape

70
Q

Hemolysis in SCD is mainly __

A

extracellular (spleen)

71
Q

Disease vs trait of SCD

A

Disease = 85-90% of normal Hbg is replaced
Trait = 30-45% per RBC = asymptomatic - carrier

72
Q

Affects persons of african descent

A

Sickle cell anemia

73
Q

Painful vaso-occlusive crises

A

Sickle cell anemia

74
Q

Vaso-occlusive crises can be predicted by

A

hypoxia and dehydration

75
Q

Splenic sequestration

A

Sickle cell anemia

76
Q

Dactylitis

A

Sickle cell anemia

77
Q

Leading cause of death with Sickle cell anemia

A

acute chest syndrome

78
Q

Leading cause of death in children with Sickle cell anemia

A

Strep. pneumoniae infection

79
Q

Renal failure (glomerulopathy)

A

Sickle cell anemia

80
Q

Osteomyelitis

A

Sickle cell anemia

81
Q

Jaundice in oral mucosal tissue

A

Sickle cell anemia

82
Q

Erythropoietic activity observable on dental x-rays within the bone

A

Sickle cell anemia

83
Q

Delayed dental eruption

A

Sickle cell anemia

84
Q

Hypoplasia

A

Sickle cell anemia

85
Q

Ischemic necrosis within the mandible and peripheral neuropathy from vaso-occlusive events

A

Sickle cell anemia

86
Q

Occurs in patients from the mediterranean region

A

Thalassemia / beta-thalassemia

87
Q

Caused by more than 200 point mutation that lead to defects in transcription, splicing, or translation of beta-globin mRNA

A

Thalassemia / beta-thalassemia

88
Q

Heterozygous form of Thalassemia / beta-thalassemia

A

Beta-thalassemia minor

89
Q

Cooleys anemia or mediterranean fever

A

Beta-thalassemia major (homozygous)

90
Q

Blood transfusion dependence

A

Beta-thalassemia major

91
Q

Severe anemia

A

Thalassemia / beta-thalassemia

92
Q

Growth retardation

A

Beta-thalassemia major (homozygous)

93
Q

Skeletal deformities

A

Beta-thalassemia major (homozygous)

94
Q

Splenomegaly, hepatomegaly, and lymphadenopathy - gallstone and or cirrhosis

A

Beta-thalassemia major (homozygous)

95
Q

Enlargement of the mandible and maxilla

A

Thalassemia / beta-thalassemia

96
Q

Chipmunk faces - frontal bossing, maxillary hytrophy, depression of nasal bridge, class II malocclusion of teeth

A

Thalassemia / beta-thalassemia

97
Q

CBC shows moderate to severe anemia with decreased RBC count, HCT and Hgb

A

Sickle cell disease

98
Q

Blood smear shows reticulocytes, nucleated RBCs and target or bullseye cells

A

sickle cell disease

99
Q

Major increase of lactic dehydrogenase (LDH)

A

sickle cell disease

100
Q

CBC shows sever anemia, decreased MCV and MCHC

A

Thalassemia / beta-thalassemia major

101
Q

CBC shows increased RDW

A

Thalassemia / beta-thalassemia major

102
Q

Blood smear show deformed RBCs, microcytic and hypochromic

A

Thalassemia / beta-thalassemia major

103
Q

Blood smear shows nucleated RBCs and target cells

A

Thalassemia / beta-thalassemia major

104
Q

Blood smear shows anisocytosis, poikilocytosis, polychromatophilia

A

Thalassemia / beta-thalassemia major

105
Q

Elevated indirect bilirubin and lactate dehyrdogenase (LDH)

A

Thalassemia / beta-thalassemia major

106
Q

Decrease haptoglobin

A

Thalassemia / beta-thalassemia major

Gen Path (11 decks)

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