Anemias Flashcards
Blood picture of AA
Normocytic, normochromic
Leucopenia
Thrombocytopenia
Pancytopenia
Causes pf aplastic anemia
Ionizng radiation
Tumor of the thymus
Exposure to radicals
Congenital/hereditary
What are the exposure to radicals
Naphthalene, arsenical, benzene, chordane
Congenital and hereditary in aplastic anemia
diamond black fan viral hep, oncogenic virus
Ofi in AA
Decreased
Formed due to excessive destruction and shortening of the life span pf the rbc and it can be an acquired or congenital
Hemolytic anemia
Causes of HA
Presence of Ab
Due to toxins
Due to drugs
Due to inherited intracorpuscular anomaly
Due to the presence of Ab in HA spec what
Hdn
Ofi pf HA
Incease
Ha is can correlate to
Spherocyte
Includion bodies of HA
Howeel jolly
Blood picture of HA
High retics
Inc nrbc
Presence of poikilocytosis
2 main dicision that causes HA
Corpuscular defect and extracorpuscular defect
The problem is the rbc itself
Intrinsic
Defect in the cell mem
Pnh
Pnh is previously known as
marchiafava micheli
Inclusion bodies in HA under intrinsic
Hereditary spherocytosis, achantocytosis, elliptocytosis and zeive syndrome
Defect in intracellular enzyme iclude
Anaerobic glycolysis Hexokinas Phosphohexose isomerase Phosphoglycerate kinase Pyruvate kinase
Transfer of glucose to cell
Hexose monophosphate shunt or g6pd
Enzyme involve in methemoglobin
Glutathione synthetase
What are wxtrinsic that cause HA
Acquired autoimmune HA PCH Infection Drugs Chemicals Mechanical Physical agents
Under chemicals
Benzene
Aniline
Lead
Acquired autoimmune HA
Blood transfusion
Mechanical
Externous exercise
Ass with exposure to cold temperature due to the presence of cold agglutinin ab called
Donath landsteiner hemolysin/ pch
Colored of urine sa,ple of PCH
Tea sampled
Ass with complement mediated hemolysis
PNH
Due to a ded of activity of acetyl cholinesterase that is found in the cell membrane
PNH
Due to the presence of HbA variant causes sickling of RBC under reduce oxygen tension
Sickle cell anemia
Inclusion bodies of SIckle cell anemia
Howell jolly and cabots ring
Sickle cell causes
Vaso occlusive crisis
Blood picture of sickle cell anemia
Normocytic normochromic Sickle cell Thrombocytosis Neutrophilia Anistocytosis Poikilocytosis
OFI of sickle cell
Dec
Presence of 2 HbS
Homozygous SC
Carrier they have the sickle cell trait
Heterozygous sc
Simple test for sickle cell anemia
Scribr and waugh method
Normal 2 aloha and 2 beta chain
HbA
Method becsuse it uses deoxygenizers
Daland and Dasilva
Sample of deoxygenizer
2% ascorbic acid, 2% na metabisulfite, 2% na dithionite
Uses formol saline solution
Shermans method
To seal and prevent the entrance of oxygen
Mineral oil
Comoutation in sickle cell anemia
of sc/100x100
40% is observed after an hr in Sc has
Sickle cell anemia
1% of SC after an hour
Sickle cell trait
Due to abnormal production rate pf the one of the polypeptide chain of hb molecule. It can be alpha or beta
Thalassemia
Other name of thalassemia
Cooleys anemia, mediterranean anemia
Predominant cell of target cell
Hereditary leptocytosis
Common in southeast asia
Alpha and beta thalassemia
Indices of thalassemia
Microcytic hypochromic
Inclusion bodies of thalassemia
Howell jolly bodies
Blood picture
Poikilo
Anisto
Inc nucleated nrbc
Hepatosplenomegaly jaundice
OFI of thalassemia
Decrease
Inclusion bodies of beta thalassemia
Heinz and howell jolly bodies
Cause by point mutation that results in premature chain termination or abnormal transcription of rna that leads to formation of reduce/absence of b globin chain
Beta thalassemia
Predominance od hbF
Beta thalassemia major
2 alpha 2 gamma
HbF
Predominance of hbA2
B thalassemia minor
2 alpha 2 delta
HbA2
Due to the gene dletion causing reduce a globulin chain synthesis and in severe form fprm there will be an excess beta chain that leads of the formation of b tetramer characterized by beta
Alpha thalassemia
Hgb variant that contains 4 beta chain
HbH
Presence of what due to reduce form of alpha
HbH
4 gamma chain
Barts hb
For,ed due to the fuctional inability if the B, to replace rbc
Apastic anemia
Results from either a dec or absence in beta chain production by both allele gene
Thalassemia major or homozygous beta thalassemia
Dec in beta chain production, gamma chain production is high which resukt in increased HbF
Thalassemia major, homozygous beta thalassemia
Excess of alpha chain due to lack of matching beta chain
Thalassemia major p, homozygous beta thalassemia
Major cause of death in beta thalassemia major
Cardiac failure
Indirect bilirubin in beta thalassemia major
Dec
Mcv and rdw in beta thalassemia major
Dec and inc
OFI of thalassemia
Dec
What would be expected because of destruction of erythroid precursor in the marrow
Retics ct is elevated
Result from the absence or dec in beta chain production of one allele gene
Thalassemia minor heterozygous beta thalassemia
Resufrom severe microcytic hypochromic anemia to what
Normal clinical finding which is thalassemia minor
Rbc ct in thalassemia minor
Inc
Hb and hct in thalassemia minor
Reduced
Rdw in thalassemia minor is
Inc
Extreme poikilo and anistocytosis and thalassemia major
Target cell, ovalocytes, hjb, normoblasts,siderocytes, cabot ring
Smear show what moderate poikilo in beta thalassemia minor
Target cell, basophilic stip
Thalassemia minor serum iron level
Normal to inc
OFI beta thalassemia minor
Dec
Resukts from a partial or total decrease in the production of alpha chain
Alpha thalassemia
Is deletion of only one gene
Mild aloha thalassemia
Deletion of two alpha globin gene
Severe alpha thalassemia
Most severe form of alpha thalassemia
Hydrops fetalis wuth Hb barts
Ansence of alpha chains 4 gamma chains
Hydrops fetalis with hb barts
Thalassemia in which three of the four alpha globin genes are absent –/-a
HbH dse, alpha thalassemia major
Patientwhi have this have a chronic HA
HbH alpha thalassemia major
Mcv and mch in alpha thalassemia major are
Dec
Due to depletion of iron storage in the body needed for hemoglobin production
Severe iron def anemia
Iron absorp by
Duodenum
Vitb12 absorp by
Ileum
Folate absorp by
Jejunum
Absence of hcl and gastric acid
Achlorydria
Severe IDA causes
Due to poor diet
Due to faulty absorption
Excessive iron loss
Iron excessive demand
Indices of IDA
Microcytic hypochromic
OFI in severe IDA
Dec
Blood picture of severe IDA
Anisto
Poikilo
Thrombocytosis
Is a conditioned nutritional def of b12
Pernicious anemia
PA also called
Macrocytic or megalocytic anemia or addisonians anemia
Due to lack of instrinsic factor needed
Absorption of B12/folic acid
Increase form of wbc specifically what rbc
Shift to the right hypersegmented neutrophils
Indices of pernicious anemia
Macrocytic hypochromic
Blood picture of PA
Leukopenia, thrombocytopenia, pancytopenia anisto, poikilo
Inclusion bodies of PA
Howell jolly bodies cabots ring
Most commonly occu as a result of an iron deficiency but can result from a block in the enzyme that inserts iron into heme ring
Iron metabolism disorder
It is a non functioning without iron and two thirs or more of the tital bidy iron is in the rbc and their precursors
Hb molecule
Each milliliter of rbc contain
1mg of iron
Storage iron is present in as what
Macrophage and normoblast as ferritin or hemosiderin
It is tranportee to normoblast gu plasma transferrin
Recycled Hb
Only lost of the iron from the body per day
0.9-1.3 mg
Result when iron loss extends iron intake for a long time and the body’s iron stores are depleted
IDA
Develops when there is excessive chronic loss of blood
IDA
Develops when increas need for iron such as rapid growth in infancy childhood and pregnancy
IDA
Beginning of iron deficiency a negative balance develops and iron mobilized from iron stores when turns process storage iron and plasma ferritin DEC. gi absorption and tibc is INC
Iron depletion stage
Occurs when tissue iron are depleted when transformed saruration falls the percent if marrow sideroblast dec and serum iron dec and level of photoporohyrin inc
Iron def erythropoiesis stage
A clinical anemia become detectable as normocytic normochromic then graduallt to a macrocytic hypochromic anemia
By the ida stage
Condition of iron excess from a abnormality gene on chrom 6
Primary familial hemachromatosis
Inc absorption by intestinal mucosal cell
Primary familial hemachromatosis
Inc serum level, transferrin saturation and iron loading macrophage and hepatocyte
Primary familial hemachromatosis
Disprdr of iroj excess that is ass with defective synthesis of heme becsuse of multiple enzyme defects and resuting a iron overload in the mitochondria of normoblast
Sideroblastic anemia
Inc serum level, transferrin, sideroblastic and dec tibc
Sideroblastic anemia
Refers to the amount of iron that could be bound by saturating transferrin and ither minor iron binding proteins present in serum or plasma sample
Tibc
Anemia of chronic infection has
Low or normal tibc
Ida has
Hight tibc
Non iron anemia has
Has low tibc
Excess iron removed by adding what to measure bound iron
Mg carbonate to
Rv of tibc in adult
245-425mg dl
Rv of tibc in 40yo
10-250ug/dl
Rv of tibc in newborn
100-200ug/dl
For,ula of tibc
Uibc + serum iron
Tibc increased in
Ida hepatistis and iron supplemented preg
Tibc dec in non ida and nephrosis
Decreased
A measure of the reserbed iron binding capacity of transferrin
UIBC
Formula of uibc
Tubc - serum iron
It is known as transferrin saturation or index of iron storage
Percent saturation
Ratio of serum iron to tibc
Percent saturation
Percent saturation inc in
Iron overdose hema, SA
Percent saturation dec
in ida, malignancy , chronic infection p, anemia of chronic dse
Percent saturation rv
20-50%
