B3-034 Introduction to RBC Disorders Flashcards
primary growth factor involved in erythropoiesis
erythropoietin
erythroids have a _________ maturation time
7 days
during erythroid maturation, the nucleus becomes
smaller and darker until it is dissolved
during erythroid maturation, the cytoplasm becomes
more pink
round, biconcave disks with central pallor
anucleate
eosinophilic cytoplasm
erythrocytes
oxygen transport
erythrocytes
total number of erythrocytes
RBC
total amount of hemoglobin
Hgb
proportion of blood occupied by RBCs
Hct
mean RBC volume/size
-cytic
MCV
average amount of hemoglobin in each RBC
MCH
average amount of hemoglobin per RBC volume
-chromic
MCHC
variation in RBC size
RDW
variation in size
anisocytosis
variation in shape
poikilocytosis
variation in size and shape
anisopoikilocytosis
immature RBCs containing residual RNA
reticulocyte
**aka polychromatic erythrocyte
circulating time of reticulocytes [increase/decreases] in anemia
increases
reticulocytes survive for _______ before becoming mature RBC
1 day
correlate with bone marrow erythropoietic activity
reticulocytes
low count of reticulocytes indicates
decreased RBC production
high count of reticulocytes indicates
increased RBC production
normal range of reticulocytes
.5-1.5% of total RBCs
measurements of anemia
Hgb, Hct, RBC
low total body red cell mass
anemia
clinical features of anemia
pallor of skin, nail beds, buccal mucosa
fatigue, weakness, malaise
dyspnea on exertion
syncope, headaches, visual disturbances
tachycardia
angina
cardiac failure
caused by inadequate or ineffective production
hypoproliferative anemia
causes of inadequate production in hypoproliferative anemia
bone marrow failure
bone marrow infiltration/replacement
nutritional deficiency
anemia of chronic disease
causes of ineffective production in hypoproliferative anemia
myelodysplastic syndromes
caused by blood loss or sequestration
anemia of blood loss
sequestration causes
splenomegaly
anemia of blood loss can be
acute or chronic
sickle cell is [intrinsic/extrinsic] and [inherited/acquired]
intrinsic inherited
hemoglobinopathy
sickle cell
thalassemia is [intrinsic/extrinsic] and [inherited/acquired]
intrinsic inherited
membrane abnormality
hereditary spherocytosis
hereditary sphereocytosis is [intrinsic/extrinsic] and [inherited/acquired]
intrinsic inherited
RBC enzyme defects
G6PD deficiency
G6PD deficiency is [intrinsic/extrinsic] and [inherited/acquired]
intrinsic inherited
paroxysmal nocturnal hemoglobinuria is [intrinsic/extrinsic] and [inherited/acquired]
intrinsic acquired
people with proxysmal nocturnal hemoglobinuria are predisposed to
cancer
autoimmune hemolytic anemia is [intrinsic/extrinsic] and [inherited/acquired]
extrinsic aquired
traumatic hemolytic anemia is [intrinsic/extrinsic] and [inherited/acquired]
extrinsic acquired
infection related anemia is [intrinsic/extrinsic] and [inherited/acquired]
extrinsic aquired
malaria can cause
anemia due to infection
prosthetic cardiac valves can cause
anemia due to traumatic hemolysis
defect in RBC itself
intrinsic
defect/problem outside of RBC
extrinsic
RBC breakdown with massive release of free hemoglobin in circulation
intravascular
**malaria, babesia, complement activation
RBC breakdown in the reticuloendothelial system cells with capture of hemoglobin
extravascular
in extravascular hemolysis haptoglobin is [increased/decreased]
decreased or normal
in intravascular hemolysis haptoglobin is [increased/decreased]
decreased
in extravascular hemolysis serum free hemoglobin is [absent/present]
absent
in intravascular hemolysis serum free hemoglobin is [absent/present]
present
in intravascular hemolysis urine hemoglobin is [absent/present]
present
in extravascular hemolysis urine hemoglobin is [absent/present]
absent
hemolytic anemia has the same general features of anemia, with _________ &__________
jaundice and gallstones
maybe splenomegaly if extravascular
circulating iron available for use
serum iron
iron transport protein
transferrin
serum iron/TIBC
percent saturation
marker of stored iron
ferritin
differential for microcytic anemia
iron deficiency
anemia of chronic disease
thalassemia
serum iron is [increased or decreased]
iron deficiency:
anemia of chronic disease:
thalassemia:
serum iron
iron deficiency: decreased
anemia of chronic disease: normal or decreased
thalassemia: normal
transferrin/TIBC is [increased or decreased]
iron deficiency:
anemia of chronic disease:
thalassemia:
transferrin/TIBC
iron deficiency: increased
anemia of chronic disease: normal
thalassemia: normal
% saturation is [increased or decreased]
iron deficiency:
anemia of chronic disease:
thalassemia:
% saturation
iron deficiency: decreased
anemia of chronic disease: normal/decreased
thalassemia: normal
ferritin is [increased or decreased]
iron deficiency:
anemia of chronic disease:
thalassemia:
ferritin
iron deficiency: decreased
anemia of chronic disease: normal/increased
thalassemia: normal or increased
soluble transferrin receptor is [increased or decreased]
iron deficiency:
anemia of chronic disease:
thalassemia:
soluble transferrin receptor
iron deficiency: increased
anemia of chronic disease: normal
thalassemia: normal
differential for macrocytic anemia
megaloblastic anemia
myelodysplasia
drugs
hypothyroidism
megaloblastic anemia can be caused by what vitamin deficiencies
vitamin B12
folate
differential for macrocytic anemia
megaloblastic anemia
myelodysplastic syndromes
hypothyroidism
differential for microcytic anemia
IDA
ACD
thalassemia
most common cause of iron deficiency in US
chronic blood loss
GI, GU, or GYN tract
chronic renal disease would cause which type of anemia?
ACD
deficiency of intrinsic factor causes
B12 deficiency, megaloblastic anemia
in thalassemia, serum ferritin and iron are
normal
increased LDH indicates
hemolytic anemia
in hemolytic anemia, serum free haptoglobin is
decreased
in hemolytic anemia, breakdown of hemoglobin leads to increased bilirubin. this causes
jaundice, gallstones
decreased serum iron
decreased ferritin
increased serum transferrin
increased TIBC
IDA
low MCV
low MCH
low MCHC
low Hgb
low Hct
low RBCs
IDA
increased RDW
IDA
normal bone marrow contains …% of erythroid cells
15-30%
thalassemia has a …… RDW
normal
iron therapy stimulates
erythropoeisis, increasing the reticulocyte count
helpful tests in establishing hemolysis as cause of anemia
LDH, haptoglobin, bilirubin