Benign RBC Disorders Flashcards

1
Q

Normal component of BM

A

50% cellular

50% fat

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2
Q

Normal constit of cellular marrow

A

65% granulocytes
25% RBCs
10% lymphs, monos, and precursors

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3
Q

Neutrophilic leukocytosis

A

acute bacterial inf

sterile inflamm d/t tissue necrosis (MI, burns)

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4
Q

Eosinophilic leukocytosis

A
allergic disorders
parasitic inf
drug reactions
collagen vascular disorders / some vasculitides
atheroembolic disease (xsient)
certain malig
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5
Q

Basophilic leukocytosis

A

rare –> ind of myeloproliferative disease

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6
Q

Monocytosis

A
chronic infections
bacterial endocarditis
rickettsiosis, and malaria
collagen vascular diseases (e.g. SLE)
IBD
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7
Q

Neoplastic prolif of RBCs

A

leukemias
Polycythemia vera
thrombocytosis

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8
Q

Sites of hematopoiesis

A

3rd wk –> yolk sac in mesoderm
3rd month of fetal life –> liver
4th month –> BM
by 18yo –> restricted to long bones and axial skeleton

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9
Q

pronormoblast

A
  1. first recognizable cell of RBC lineage
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10
Q

basophilic normoblast

A
  1. baso cyto d/t ribosomes and active protein synth
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11
Q

polychromatophilic normoblast

A
  1. cyto more pink d/t Hb

more condensed chromatin

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12
Q

orthochromic

A
  1. orange/red cyto
    pyknotic
    non-dividing nucleus
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13
Q

reticulocyte

A
  1. anucleate RBC

methylene blue stain to see ribos

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14
Q

CFU-E

A

erythropoieting receptor on erythroid precursor cells

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15
Q

Acute anemia of blood loss

A

loss of blood volume
hemodilution –> shift of water from interstitial fluid
reduction on O2 triggers erythropoietin prod
reactive thrombocytosis and leukocytosis
reticulocyte count inc 10-15% after 7d

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16
Q

Chronic anemia of blood loss

A

blood loss exceeds regenerative capacity OR

iron preserves are depleted

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17
Q

Morpho features of Hemolytic anemias

A

inc normoblasts in BM
reticulocytosis in periph blood
cholelithiasis
hemosiderosis

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18
Q

Intravascular Hemolytic Anemia

A
mechanical injury, C' fixation, or exogenous toxic factors
hemoglobinemia
hemoglobinuria
jaundice and hemosiderinuria
low haptoglobin
19
Q

Extravascular hemolysis

A

injury to red cells, rendered “foreign”, or becoming less deformable

20
Q

Hereditary Spherocytosis

A
  • -AD
  • -intrinsic defect in red cell membrane
  • -def in spectrin –> reduced membrane stability and spontaneous loss
  • -inc osmotic fragility
  • -spherocytes are less deformable
21
Q

G6PD deficiency

A
abnormal HMP shunt or glutathione metab
X-recessive
heinz bodies --> bite cells
hemoglobinuria
chronic non-spherocytic hemolytic anemia
22
Q

Sickle Cell Disease

A

–pt mutation = valine for glutamic acid @ 6th position of beta-globin chain
deoxygenation = HbS aggregate, polymerize, and sickle
inc Hb release –> inc bilirubin
capillary stasis and thrombosis

23
Q

Sickle Cell Disease pathology

A
BM : erythroid hyperplasia
can experience extra medullary hematopoiesis
adults have small spleen
cor pulmonale
leg ulcers
pigment gallstones
infarction secondary to vasc occlusion
24
Q

Sickle Cell aplastic crisis

A

Parvovirus B19

infects RBC progenitor and interrupts production

25
Chronic Sickle Cell --> Bone
widening of medullary space thinning of cortex sparse trabecular pattern
26
Chronic Sickle Cell --> GU
anoxic renal medulla
27
Chronic Sickle Cell --> Spleen
multiple infarcts --> autosplenectomy
28
Chronic Sickle cells --> liver
hepatitis intrahepatic cholestasis gallstones
29
Chronic sickle cell --> heart
tachy | flow murmurs
30
chronic sickle cell --> pulmonary
infarction pneumonia CHF
31
chronic sickle cell --> retina
retinal vessel destruction
32
chronic sickle cell --> CNS
children = 8% risk of stroke
33
Sickle C Disease
equal amounts of HbS and HbC mild to mod hemolytic anemia / target cells painful crisis occurs splenomeg / hematuria / avascular necrosis retinal detachment and prolif retinopathy
34
Sickle Beta Thalassemia
mod severe hemolytic anemia splenomeg primarily HbS on electro 15-30% HbA
35
Thalassemia
mild anemia hypochromic, microcytic red blood cells, basophilic stippling expanded marrow cavity from massive erythroid hyperplasia
36
Beta Thalassemia minor
Hb 10-13g/dL slightly elevated RBC count MCV 60-70 fL inc in HbA2
37
Beta Thalassemia major
``` severe childhood anemia Hb very low (3 gm/dL) hypochromic, anisoctytosis, poikilocytosis, etc slightly inc HbA2 the rest is HbF ```
38
Hydrops fetalis syndrome
deletion of all four alpha globulin genes | see Hb Barts on electro
39
Alpha thalassemia trait
deletion of two alpha glob genes mild microcytic anemia normal to elevated RBC count
40
Autoimmune hemolytic anemias
positive Coombs test warm type : spherocytes cold type: autoagglutination
41
Warm type immunohemolytic anemia
most common IgG extravascular splenomegaly
42
Cold type immunohemolytic anemia
``` IgM type mycoplasma inf mono flu HIV ```
43
Drug induced immune hemolytic anemia
PCN --> Ab against membrane/drug complex Phenacetin --> deposition of complex Methyldopa --> autoimmune process