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TERM 3 BIOL2292 PATHO 2 > BLOOD LECTURE 1: ANEMIA > Flashcards

BLOOD LECTURE 1: ANEMIA Flashcards

1
Q

What are the components of blood, and what percent of the blood volume do they make up?

A
  1. Plasma: 55%
  2. RBCs: 45%
  3. Buffy coat (WBCs, platelets): <1%
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2
Q

What are the 2 categories of leukocytes?

A

Polymorphonuclear granular cells
Mononuclear cells

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3
Q

What are the 3 types of PMN cells?

A

Neutrophils
Eosinophils
Basophils

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4
Q

What are the 2 types of mononuclear cells?

A

Monocytes
Lymphocytes

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5
Q

What is the precursor to all blood cells?

A

Pluripotent stem cell

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6
Q

Pluripotent stem cells differentiate into which two precursor cells?

A
  1. Myeloid stem cell
  2. Lymphoid stem cell
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7
Q

Myeloid stem cells are the precursor to which 5 types of cells?

A
  1. Erythrocyte
  2. Platelets
  3. Mast cells
  4. PMNs
  5. Monocytes (macrophages)
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8
Q

What is the precursor cell to platelets?

A

Megakaryocyte

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9
Q

Lymphoid stem cells are the precursor to which 3 types of cells?

A
  1. T cells
  2. B cells
  3. NK cells
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10
Q

B cells further differentiate into what kind of cells?

A

Plasma cells

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11
Q

What is the name for the iron containing compound found in erythrocytes?

A

Heme

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12
Q

What is the globin part of hemoglobin composed of?

A

Protein

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13
Q

Iron from heme is transported to the liver and then to the bone marrow via which carrier glycoprotein?

A

Transferrin

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14
Q

Which 2 pigments from heme are disposed of through the liver and GI tract?

A

Bilirubin and biliverdin

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15
Q

Iron transported to the liver by transferrin become what iron containing blood protein?

A

Ferritin

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16
Q

What is the term for anemia where the red cell mass is normal but plasma volume is high?

A

Relative/dilutional anemia

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17
Q

What is the term for anemia where there is a true decrease in erythrocyte numbers, either due to a decrease in production or an increase in breakdown?

A

Absolute anemia

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18
Q

What are 3 reasons for decreased production/maturation of RBCs?

A
  1. Diet
  2. Genetics
  3. Bone marrow disease
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19
Q

What are 3 reasons for increased destruction of RBCs?

A
  1. Autoimmune
  2. Infection
  3. Genetics
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20
Q

Besides decreased production and increased destruction of RBCs, what is a 3rd reason for anemia?

A

Acute or chronic blood loss

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21
Q

What is the main effect of anemia?

A

Tissue hypoxia

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22
Q

What are 3 compensatory mechanisms to restore tissue O2?

A
  1. Increased heartrate and cardiac output
  2. Increased EPO
  3. 2,3-BPG binds to deoxygenated HGB, which makes O2 detach from it easier so it will go into the tissues
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23
Q

What are the symptoms of mild anemia?

A

Usually asymptomatic, although elderly with comorbid conditions may have symptoms

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24
Q

What are 3 important signs of severe anemia?

A
  1. Fainting
  2. Chest pain/angina
  3. MI
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25
Q

What does hematocrit indicate?

A

The ratio of RBCs to plasma in a blood specimen

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26
Q

What does the lab value mean corpuscular volume (MCV) indicate?

A

The average volume of 1 red blood cell in a specimen

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27
Q

What is the difference between mean cell hemoglobin (MCH) and mean cell hemoglobin concentration (MCHC)?

A

MCH: Average amount of HGB per each RBC

MCHC: Average amount of HGB per volume of RBCs

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28
Q

What is the name for immature RBCs?

A

Reticulocytes

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29
Q

Which 2 lab tests detect hemolysis?

A

Bilirubin, lactate dehydrogenase

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30
Q

Which lab tests can determine RBC morphology and the presence of parasites?

A

Blood smear

31
Q

What are 3 classifications of anemia based on cell size?

A

Normocytic, microcytic, macrocytic

32
Q

What are 2 classifications of anemia based on cell hemoglobin content?

A

Normochromic, hypochromic

33
Q

What are 4 kinds of anemia related to decreased erythrocyte production?

A
  1. Iron deficiency
  2. Megaloblastic
  3. Chronic disease
  4. Aplastic
34
Q

What are 4 kinds of anemia related to increased erythrocyte destruction?

A
  1. Immune related hemolytic
  2. Spherocytosis
  3. Sickle cell
  4. Thalassemias
35
Q

What are 4 possible causes for iron deficiency anemia with examples?

A
  1. Iron loss (bleeding)
  2. Insufficiency dietary intake/absoprtion (celiac)
  3. Impaired iron storage (ferritin deficient, liver disease)
  4. Increased iron requirement (pregnancy)
36
Q

What are 3 unique clinical manifestations of iron deficiency anemia?

A
  1. Koilonychia
  2. Atrophic glossitis
  3. Pica
37
Q

What does the lab test iron binding capacity indicate?

A

Function of transferrin

38
Q

How does chronic disease cause anemia?

A

Inflammation suppresses RBC synthesis

39
Q

Why does CKD in particular cause anemia?

A

Impaired EPO production

40
Q

What is the primary cause of megaloblastic anemia?

A

Vitamin B12 or folic acid deficiency impairs DNA synthesis/RBC maturation

41
Q

What is the morphological appearance of RBCs in megaloblastic anemia?

A

Macrocytic, nucleated

42
Q

What is the consequence of the abnormal RBCs produced in megaloblastic anemia?

A

They are destroyed prematurely

43
Q

What are 3 reasons for vitamin B12 deficiency?

A
  1. Diet/absorption (vegan, celiac)
  2. Parasitic infection
  3. Lack of intrinsic factor
44
Q

What is the term for anemia caused by lack of intrinsic factor?

A

Pernicious anemia

45
Q

What are 4 possible causes for lack of intrinsic factor?

A
  1. Autoimmune attack of parietal cells
  2. Gastric surgery
  3. Chronic gastritis
  4. Lifestyle factors
46
Q

What are 2 possible reasons for folate deficiency?

A
  1. Pregnancy
  2. Medication side effects
47
Q

What are 2 diagnostic results that would indicate pernicious anemia?

A
  1. Autoantibodies against instrinsic factor/parietal cells
  2. Gastric atrophy
48
Q

What are 2 ways megaloblastic anemia due to folate deficiency differ from megaloblastic anemia due to vitamin B12 deficiency?

A
  1. Develops more rapidly
  2. Fewer neurological symptoms
49
Q

Which type of anemia is due to injury/reduction of hematopoietic stem cells in the bone marrow?

A

Aplastic anemia

50
Q

What are 5 possible causes for aplastic anemia?

A
  1. Idiopathic (most common)
  2. Myelotoxins
  3. Viral infection
  4. Immune disorders
  5. Genetic (Fanconi’s)
51
Q

What are the 2 categories of hemolytic anemias based on etiology?

A
  1. Intracorpuscular
  2. Extracorpuscular
52
Q

What are 3 signs of hemolytic anemia?

A
  1. Splenomegaly
  2. Increased EPO
  3. Accumulation of Hgb degradation products
52
Q

What are

A
53
Q

What are 3 signs of megaloblastic anemia?

A
  1. Abdo pain, GI upset
  2. Signs of hemolysis i.e. jaundice, splenomegaly
  3. Neurocognitive changes
54
Q

What 2 CBC/blood smear results would indicate megaloblastic anemia?

A
  1. High MCV
  2. Macrocytic RBCs
55
Q

How are iron deficiency anemia, anemia of chronic disease, and megaloblastic anemia treated?

A
  1. Supplements (iron, B12, folate)
  2. Treat underlying condition
  3. EPO (in CKD)
56
Q

What 2 CBC/blood smear results would indicate aplastic anemia?

A
  1. Pancytopenia
  2. Normocytic RBCs
57
Q

What other diagnostic study can be performed to diagnose aplastic anemia?

A

Bone marrow aspiration/biopsy

58
Q

What 2 CBC results would indicated hemolytic anemia?

A
  1. Low RBCs
  2. High reticulocytes
59
Q

Other than CBC findings, what 3 lab findings would indicate hemolytic anemia?

A
  1. Elevated bilirubin
  2. Elevated lactate dehydrogenase
  3. RBC binding antibodies
60
Q

What are 3 general treatments for hemolytic anemias?

A
  1. Blood transfusion
  2. Splenectomy
  3. Immunosuppressants
61
Q

What is used to prevent hemolytic anemia in pregnant Rh-negative women?

A

RhoGAM

62
Q

What type of hemolytic anemia involve a genetic mutation in membrane proteins, causing RBCs to become more fragile?

A

Spherocytosis

63
Q

What is the prognosis for spherocytosis?

A

Cured with splenectomy, but risk for infection

64
Q

Which type of hemolytic anemia involves a genetic mutation in Hgb beta chains, causing RBC distortion under hypoxic conditions?

A

Sickle cell anemia

65
Q

What causes hemolytic crisis in sickle cell anemia?

A

Sickled cells get stuck in microcirculation

66
Q

Other than general symptoms of hemolytic anemia, what is 1 major consequence of sickle cell anemia?

A

Ischemia and infarction of major organs

67
Q

Which diagnostic test is used to detect abnormal types of hemoglobin such as HbS?

A

Hemoglobin electrophoresis

68
Q

Other than general treatments for hemolytic anemias, what are 3 ways sickle cell anemia is treated?

A
  1. Lifestyle changes (avoid infection and physical exertion)
  2. Hydroxyurea: stimulates production of fetal Hgb
  3. Bone marrow transplant
69
Q

Which type of hemolytic anemia involves genetic mutation of globin chain formation, impairing RBC structure and maturation?

A

Thalassemia

70
Q

Other than general symptoms of hemolytic anemias, what are 2 signs of thalassemia?

A
  1. Iron overload
  2. Skeletal changes
71
Q

What blood smear findings would indicate thalassemia?

A

Microcytic, hypochromic RBCs

72
Q

What are 2 ways to treat thalassemia?

A
  1. BMT
  2. Iron chelation

TERM 3 BIOL2292 PATHO 2 (19 decks)

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