Ch. 18 - Anemias: Red Blood Cell Morphology and Approach to Diagnosis (RVSP) Flashcards

0
Q

2 classical symptoms of anemia

A
  • fatigue

- shortness of breath

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1
Q

2 important components in making clinical diagnosis of anemia

A
  • history

- physical examination

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2
Q

Condition having a symptom of pica

A

Iron deficiency

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3
Q

Having cravings for unusual substances

A

Pica

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4
Q

Craving for ice

A

Pagophagia

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5
Q

Shift in the oxygen dissociation curve caused by 2,3-bisphosphoglycerate

A

Shift to the right (decreased oxygen affinity of Hb)

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6
Q

Percent of RBCs removed per day due to senescence

A

1%

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7
Q

Marrow erythroid proliferative activity

A

Erythropoiesis

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8
Q

Production of erythroid progenitor cells that are defective

A

Ineffective erythropoiesis

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9
Q

3 examples of conditions for ineffective erythropoiesis

A
  • megaloblastic anemia
  • thalassemia
  • sideroblastic anemia
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10
Q

A decrease in the number of erythroid precursors in the bone marrow

A

Insufficient erythropoiesis

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11
Q

Measure of the average RBC volume in femtoliters (fL)

A

MCV

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12
Q

Most important RBC indice to detect anemia

A

MCV

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13
Q

Unit for MCV

A

Femtoliters (fL)

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14
Q

An RBC volume frequency distribution curve

A

RBC histogram

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15
Q

With normal population of RBCs, the distribution of the RBC histogram is approximately ___________

A

Gaussian

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16
Q

Shift in the RBC histogram due to microcytosis

A

Left shift

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17
Q

Shift in the RBC histogram due to macrocytosis

A

Right shift

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18
Q

Causes widening of the curve of the RBC histogram

A

Anisocytosis

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19
Q

The coefficient of variation of RBC volume expressed as a percentageq

A

RDW

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20
Q

Indicates the variation in RBC volume within th epopulation measured

A

RDW

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21
Q

Important tool to assess the bone marrow’s ability to increase RBC production in response to an anemia

A

Reticulocyte count

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22
Q

Young RBCs lacking a nucleus but still containing residual RNA

A

Reticulocytes

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23
Q

Adult reference range for reticulocyte count

A

0.5 - 1.5%

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24
Q

Newborn reference range for retic count

A

1.5 - 5.8%

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25
Q

Reference range for absolute retic count

A

25-75 x 10^9/L

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26
Q

Average normal hematocrit

A

45

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27
Q

Abnormal variation in RBC volume or diameterq

A

Anisocytosis

28
Q

Large RBC (>8 um in diameter), MCV >100 fL

A

Macrocyte

29
Q

Large oval RBC

A

Oval macrocyte

30
Q

Small RBC (MCV <6 um in diameter)

A

Microcyte

31
Q

Abnormal variation in RBC shape

A

Poikilocytosis

32
Q

Small, round, dense RBC with no central pallow

A

Spherocyte

33
Q

Elliptical (cigar-shaped)/oval (egg-shaped) RBC

A

Elliptocyte/ovalocyte

34
Q

RBC with slitlike area of central pallor

A

Stomatocyte

35
Q

Thin, dense, elongated RBC pointed at each end

A

Sickle cell (drepanocyte)

36
Q

Hexagonal crystal of dense Hb formed within the RBC membrane

A

Hb C crystal

37
Q

Fingerlike or quartzlike crystal of dense Hb protruding from the RBC membrane

A

Hb SC crystal

38
Q

RBC with Hb concentrated in the center and around the periphery resembling a target

A

Codocyte (target cell)

39
Q

Fragmented RBC due to rupture in the peripheral circulation

A

Schistocyte (schizocyte)

40
Q

RBC fragment in the shape of a helmet

A

Keratocyte (bite cell/helmet cell)

41
Q

RBC with membrane folded over

A

Folded cell

42
Q

Small, dense RBC with few irregularly spaced projections of varying length

A

Acanthocyte (spur cell)

43
Q

RBC with blunt or pointed, short projections that are usually evenly spaced over the surface of the cell

A

Burr cell (echinocyte)

44
Q

RBC with a single pointed extension resembling a teardrop or pear

A

Dacryocyte (teardrop cell)

45
Q

Diffuse basophilia composed of

A

RNA

46
Q

Basophilic stippling (punctate basophilia) composed of

A

Precipitated RNA

47
Q

Howell-Jolly body composed of

A

DNA (nuclear fragment)

48
Q

Heinz body composed of

A

Denatured Hb

49
Q

Pappenheimer bodies composed of

A

Non-heme iron

50
Q

Cabot ring composed of

A

Mitotic spindle remnants

51
Q

Hb H composed of

A

Precipitated ß chains of Hb

52
Q

Used to investigate the presence of inappropriately low retic count and a microcytic anemia

A

Iron studies

53
Q

2 assays helpful in investigsting a low retic count with a macrocytic anemia

A
  • vitamin B12 assay

- serum folate assay

54
Q

Test used to differentiate autoimmune hemolytic anemias from hemolytic anemias of othe causes

A

Direct antiglobulin test

55
Q

Anemia characterized by an MCV of less than 80 fL with small RBCs

A

Microcytic anemia

56
Q

Most common cause of microcytic anemia

A

Iron deficiency

57
Q

Anemia characterized by an MCV greater than 100 fL with large RBCs

A

Macrocytic anemia

58
Q

2 types of macrocytic anemias

A

Megaloblastic

Nonmegaloblastic

59
Q

Type of macrocytic anemia caused by impairment of DNA synthesis

A

Megaloblastic anemia

60
Q

3 causes of megaloblastic anemia

A
  • vitamin B12 deficiency
  • folate deficiency
  • myelodysolasia
61
Q

Type of macrocytic anemia where the nuclear maturation lags behind cytoplasmic development

A

Megaloblastic anemia

62
Q

Anemia that causes vitamin B12 deficiency

A

Pernicious anemia

63
Q

Causes folate deficiency

A

Malabsorption secondary to inflammatory bowel disease

64
Q

2 characteristics of megaloblastic anemia in peripheral blood

A
  • oval macrocytes

- hypersegmented neutrophils

65
Q

Characteristic of megaloblastic anemia in bone marrow

A

megaloblasts

66
Q

Type of macrocytic anemia where there ae membrane changes due to disruption of the cholesterol-to-phospholipid ratio

A

Nonmegaloblastic anemia

67
Q

2 conditions where nonmegaloblastic anemia is commonly seen

A
  • chronic liver disease

- bone marrow failure

68
Q

Anemia with MCV in the range of 80-100 fL

A

Normocytic anemia