Ch 28 Alterations of Erythrocyte Function

Question 1

Polycythemia

Answer 1

Increased number or volume of circulating erythrocytes

Question 2

Anemia

Answer 2

Decreased number or volume of circulating erythrocytes

Question 3

Poikilocytosis

Answer 3

Having erythrocutes of diffrent shapes

Question 4

Anisocytosis

Answer 4

Having erythrocytes of different sizes

Question 5

Pancytopenia

Answer 5

Decreased number of circulating erythrocytes, leukocytes, and platelets

Question 6

When plasma volume increases to compensate for anemia, the blood viscosity ___ , which causes blood flow to be ____.

Answer 6

decreases; turbulent

Question 7

Defective DNA synthesis in bone marrow precursors usually creates erythrocytes that are ____ and normochromic

Answer 7

macrocytic

Question 8

Folate deficiency anemia is associated with chronic malnourishment and chronic abuse of ____

Answer 8

alcohol

Question 9

The term megalobalstic anemia indicates that the erythrocytes are _____

Answer 9

macrocytic

Question 10

The incidence of iron deficiency anemia is (lowest, highest) in women during their reproductive years, and (increases, decreases) after menopause

Answer 10

highest, decreases

Question 11

Lactoferrin released by neutrophils during bacterial infection (binds, releases) iron thus contributing to (iron deficiency anemia, anemia of chronic disease)

Answer 11

binds; anemia of chronic disease

Question 12

A major contributor to the anemia of chronic kidney disease is (deficiency, excess) of erythropoeitin

Answer 12

deficiency

Question 13

People who are dehydrated after extensive diarrhea have (absolute, relative) polycythemia; people who have hypercapneic chronic obstructive pulmonary disease have (absolute, relative) polycythemia

Answer 13

relative; absolute

Question 14

Hemolysis from a mismatched blood transfusion is an example of (autoimmune, alloimmune) hemolytic anemia that occurs (intravascularly, extravascularly)

Answer 14

alloimmune; intravascularly

Question 15

Individuals who have congenital hemolytic disorders typically have a (small, large) spleen

Answer 15

large

Question 16

What anemias are microcytic-hypochromic

Answer 16

thalassemia, sideroblastic, iron deficiency anemia, anemia of chronic diseases (sometimes), lead

Remember: “The size is always less”=Thalassemia, sideroblastic, Iron def., anemia of chron. dz, lead

Question 17

What anemias are normocytic-normochromic

Answer 17

aplastic anemia, posthemorrhagic anemia, sickle cell anemia, anemia of of chronic disease
Remember: “Some crazy apes phone home”=sickle-cell, chronic dz., aplastic, post-hem, hemolytic

Question 18

What anemias are macrocytic-normochromic

Answer 18

pernicious anemia, folate deficiency anemia

Question 19

Glossitis

Answer 19

tongue has lost papillae, looks fissured characteristic of iron deficiency anemia

Question 20

Koilonchia

Answer 20

concave, brittle fingernails, characteristic of iron deficiency anemia

Question 21

pallor or jaundice in iron deficiency anemia?

Answer 21

pallor due to decreased erythrocyte production

Question 22

Chromic

Answer 22

refers to hemoglobin content

Question 23

Cytic

Answer 23

refers to cell size

Question 24

Sideroblastic anemias are characterized by defective synthesis of ____ and may be acquired or hereditary, in which case they usually have recessive ____ transmission

Answer 24

heme; x chromosome

Question 25

Myelodysplastic syndrome involves defects in all lines of hematopoietic ____ cells; some persons with this condition develop acute ____

Answer 25

stem; leukemia

Question 26

Serum ferritin levels are used to evaluate ____ status when diagnosing anemia

Answer 26

iron

Question 27

Primary acquired aplastic anemia is an ____ disease in which ____ T cells damage the hematopoietic stem cells in the ____ ____

Answer 27

autoimmune; cytotoxic; bone marrow

Question 28

Release of ____ during chronic inflammations contributes to the anemia of chronic disease by decreasing the availability of ____ and inhibiting erythroid progenitors

Answer 28

cytokines; iron

Question 29

Congenital hemolytic anemias are caused by ____ defects in erythrocytes, but acquired hemolytic anemias are usually caused by the ____ system

Answer 29

intrinsic; immune

Question 30

Hemolysis in most inherited hemolytic anemias occurs in the ____by the action of ____

Answer 30

spleen, macrophages

Question 31

Warm autoimmune hemolytic anemia is caused by ____ binding to erythrocytes with subsequent destruction of those erythrocytes in the ____

Answer 31

IgG; spleen

Question 32

Drug-induced hemolytic anemia from antibiotics usually begins when the antibiotic serves as a ____ and binds to erythrocyte proteins

Answer 32

hapten

Question 33

Hemolysis that occurs slowly will not cause anemia because bone marrow can increase erythrocyte production up to ____ times its normal rate; jaundice occurs from hemolysis only when heme destruction exceeds the liver's ability to process and excrete ____

Answer 33

eight; bilirubin

Question 34

How does chronic kidney disease cause anemia?

Answer 34

Normal kidney secretes erythropoietin to signal bone marrow to make RBCs, in a diseased kidney this does not happen

Question 35

What causes clotting in polycythemia vera?

Answer 35

Too many RBCs makes the blood thicker and more likely to clot

Question 36

Why does anemia cause fatigue?

Answer 36

Not enough RBCs to carry oxygen to muscles and body

Question 37

In hereditary hemochromatosis, how does regular removal of blood protect liver?

Answer 37

Too much blood means too much iron which can cause liver damage

Question 38

In aplastic anemia, why do the symptoms of infections and bleeds occur before symptoms of fatigue?

Answer 38

WBC and platelets have a shorter lifespan than RBCs

Question 39

Why does posthemorrhagic anemia cause lightheadedness at first?

Answer 39

There is less fluid, meaning less blood bringing oxygen to the brain

Question 40

What is happening in hemolytic anemia from antibiotics?

Answer 40

Antibiotic binds to RBC, antibodies mark for destruction in spleen

Question 41

What is the normal process of absorption of dietary vitamin b12?

Answer 41

Vitamin B 12 binds to intrinsic factor from gastric parietal cells, this complex binds to receptors in the ileum which enables vitamin b12 absorption

Question 42

What causes pernicious anemia?

Answer 42

Autoantibodies destroy parietal cells, causing decreased intrinsic factor, causing decreased vitamin b12 absorption. Since vitamin b12 is necessary for erythropoiesis, this causes anemia

Question 43

Why are erythrocytes macrocytic in pernicious anemia?

Answer 43

Vitamin b12 is a cofactor for DNA synthesis, without it division slows and erythrocytes grow larger

Question 44

How is numbness and tingling related to pernicious anemia?

Answer 44

Vitamin b12 for normal nerve function. demyelination and damage is progressive and irreversible

Question 45

In pernicious anemia, after vitamin b12 is brought to normal with injections, why do treatments continue?

Answer 45

Body cannot absorb dietary vitamin b12