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System P 2 > Chapter 11 > Flashcards

Chapter 11 Flashcards

1
Q

Where does hematopoiesis occur in children?

A

Marrow of long bones

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2
Q

Where does hematopoiesis occur in adults?

A

Pelvis, cranium, vertebra, sternum, ribs

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3
Q

Where does extra medullary hematopoiesis occur?

A

Spleen and liver, lymph nodes, thymus

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4
Q

What is hemolysis?

A

Ruptured RBCs

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5
Q

What is erythropoiesis?

A

Red bone marrow

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6
Q

What is a reticulocyte?

A

Immature RBC

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7
Q

What is polythemia? Q

A

Increased RBC

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8
Q

What is reduced red blood cells with reduced o2 capacity more common in women?

A

Anemia

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9
Q

Hemorrhagic Anemia causes what?

A

Hypoxia

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10
Q

Hypoxia in hemorrhagic anemia results in what?

A

Increased erythropoietin (EPO)

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11
Q

If hemorrhagic anemia results in a loss of more that_____% of blood what can happen?

A

Hypovololemic shock

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12
Q

Chronic blood loss in hemorrhagic anemia leads to a depletion of what which can cause what?

A

Iron stores, IDA

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13
Q

What does hypoxia for 3 days result in?

A

Increased plasma (hemodilution)

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14
Q

Hypoxia for 7 days results in what?

A

Increased reticulocytes (reticulocytosis)

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15
Q

What are symptoms of anemia?

A

Pallor, fatigue, weakness (lassitude) decreased growth, cachexia, ossenous malformations

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16
Q

Hemolytic anemia can lean to what?

A

Jaundice/gall stones

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17
Q

Anemia can produces tissue hypoxia that can increase erythropoiesis how much?

A

Up to 8x

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18
Q

What is hemolytic anemia?

A

Decreased RBC life span (less than 120 days)

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19
Q

Is iron retained in hemolytic anemia?

A

Yes, it’s recycled

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20
Q

What type of hemolytic anemia is hereditary and has abnormal RBC membranes, enzyme def

A

Intracorpuscular defect

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21
Q

What hemolytic anemia is acquired, RBC trauma, and antibodies, malaria?

A

Extra corpuscular defect

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22
Q

Where is the hemolytic anemia most common? Q

A

Extra vascular hemolysis (in spleen and liver

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23
Q

What form of hemolysis is also acted with physical or biochemical damage, (heart) ?

A

Intravascular hemolysis

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24
Q

What is an abnormally shaped RBC?

A

Poikilocyte

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25
Q

What is a irregular shaped RBC from hemolysis ?

A

Schistocyte

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26
Q

What is a tear drop shaped RBC?

A

Dacrocyte

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27
Q

What is an autosomal dominant abnormal RBC membrane problem?

A

Hereditary spherocytosis

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28
Q

What form of anemia is fragile RBC that causes them to shed pieces?

A

Hereditary spherocytosis

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29
Q

A possible aplastic crisis (parvovirus b19) is associated with what form of anemia ?

A

Hereditary spherocytosis

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30
Q

What is the treatment for hereditary spherocytosis ?

A

Splenectomy

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31
Q

What is associated with B-global mutation?

A

Sickle cell anemia

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32
Q

Is sickle cell anemia autosomal dominant or rescessive?

A

Recessive

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33
Q

What is heterozygous sickle cell anemia mean?

A

Sickle cell train, carries, not affected. 8% of African Americans

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34
Q

What is homozygous sickle cell anemia?

A

Means they have the disease, 1 in every 600 African Americans

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35
Q

What 4 thing are associated with sickle cell anemia?

A

Acute chest syndrome, stroke, infection/septicemia, fatty changes

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36
Q

Stasis increases what?

A

Sickling

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37
Q

What are symptoms of sickle cell anemia, ?

A

Chronic low level joint pain., priapism, gallstones stunted growth

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38
Q

Is you have homozygous sickle cell anemia only 50% live beyond_____?

A

5th decade

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39
Q

What condition is assopacted with an H shaped vertebrae (Lincoln log vertebra) ?

A

Sickle cell anemia

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40
Q

What is associated with mutated alpha or beta blobin genes ?

A

Thalassemia

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41
Q

Is thalassemia auto dominated or recessive ?

A

Recessive

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42
Q

Beta thalassemia is associated with what chromosome?

A

11

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43
Q

Alpha thalassemia is associated with what chromosome?

A

16

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44
Q

What areas are commonly have a lot of thalassemia?

A

Africa, SE Asia, Mediterranean because of malaria

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45
Q

What condition causes a excess of opposite globin chain?

A

Thalassemia

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46
Q

What form of beta thalassemia is more severe?

A

Major (2 alleles)

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47
Q

Asymptomatic thalassemia =

A

Minor ( 1 allele)

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48
Q

What is associated with beta thalassemia major?

A

Skeletal deformities

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49
Q

What form of beta thalassemia is microcytic and hypochromic?

A

Minor

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50
Q

How is beta thalassemia minor diagnosed?

A

Electrophoresis

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51
Q

What is the treatment for beta thalassemia major?

A

Blood transfusions and iron chelation

52
Q

What eventually happens in beta thalassemia major?

A

Hemochromatosis (iron overload)

53
Q

What is the lethal side affect of beta thalassemia?

A

Dilated cardiomyopathy

54
Q

What type of facies is associated with beta thalassemia major?

A

Chipmunk facies

55
Q

Alpha thalassemia is a mutated alpha globin gene that creates an excess of what?

A

B-globin chains (less damaging that excessive alpha)

56
Q

Which is more severe alpha or beta thalassemia?

A

BETA

57
Q

How many genes need to be altered for alpha thalassemia?

A

4

58
Q

Abnormal Hb in alpha thalassemia results in what?

A

Decreased o2 capacity

59
Q

If you have 4 deletions in alpha thalassemia what is the outcome?

A

No o2 capacity, lethal hydrops fetalis

60
Q

What protects RBCs against hemolysis ?

A

Glutathione (GSH)

61
Q

A G6PD results in what and is most common in who:?

A

Decreased GSH, older RBCs at risk for hemolysis, males

62
Q

Bite cells and Heinz bodies are associated with what?

A

G6PD

63
Q

What are causes of G6PD?

A

Infections (MC), fava beans (favism) , ADR

64
Q

How long after exposure does hemolysis in

G6PD?

A

2-3 days

65
Q

What are symptoms of G6PD?

A

Fatigue, splenomegaly, BACK PAIN, dark urine

66
Q

What are risks for G6PD?>

A

Males, Africans, areas of malaria

67
Q

Paroxysmal nocturnal hemoglobinuria (PNH) is associated with what gene and in who?

A

PIGA, X chromosome

68
Q

What is associated with increased complement fixation, decreased pH and respiration while sleeping and increase thrombosis?

A

Paroxysmal nocturnal hemoglobinuria

69
Q

What is the treatment for PNH?

A

Antibodies that inhibit the Mac

70
Q

What disorder is associated with Immue attack on RBCs?

A

Immunohemolytic anemias

71
Q

How does one diagnose immunohemolytic anemia?

A

DIRECT COOMBS anti globulin test

72
Q

For form of immunohemolytic anemia is spontaneous and idiopathic ?

A

Endogenous

73
Q

Exogenous immunohemolytic anemia is caused by what?

A

Toxic exposure or ADR

74
Q

Warm antibody immunohemolytic anemia is also acted with what ?

A

IgG opsonization

75
Q

Cold antibody immunohemolytic anemia occurs at what temp, and because of what?

A

Less that 86 degrees, IgM opsonization

76
Q

What in particular is associated with immunohemolytic anemia?

A

Raynaud phenomenon

77
Q

What are causes of traumatic hemolysis?

A

Prosthetic heart valves “blender effect “

78
Q

Narrowing of the blood vessels can cause what kind of anemia?

A

Microangiopathic hemolytic anemia

79
Q

What cells are associated with traumatic hemolysis ?

A

Burr cells, helmet cells (schistocytes)

80
Q

How many people does malaria affect each year and how many die?

A

500 million, 1 million die.

81
Q

What is the name of the protozoan that causes malaria?

A

Plasmodium falciparum

82
Q

What transmits malaria?

A

female Anopheles mosquito

83
Q

What is another name for malaria ?

A

Black water fever

84
Q

Merozoite showers happen how often in malaria?

A

Every 48 hours

85
Q

What are symptoms of malaria?

A

Epsodic shaking, chills, fever, splenomegaly, jaunmadce, headache, joint paint

86
Q

Cerebral malaria is associated with what?

A

Seizures coma death, lethal in days

87
Q

Anemias of diminished erythropoiesis are a combination of what to things?

A

Anemia and reticulocytopenia

88
Q

What are to nutritional deficiencies associated with anemias of de insisted erythropoiesis?

A

Iron deficiency anemia, mealoblastic anemias :(folate, b12)

89
Q

What are the four anemias of diminished erythropoiesis?

A

Nutritional deficiencies, an exam of chronic disease, aplastic anemia, myelopththisic anmea,

90
Q

What is the worlds most common nutritional def?

A

Iron

91
Q

What is the most common cause of anemia?

A

IRON DEF

92
Q

Iron def affects what perfect of developed counties? Developing countries. ?

A

10, 25-50

93
Q

Who stores more iron Men or woman?

A

Men 3.5 to woman 2.5

94
Q

How is iron transported ?

A

Transferrin

95
Q

What is the most common cause of iron def in developing nations?

A

Low intake

96
Q

What is the most common cause of iron def in developed countries>?

A

Chronic blood loss

97
Q

What 3 things cause iron def?

A

Poor bioavailability, increased metabolic demand, chronic blood loss

98
Q

In what way does iron def cause anemia?

A

Reduced hemoglobin synth

99
Q

What are symptoms of iron deficiency anemia?

A

Pica, fingernail spooning, fatigue, decreased immunity, insidious onset

100
Q

What are to common causes of chronic blood loss?

A

GI tract, female genital tract

101
Q

Someone who is deficient in either folate, or vit b12 could have what?

A

Mealoblastic anemia

102
Q

Mealoblastic anemia produce what kind of RBCs?

A

Macrocytic, hyperchromic

103
Q

Pancytopenia is seen in what condition?

A

Megaloblastic anemia

104
Q

What type of disjunction do we not see with folate deficiency anemia?

A

Neurologic dysfunction

105
Q

Vit B12 def (pernicious anemia) can effect what?

A

PNS and spinal cord

106
Q

What can chronic malabsorption of vit b12 cause ?

A

Autoimmune gastritis (decrease in intrinsic factor

107
Q

Vitamin b12 def is most common in what population?

A

Old

108
Q

What are features of b12 def?

A

Fatigue, neuropathy, ataxia

109
Q

Is neurological recovery likely in someone who has had a B12 def anemia?

A

No

110
Q

Vit B12 def anemia puts one at a slight risk for what kind of cancer?

A

Gastric carcinoma

111
Q

Anemia of chronic disease is most common seen where?

A

Hospitalizations

112
Q

What are 3 things anemia of chronic diseases can cause?

A

Infections, autoimmunity, cancer

113
Q

What is associated with suppression of myeloid stem cells?

A

Aplastic anemia

114
Q

Pancytopenia is seen in what ?

A

Aplastic anemia

115
Q

What attacks the marrow in aplastic anemia ?

A

T cells

116
Q

What are the causes of aplastic anemia ?>

A

1/2 idiopathic, rest myelotoxic agent

117
Q

80% of aplastic anemia patients respond to what treatment?

A

Immunosuppressive medication

118
Q

What is the worst prognosis for aplastic anmea ?

A

If it is idiopathic

119
Q

What are features of aplastic anemia?

A

Thrombocytopenia, graulocytopenia

120
Q

What is characteristicly absent from aplastic anemia?

A

Splenomegaly

121
Q

What type of anemia is normocytic, normochromic, reticulocytopenia?

A

Aplastic

122
Q

For form of anemia is associated with extensive marrow infiltration

A

Myelophthisic anemia

123
Q

What is the most common cause of myelophthisic anemia?

A

Mets to bone (breast, lung, prostate)

124
Q

What are 2 other causes of myelophthisic anemia besides mets to bone?

A

Granulomatous disease (TB, bridges good syndrome,) and lipid storage disease ( niemann pick type C)

125
Q

Dacrocytes are seen in what kind of anemia ?

A

Myelophthisic anemia

System P 2 (6 decks)

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