Chapter 11. Blood and Anemia

Question 1

Most common extracellular cation and anion.

Answer 1

Na

Cl

Question 2

Precursor of erythrocytes.

Answer 2

Reticulocytes

Question 3

Life of thrombocytes?

Erythrocytes?

Answer 3

7-10 days

120 days

Question 4

Organ for erythropoietin synthesis.
RBCs are destroyed where?
Metabolic degradation of Hb.

Answer 4

kidney
spleen (graveyard of RBC)
reticuloendothelial (Endoplasmic reticulum)

Question 5

Define:
Platelets
Leukocytes

Answer 5

Platelets (Thrombocytes) lack nuclei

Leukocytes (WBC) defined nuclei, about lymphocytes 30%, neutrophils 60% and monocytes 8%

Question 6

Basophils
Eosinophils 
Monocytes
B-lymph
T-lymph

Answer 6

Basophils- resp for infmm response
Eosinophils- defebse againts parasites
Monocytes- immune defense (precursor of tissue macrophage) big eaters
B-lymph -abody prod. (precursor of plasma cells)
T-lymph -cellular immune response

Question 7

Test to diagnose iron deficiency anemia

Answer 7

Serum ferritin

Question 8

In Microcytic anemia?

Answer 8

MCV MCHC and serum ferritin decreases

TIBC increases

Question 9

Antidote for iron overdose

Answer 9

Deferoxamine

Question 10

Among the iron salts, what has the highest GI absorption?

Highest elemental?

Answer 10

Ferrous gluconate

Ferrous fumarate 33%

Question 11

Main source of Vit B 12

Answer 11

Meat and dairy products

Question 12

Megaloblastic anemia. Deficiency and from what possible causes?

Answer 12

B12 or folate deficiency due to decreased of DNA syn. Causes chemotherapy, alcoholism and seniors.

Question 13

Drugs that cause Megaloblastic anemia.

Answer 13

Acyclovir antiepileptics (carb, valp a) methotrexate nitrofurantoin OCP proguanil sulfasalazine trimethoprim

Question 14

Pernicious anemia. What test:

• to detect pernicious anemia that caused by deficiency of vitamin B12.
• is used to diagnose deficiency of vitamin B12 caused by decreased vitamin B12 absorption (lack of intrinsic factor cause pernicious anemia

Answer 14

Deficiency of intrinsic factor that absorbs B12 in stomach/ileum

• Schilling test
• Urinary excretion test

Question 15

Folic acid requirement.

Answer 15

200mcg daily
1mg therapy - in pregnancy start 1 mo before conception
Methotrexate- 5mg once a week
Carbamazepine 5mg daily

Question 16

Hemolytic anemia.

Answer 16

-Sickle cell anemia and thalassemia.

Defect gene/ abnormal hemoglobin , poor solubility of Hb semicrystalline bodies are formed that ruptures RBC.

Question 17

Glucose-6-phosphate dehydrogenase deficiency hemolytic anemia.

Answer 17

enzyme G6PD necessary to maintain the reduced glutathione level in RBC, enzyme to prevent hemolysis.

Question 18

Test to distinguish G6PD deficiency anemia or immune mechanism? And examples of drugs that cause false positive.

Answer 18

Coombs test.

Penicillins, Cephalosporins, Methyldopa

Question 19

Deficinecy of this enzyme leads to severe hemolytic anemia. Give examples of oxidant drugs that induce hemolytic anemia.

Answer 19

Sulfa, penicillins, primaquin

Question 20

Site of calcium reabsorption

Answer 20

Proximal convulated tubule

Question 21

An antioxidant that prevents oxidation of Hb to methemoglobin.

Answer 21

Glutathione

Question 22

Define Normocytic anemia. Give examples.

Answer 22

MCV is normal.

Due to acute hemorrhagic or RBC hemolysis. Hemolytic, sickle cell and thalassemia.

Question 23

Total or partial destruction of the bone marrow. Reduced RBC, WBC and platelets counts, inadequate production or release of myeloid stem cells.

Answer 23

Aplastic anemia

Question 24

Pharmacologic stimulation of RBC production using erythropoiesis stimulating agents such as?

Answer 24

Epoeitin alpha (Eprex)
Darbepoetin alpha (Aranesp)

Question 25

These are small red/purple spots on skin or conjunctiva caused by broken capillary blood vessels.

Answer 25

Petechia

Question 26

The percentage of red blood cells to the blood volume is the? What does it mean?

Answer 26

Hematocrit (Hct): Packed cell volume

Question 27

Laboratory tests for iron deficiency anemia -is not screening test for microcytic anemia, used for acute, chronic infections, malignancies, rheumatic factors, and seizures.

Answer 27

HgB, Hct, Serum Ferritin, Iron binding capacity | NOT: Erythrocyte Sedimentation Rate

Question 28

The most accurate to screening iron deficient anemia is serum ferritin. Result and explain

Answer 28

= Decrease because serum ferritin is protein that stores iron. -Serum ferritin is protein that stores iron. In case of iron deficiency, tissue absorbs water and dilutes iron stores thus decrease serum ferritin.

Question 29

A patient complains constipation and currently using iron supplements. What is correct recommendation? I) Take with food II) Take orange juice III) Take plenty of water

Answer 29

``` A) I only B) III only C) I and II D) II and III E) I, II, III ```

Question 30

- Pregnancy related anemia is due to? | - Common deficiency in pregnancy?

Answer 30

- Deficiency of folic acid | - Iron