Chapter 12: Summaries

Question 1

Name three causes of anemia.

Answer 1

Blood loss (hemorrhage), increased red cell destruction (hemolysis) and decreased red cell production (erythropoiesis).

Question 2

Name three forms (morphology) of anemia.

Answer 2

Microcytic, macrocytic and normocytic.

Question 3

What causes microcytic anemia? What are characteristics?

Answer 3

Microcytic anemia occurs due to iron deficiency or thalassemia. Microcytic anemia means that red blood cells are smaller and are present in lower numbers than normal.

Question 4

What causes macrocytic anemia? What are characteristics?

Answer 4

It occurs due to folate or vitamine B12 deficiency. Red blood cells are bigger and are present in lower numbers than normal.

Question 5

What causes normocytic anemia? What are characteristics?

Answer 5

Red blood cells have a normal size, but have abnormal shapes. It is due to hereditary spherocytosis or sickel cell disease.

Question 6

What are clinical manifestations of acute anemia?

Answer 6

Shortness of breath, organ failure, shock.

Question 7

What is a general clinical manifestation of chronic anemia?

Answer 7

Pallor and fatigue/lassitude

Question 8

What clinical manifestations are there during anemia when it is caused by hemolysis?

Answer 8

Jaundice and gallstones.

Question 9

What clinical manifestations are there during anemia when it is caused by ineffective erythropoiesis?

Answer 9

Iron overload, heart and endocrine failure.

Question 10

What clinical manifestations are there during severe and congenital anemia?

Answer 10

Growth retardation, bone deformities due to reactive marrow hyperplasia.

Question 11

What two diseases can lead to hemolytic anemia?

Answer 11

Hereditary Spherocytosis and Sickle Cell Anemia.

Question 12

What is Hereditary Spherocytosis?

Answer 12

It is an autosomal dominant disorder caused by mutations that affect the red cell membrane skeleton. This causes a loss of membranes and with that the formation of spherocytes. These are phagocytosed and removed in the spleen.

Question 13

What is Sickle Cell Anemia?

Answer 13

It is an autosomal recessive disorder where a mutation in β-globin causes deoxygenated hemoglobin to self-associate into long polymers that distort the red cells.

Question 14

What is the consequence of distorted red blood cells in Sicke Cell Anemia?

Answer 14

The distorted red blood cells block vessels. This causes pain crises and tissue infarction.

Question 15

Where does blockage of vessels and tissue infarction mostly occur in Sickle Cell Anemia?

Answer 15

In the marrow and spleen.

Question 16

Patients with Sickle Cell Anemia are at high risk for … and …

Answer 16

bacterial infections and stroke

Question 17

What is Thalassemia?

Answer 17

It is an autosomal codominant disorder caused by mutation in α- or β-globin. This reduces synthesis of hemoglobin which results in microcytic and hypochromic (red blood cells are paler) anemia.

Question 18

What is Glucose-6-Phosphate Dehydrogenase

(G6PD) Deficiency?

Answer 18

An X-linked disorder caused by mutations that destabilize G6PD, making red cells susceptible to oxidant damage.

Question 19

What is Immunohemolytic Anemia caused by?

Answer 19

It is caused by antibodies against either normal red cell constituents or antigens modified by haptens (small molecules that elicit an immune response only when attached to a large carrier such as a protein).

Question 20

What happens upon antibody binding in Immunohemolytic Anemia?

Answer 20

It results in red cell opsonization and extravascular hemolysis. But can also result in complement fixation and intravascular hemolysis (less common).

Question 21

How can the parasite malaria cause anemia?

Answer 21

The parasite causes chronic hemolysis of variable severity.

Question 22

Why is falciparum malaria fatal?

Answer 22

Because of the propensity of infected red cells to adhere to small vessels in the brain (cerebral malaria).

Question 23

Name three kinds of anemia of diminished erythropoiesis.

Answer 23

Iron deficiency anemia, anemia of chronic inflammation and megaloblastic anemia.

Question 24

What is the cause and result of iron deficiency anemia?

Answer 24

It is caused by chronic bleeding or inadequate iron intake which results in insufficient hemoglobin synthesis and hypochromic, microcytic red cells.

Question 25

What is the cause and result of anemia of chronic inflammation?

Answer 25

It is caused by inflammatory cytokines which results in an increase in hepcidin. This causes sequestering of iron in macrophages and suppressing of erythropoiesis.

Question 26

What is the cause and result of megaloblastic anemia?

Answer 26

It is caused by deficiencies of folate or vitamine B12. This results in defective synthesis of thymidine and DNA replication.

Question 27

What is the result of defective synthesis of thymidine and DNA replication during megaloblastic anemia?

Answer 27

Enlarged abnormal hematopoietic precursors (megaloblasts), ineffective hematopoiesis, macrocytic anemia, and (in most cases) pancytopenia

Question 28

What is the cause and result of aplastic anemia?

Answer 28

It is caused by various things, like exposure to toxins or radiation, idiosyncrtiac reations to drugs and viruses, and inherited defects in telomerase and DNA repair. The result is bone marrow failure (hypocellularity).

Question 29

What is the cause and result of myelophthisic anemia?

Answer 29

It is caused by the replacement of bone marrow by infiltrative processes such as metastatic carcinoma. The result is the appearance of early erythroid and granulocytic precursors and teardrop-shaped red cells in the peripheral blood.

Question 30

The classification of lymphoid neoplasms is based on …

Answer 30

cell of origin and stage of differentiation.

Question 31

What are the most common types of lymphoid neoplasms in children?

Answer 31

(acute) lymphoblastic lymphomas derived from precursor B and T cells.

Question 32

What are the most common types of lymphoid neoplasms in adults?

Answer 32

Non-Hodgkin lymphomas derived from germinal center B cells.

Question 33

What are characteristics of Acute Lymphoblastic Leukemia (ALL)?

Answer 33

These are highly aggressive tumors that manifest with signs and symptoms of bone marrow failure or as rapidly growing masses.

Question 34

What do the tumor cells of Acute Lymphoblastic Leukemia (ALL) contain? What is the result of this?

Answer 34

They contain genetic lesions that block differentiation. This leads to accumulation of immature, nonfunctional blasts.

Question 35

What are characteristics of Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia?

Answer 35

The tumor consists of mature B cells. The tumor manifests with bone marrow an lymph node involvement.

Question 36

What are characteristics of Mantle Cell lymphoma?

Answer 36

Tumor consisting of mature B cells that usually manifests with advanced disease involving lymph nodes, bone marrow and extranodal sites such as the gut.