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Heme and Lymph Final > CIS: RBC Disorders > Flashcards

CIS: RBC Disorders Flashcards

1
Q

If on a deserted island and you have anemia, what is the one test that you would order?

A

The reticulocyte count

-represents immature blood cells

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2
Q

RBC’s live in blood how long?

A

120 days

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3
Q

What is a RBC 1-2 days before it is fully mature?

A

A reticulocyte

-we can test for reticulin

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4
Q

Aplastic anemia

A

The congenital kind is Fanconi anemia

  • most cases are secondary to other causes
  • EBV, HIV, radiation, chloramphenicol, quinacrine
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5
Q

What is chloramphenicol?

A

An antibiotic

  • risk is 1:30,000 for aplastic anemia
  • bone marrow replacement is a good treatment for it
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6
Q

What do people who sniff glue have increased risk for?

A

Aplastic anemia

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7
Q

What has aplastic anemia as a hallmark of the disease?

A

PNH

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8
Q

What will we see on a blood smear in chronic kidney disease

A
  • spikes cells… Acanthocytes

- nor chromic normacytic anemia

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9
Q

Megaloblastic anemias

A

95% due to deficiency of either B12 or folic acid

-rest are due to drugs

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10
Q

What does the neuro symptoms with B12 patients look like?

A
  • tertiary syphillis related tabes dorsalis
  • so always check B12 levels
  • the difference is that in tabes, there will be more urinary incontinence symptoms
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11
Q

What lab test do you do for folic acid deficiency?

A

Folate levels!

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12
Q

Tx of folate deficiency

A

Supplemental folate… 1mg/day

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13
Q

what is B12 deficiency due to ?

A
  • impaired absorption
  • pernicious anemia
  • gastrectomy
  • Zollinger-Ellison syndrome
  • blind loop syndrome
  • tapeworm infestation
  • being a vegan….
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14
Q

What is pernicious anemia

A

-auto antibodies directs against PARIETAL CELLS, not Intrinsic factor itself

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15
Q

Iron deficiency anemia

A
  • dietary deficiency: most infants have problems

- if bleeding from GI tract, it’s cancer until proven otherwise

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16
Q

What is Asthenia?

A
  • pale

- ppl look like their just a bag of bones

17
Q

What is the result of an altered expression of nRAMP2 gene?

A
  • that encodes the DCT1 transport protein

- iron deficiency anemia

18
Q

What is myoglobin

A

It’s in the muscles and gives them a store of Oxygen

-this is why iron deficient people have sore muscles

19
Q

What do iron deficient people like to eat a lot?

A
  • dirt (pica)

- ice

20
Q

Is iron supplementation effective in anemia of chronic disease?

A

No

-if anemia is that severe, transfusions may be helpful to keep Hb in check

21
Q

What is a myelopthisic anemia?

A

Anemia due to infiltration of the bone marrow

-like, by cancer or something

22
Q

What are the ice cravings seen in iron deficiency anemia called?

A

Pagophagia

23
Q

Clinical triad of diabetes

A

Polyuria, polydipsia, and something else

24
Q

What the hallmark disorder for enzyme deficiency blood disorder

A

G6PD deficiency

  • X-linked
  • fava beans!!! Favism
25
Q

What are Heinz bodies?

A

Collection of denatured hemoglobin

-spleen removes this and results in “bite cells”

26
Q

March hemoglobinuria

A
  • feet striking the ground repeatedly causes damage/lysis of RBCs in capillaries on plantar surface of feet
  • common in marathon runners
  • treat with well padded footwear and reassurance
  • originally described in soldiers who developed hemoglobinuria after long marches
27
Q

What was some of the chemical induced hemolytic anemias caused by?

A

Lead!
-slows production of RBC’s in marrow
Copper

28
Q

What is the most common cause of hemolytic anemia in the world?

A

Malaria

  • backwater fever
  • their urine gets REALLY dark
29
Q

Bartonellosis

A
  • Bartonellosis bacilli forms
  • does not infect, but adheres to RBC membrane
  • hemolysis is the initial stage of the infection (Oroya fever)
  • transmitted by sand flea
  • treatment with Abx and supportive care
30
Q

Babesiosis

A
  • intraerythrocytic protozoa
  • rodents
  • “Maltese cross” appearance in RBCs with Giemsa-stained peripheral smears
31
Q

What is a normal hemoglobin level in a woman

A

About 13 or so
-remember that if it’s like 6 or something, they will be VERY sick… Probably not walking into the clinic, but carried by a stretcher lol

32
Q

If someone has hemolysis, what will the LDH level look like?

A
  • it will be elevated

- it is normally around 200 or so

33
Q

What will the reticulocyte count do when hemolysis is going on?

A

It will increase

  • like up to 4%
  • not 12 or anything like that
34
Q

What do we look for in the indirect coomb’s test?

A

We look for antibodies that could potentially bind RBCs IN THE SERUM
-if it’s direct, we are looking on the red blood cell

35
Q

What is characteristic of HUS?

A
  • purpura

- acute kidney injury!

36
Q

Immune mediated hemolytic anemia

A
  • cold reacting antibodies… IgM
  • simple meant may directly lose RBCs or opsonize RBCs for lysis in the spleen
  • positive Indirect anti globulin test (coomb’s test)
37
Q

Tx of warm antibody hemolysis

A
  • most pts are not in imminent danger

- high dose steroids are the mainstay of therapy

38
Q

WHAT can cause cold agglutinin disease?

A

Mycoplasma

-walking pneumonia

39
Q

Acute intermittent porphyria AIP

A
  • Scandinavian
  • deficiency of porphobilinogen deaminase
  • results in excretion of increased ALA and PBG in urine
  • symptoms rare before puberty
  • abdominal pain is most common symptom

Heme and Lymph Final (14 decks)

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