Exam 1 High Yield

Question 1

Causes of microcytic anemia

Answer 1

Iron deficiency
anemia of chronic disease
thalassemias
lead poisoning
sideroblastic anemia

Question 2

Causes of normocytic anemia

Answer 2

sickle cell anemia

Question 3

Causes of macrocytic anemia

Answer 3

alcohol abuse
B12 deficiency
folate deficiency

Question 4

Chemotactic pathway factors

Answer 4

C5a

Question 5

Opsonizing pathway factors

Answer 5

C3b

Question 6

Anaphylatoxic (histamine)

Answer 6

C3a, C4a, C5a

Question 7

Lytic

Answer 7

C9

Question 8

IgG

Answer 8

Binds toxins to phagocytic cells
activates complement (but not as good as IgM)
2 IgG’s bind C1q
Passes placenta
Responds after IgM, but bigger/faster/stronger on 2nd exp.
Any presence in

Question 9

IgD

Answer 9

Extra long hinge region
Presence on cell surface indicates mature B cell (in addition to sIgM)
MW 180,000

Question 10

IgE

Answer 10

Extra constant domain (4 total)
Lots of sugar (carbs)
Type I (immediate hypersensitivity)
Resistance to worms/parasites
Fc binds mast cells and basophils
MW 190,000

Question 11

IgM

Answer 11

Pentamer
Mu has extra constant domain
Excellent at activating complement
Can't get into tissues or bind phagocytes
Small secretory component
1 IgM binds C1q
Responds first (before IgG)
MW 900,000/100 mg/dL (too viscous if high)

Question 12

IgA

Answer 12

Secreted in mucus membranes as dimer
Protected by secretory component
Uses alternative pathway in blood
MW 4,000,000/200 mg/dL

Question 13

CBC values/labs for thalassemia (alpha or beta)

Answer 13

Decreased MCV, MCH, MCHC
Normal RDW
Increased RBC #/production (compensatory), lysis (unconj bilirubin, LDH, AST)
Splenomegaly, bilirubin gallstones, anemia (?)

Question 14

Dx’ing alpha thalassemia

Answer 14

2 gene deletion: microcytosis
3 gene deletion: anemia, microcytosis
Hgb electrophoresis: NORMAL

Question 15

Types of alpha thalassemia

Answer 15

1 gene deletion: silent carrier
2 gene deletion: trait (trans and cis, Africa and Asia)
3 gene deletion: Hb H Disease
4 gene deletion: hydrops fetalis

Question 16

Types of beta thalassemia

Answer 16

Normal (ß/ß)
Trait (one unaffected, one affected or both ßE)
Intermedia (both affected somehow)
Cooley’s anemia (ßo/ßo)

Question 17

Dx’ing beta thalassemia

Answer 17

Microcytosis
\+/- anemia
Hgb electrophoresis: 
     Increased HbA2 and HbF, decreased HbA (milder)
     No HbA (Cooley's anemia)

Question 18

Dx’ing Fe deficiency (vs. thalassemia)

Answer 18

Decreased RBC (increased in thal)
Increased RDW (normal in thal)
Decreased ferritin (normal/up in thal)
Responds to iron
Normal Hb EP (abnormal in ß thal)

Question 19

Dx’ing sickle cell anemia

Answer 19

Chronic anemia
Increased reticulocyte count
Increased lysis (bilirubin, LDH, AST)
Howell-Jolly bodies

Question 20

Sickle cell anemia complications

Answer 20

Vaso-occlusive pain
Acute chest syndrome
Infections (aplastic crisis, parvovirus B19
Splenic sequestration/infarction
Stroke (loss of vasoregulation)

Question 21

Sickle cell anemia chronic complications

Answer 21

Lung disease (pulmonary hypertension)
Nephropathy
Retinopathy
Leg ulcers
Avascular necrosis

Question 22

WBC Smear ID

Answer 22

Neutrophil: granules, lobed nuc
Lymphocyte: scant cyto, big nuc
Monocytes: vacuoles
Eosinophils: larger granules, lobed nuc
Basophils: all granules