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Hemotology/Hemostasis > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

How are anemias classified according to cause?

A

Increased red cell destruction= hemolytic

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2
Q

According to morphology?

A

Macrocytic Normochromic- means they’re not low in iron
Microcytic Hypocromic
Normocytic Normochromic-both normal
(No such thing as “hyperchromic”)

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3
Q

What are the symptoms of anemia

A

Weak, pallored, shortness of breath, hypotension (low BP), fatigue, increased cardiac output, syncope

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4
Q

Given the values for the red blood cell indices, suggest a possible diagnosis in the following
situations
increased MCV  MCHC Normal

A

B12 Def (PA)
Folate def
Liver PA
Alcholism

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5
Q

Given the values for the red blood cell indices, suggest a possible diagnosis in the following
situations
MCV & MCHC Normal

A

Aplastic anemia… EVERYTHING ELSE

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6
Q

Given the values for the red blood cell indices, suggest a possible diagnosis in the following
situations
MCV ↓ MCHC ↓

A

IDA (iron defficency)
Thalassemia
Sideroblastic Anemica
Pb poisoning

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7
Q

What is the peripheral blood picture in vitamin B12 and folate deficiency?

A

oval
macrocitic
hypercegs
Pancytosemia

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8
Q

What do you see in the bone marrow? In vitamin b12 def and folate def

A

megaloblast
giant bands
precursor cells

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9
Q

What deficiency diseases cause megaloblastic erythropoiesis and what cellular consituents are
affected?

A

Vitamin B12 & Folic Acid

Affects DNA & RNA

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10
Q

What specifically causes pernicious anemia?

A

Lack of intrinsic factor

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11
Q

What main clinical manifestation distinguishes vitamin B12 deficiency from folic acid
deficiency

A

Pernicious anemia. Clinical manifestation is neurological symptoms relating to the myelin sheath.

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12
Q

What conditions can produce non-megaloblastic macrocytic anemia?

A

Alcoholism and liver disease are most common. Also hypothyroidism

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13
Q

What poikilocytes are often seen in liver disease

A

round macrocytes, target cells, acanthrocytes

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14
Q

What parameters are decreased in aplastic anemia and what bone marrow precursor cells are
decreased?

A

All precursor cells decreased, all cells decreased.

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15
Q

What is the peripheral blood picture in aplastic anemia and what would the reticulocyte count
be expected to be?

A

normocytic normochromic cells- no signs of increased red cell formation
decreased bone marrow

Retic= decreased

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16
Q

What are the most common causes of aplastic anemia?

A

Chemical exposure: Benzene and chloramphenicol

Radiation

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17
Q

Name several causes of myelophthisic anemia

A

Leukemia, Lymphomas, Multiple myeloma, Metastatic Carcinoma

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18
Q

What poikilocyte is especially associated with the above condition because it indicates
extramedullary hematopoiesis

A

Tear drop cells

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19
Q

What is the blood picture in chronic renal disease?

A

Normocytic

normochromic-burr cells, helmet cells

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20
Q

What is the main cause of anemia due to renal disease and to what kidney function test is the
anemia frequently proportional

A

Failure of kidney to produce erythropoietin.

Decreased EPO, BUN.

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21
Q

What are the characteristics of anemia due to chronic disorders?

A

Often start out normocytic normochromic but then as condition continues become microcytic hyperchromic. Increased anemia, Increased BUN. Can look similar to Fe deficiency (Fe stores increased, serum Fe decreased, TIBC normal).

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22
Q

What is the common characteristic of ALL hemolytic anemias

A

Increased RBC destruction

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23
Q

What type of RBC abnormality results in hereditary spherocytosis and how does it affect the
shape and osmotic fragility of the RBC?

A

Membrane abnormality-causes cell to be more permeable to sodium; makes them small and round rather than biconcave; and osmotic fragility is increased

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24
Q

What biochemical pathway involves the enzyme glucose-6-phosphate dehydrogenase
(G-6-P-D)?

A

HMP shunt- to protect red cell (hemoglobin) from oxidation

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25
Q

What usually precipitates a hemolytic crisis in G-6-P-D deficiency?

A

Exposure to oxidizing drugs

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26
Q

What RBC inclusions does this deficiency produce?g-6-p-d

A

Heinz bodies

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27
Q

What is the most unusual characteristic laboratory finding in ABO erythroblastosis of the
newborn?
In AIHA?

A

Newborn?
Spherocytes
AIHA?
Positive Direct Coombs Test- extremely unusual in adult

28
Q

How do PCH and PNH differ

A

PCH: is extrinsic- have an antibody. Extracorpuscular defect.
PNH: intrinsic, acquired, sensitive to complement

29
Q

In which condition is the Donath-Landsteiner antibody found?

A

PCH

30
Q

What is the difference between an intrinsic (intracorpuscular defect)and an extrinsic
(extracorpuscular) defect

A

Intrinsic: Something in the cell (genetic) is causing hemolysis
Extrinsic: Something outside the cell is causing the hemolysis

31
Q

What RBC abnormality is responsible for the formation of burr cells and thorn cells?

A

Membrane abnormalities

32
Q

What globin chains are found in the following hemoglobins?

  • A2
  • F
  • H
  • Bart’s
  • Gower-1
  • Gover-2
A 
A2: 2 alpha and 2 delta
F: 2 alpha and 2 gamma
H: 4 Beta
Bart's: 4 Gamma
Gower-1:Epsilon
Gower-2: Zeta
33
Q

Which ones are present only during embryonic development?

A

Epsilon and Zeta

34
Q

What is the major hemoglobin of the newborn?

A

F

35
Q

What hemoglobin is insoluble when reduced

A

S

36
Q

What hemoglobin is resistant to alkali?

A

F

37
Q

What are the normal mobilities of hemoglobins A, C, F, and S on hemoglobin electrophoresis
at pH 8.6

A

C-crawls,
S-slow,
F-fast,
A-accelerates faster than fast

38
Q

What is poikilocyte is the “common denominator” of peripheral blood smears of patients with hereditary hemoglobinopathies

A

Target Cells

39
Q

What is the specific amino acid substitution in hemoglobin S?
In hemoglobin C?

A

Valine substitutes in for Glutamic acid on # 6 position for S
Lysine at same position for C only on beta chain

40
Q

What are the clinical manifestations of sickle cell anemia

A

Frequent crises like aplastic and thrombotic crises, osteomyelitis, sickled cells, decreased osmotic fragility

41
Q

What is the best test to use to differentiate sickle cell anemia and sickle cell trait?

A

Hg Electrophoresis

42
Q

What does the peripheral blood smear usually show in sickle cell trait

A

Occasional Target Cell

43
Q

What are the characteristics of Hemoglobin C disease?

A

Target cells, rod shaped crystals, envelope cells, mild hemolytic anemia

44
Q

Hemoglobin SC disease

A

SC crystals, positive tube solubility test, some sickle cells but not usually and not numerous

45
Q

Why does the hemoglobin combination of S and D create a problem in the laboratory
diagnosis of hemoglobinopathies

A

Migrate together, alkaline pH S & D migrate together, further testing

46
Q

What does the peripheral blood smear usually show in IDA?

A

Microcytic hyperchromic

47
Q

What does the serum iron and TIBC show?

A

Serum iron-decreased

TIBC- increased

48
Q

Chlorosis

A

Green coloration of skin in hypochromic anemia

49
Q

Favism

A

G6 PD deficiency

50
Q

Koilonychia

A

spoon shaped nails found in iron deficency

51
Q

Pica syndrome

A

Eating weird stuff

52
Q

What are some causes of IDA

A

Chronic bleeding, hookworm infection, menstrual problems, bleeding ulcers

53
Q

What is the specific cause of the thalassemias?

A

Decreased rate of synthesis of either the alpha or beta chain.

54
Q

What is another name for beta thalassemia

A

Cooley’s Anemia, Mediterranean anemia.

55
Q

What hemoglobins are increased in thalassemia major?

A

Can’t make beta chain- increases A2(alpha 2 and delta 2) and F(alpha 2 and gamma 2)

56
Q

Barts Disease

A

Homozygous alpha thalassemia

57
Q

Cooley’s trait

A

Beta thalassemia minor

58
Q

Fanconi’s anemia

A

Congenital Aplastic Anemia

59
Q

Hemoglobin H disease

A

Heterozygous alpha thalassemia

60
Q

What are the characteristics of sideroblastic anemia?

A

Microcytic hypochromic, increased iron stores, increased ringed sideroblast

61
Q

What is the RBC inclusion most frequently associated with lead poisoning

A

Basophilic Stippling

62
Q

What blood cell parameters are increased in polycythemia vera

A

All are increased; plasma volume= normal

63
Q

What is the cause of secondary polycythemia

A

Overproduction of erythropoetin

64
Q

What parameters are increased in this condition

A

Red cell parameters

65
Q

How do hemachromatosis and hemosiderosis differ?

A

Stress, dehydration, burns

66
Q

What are some possible causes of relative polycythemia?

A

Both involve deposition of excess iron. Hemosiderosis is in the normal cells of the liver, spleen. Hemochromatosis is deposited in functional cells where they shouldn’t be placed causing tissue damage.

(Tissue damage is the most important to remember here)

Hemotology/Hemostasis (8 decks)

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