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Hematolgy > 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

how are anemias classified according to morphology?

A 
macrocytic
normochromic ( not iron low)
microcytic
hypochromic
normochromic/normocytic (both normal)
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3
Q

what are the symtoms of anemia?

A 
weak
pallored
shortness in breath
hypotension
fatigue
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4
Q

MCV ^ MCHC normal

A

macrocytic anemia, pernicous anemia

liver disease, B12 deficiency, alcholism

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5
Q

MCV & MCHC normal

A

aplastic anemia-hemolytic

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6
Q

MCV decrease MCHC decrease

A 
microcytic anemia (iron deficient anemia)
siderblastic anemia, thlassemia, lea poisoning
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7
Q

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

A

pancytopemia
all cells decreased
ovalmacrocytes-WBCs look like hypersegs

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8
Q

what do you see in the bone marrow in vitamin B12 and folate deficiency?

A

giant bands, precursor cells, megaloblasts

ME ration decreased

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9
Q

what deficiency diseases cause megaloblastic erythroopoiesis and what cellular constituents are affected?

A

vitamin B12 and folic acid

affects DNA and 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 clincal manifestation distinguishes vitamin B12 deficiency from folic acid deficiency?

A

pernicious anemia.

Clincal manifestation is neurological symptoms relating to the myelin sheath

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12
Q

what conditions can produce non-megaloblastic macrocytic anemia?

A
  • alcholism and liver disease are most common

* hyperthyroidism associated with round macrocytes and target cells

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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 amemia and what would the retic count be expected to be?

A

*normocytic normochoromic cells(no HJB, NRBCs ect)
increased red cell formation decreased bone marrow
*retic=decreased

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16
Q

what are the common causes of aplastic anemia?

A 
chemical exposure (benzene and chloramphenicol)
radiation and drugs
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17
Q

several causes of myleophtisic anemia

A

leukemia, lyphomas, multiple myeloma, metastatic carcinoma

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18
Q

what piokilocyte is associated with myleophtisic anemia because it indictes extramedullary hematopoiesis?

A

tear drop cells

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19
Q

what is the blood picture in chronic renal disease?

A

normocytic normochoromic, burr cells and 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 BUN and EPO

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21
Q

what are the characteristics of anemia due to chronic disorders?

A
  • often start out as normocytic normochromic but as condition continues it becomes microcytic hyperchromic
  • ^ anemia ^ BUN, looks similar to Fe deficiency
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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 herditary spherocytosis and how does it affect the shape and osmotic fragility of the RBC?

A
  • membrane abnormality causes cells to be more permeable to Na
  • 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

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25
Q

what usually preciitates 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?

A

heinz bodies denatured hemoglobin

27
Q

what is the most unusual characterisitic lab finding in ABO erythroblastosis of the newborn?

A

spherocytes

28
Q

what is the most unusual characteristic lab finding in AIHA?

A

positive direct coombs test (extremely unusal in an adult)

29
Q

How do PCH and PNH differ?

A

PCH: is extrinsic and have anitbody. Extracorpuscular defect (outside RBC)
PNH: intrinsic acquired, sensitive to complement (genetic and inside RBC)

30
Q

in which condition is the Donath-Landsteiner antibody found?

A

PCH

31
Q

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

A
  • Intrinsic-something in the cell is causing hemolysis

* extrinsic-something outside the cells is causing hemolysis

32
Q

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

A

membrane abnormalities

33
Q

which globin chain is present 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 specific amino acid substitution is in hemoglobin S?

A

valine substitutes in for glutamin acid on the #6 or beta chain

40
Q

what specific amino acid substitution is in hemoglobin C?

A

lysine at the same time for c only on beta chain

41
Q

What are the clinical manifestations of Hemoglobin C disease?

A
  • frequent crises like aplastic and thrombotic
  • sickled cells
  • decreases osmotic fragility due to target cells
42
Q

why does the hemoglobin combinaion of S and D create a problem in the lab diagnosis of hemoglobinopathies?

A

S and D migrate together

43
Q

what does the peripheral blood smear usually show in IDA?

A

micorcytic hyperchromic

44
Q

what doe the serum iron and TIBC show in a peripheral blood smear?

A

serum iron decrease

TIBC increased

45
Q

green coloration of skin in hypochromic anemia

A

chlorosis

46
Q

G-6-P-D deficiency

A

favism

47
Q

spoon shaped nails found in iron deficiency

A

koilonychia

48
Q

eating weird stuff

A

pica syndrome

49
Q

what are some causes of IDA?

A
  • chronic bleeding
  • hookwork
  • menstral problems
  • bleeding ulcers
50
Q

what is the specific cause of the thalassemias?

A

decreased rate of synthesis of either the alpha or beta chain. Abnormal one cant keep up level of synthsis, so normal Alpha chain could not be made

51
Q

what is another name for beta thalassemia?

A

coolys anemia

meditterania anemia

52
Q

what hemoglobins are increased in thalassemia major? Why are they increased?

A

F (alpha 2, gamma 2)
A2 (alpha 2, delta 2)
can not make the beta chain

53
Q

homozygous alpha thalassemia

A

barts disease

54
Q

beta thalassemia minor

A

cooleys trait

55
Q

congenital aplastic anemia

A

fanconis anemia

56
Q

heterozygous alpha thalassemia

A

Hemoglobin H disease

57
Q

what are the characterisitcs of siderblastic anemia?

A

microcytic hypochromic
increased iron stores
increased ringed sideroblasts

58
Q

what is the RBC inclusion most frequently associated with lead poisoning?

A

basophilic stippling

59
Q

what blood cell parameters are increased in polycythemia vera?

A

all cells are increased

plasma volume is normal

60
Q

what is the cause of secondary polycythemia?

A

over production of erythropoeitin

61
Q

what parameters are increased in polycythemia?

A

red cell parameters

62
Q

what are some possible causes of relative polycythemia?

A

stress
dehydration
burns

63
Q

how do hemachromatosis and hemosiderosis differ?

A

both involve decomposition of excess iron. Hemosiderosis is in the normal cells of the liver/spleen. hemochromatosis is deposited in functional cells where they should not be placed causing TISSUE DAMAGE.

Hematolgy (7 decks)

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