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Hematolgy > Exam 2 > Flashcards

Exam 2 Flashcards

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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
what usually preciitates a hemolytic crisis in G-6-P-D deficiency?
exposure to oxidizing drugs
26
what RBC inclusions does this deficiency produce?
heinz bodies denatured hemoglobin
27
what is the most unusual characterisitic lab finding in ABO erythroblastosis of the newborn?
spherocytes
28
what is the most unusual characteristic lab finding in AIHA?
positive direct coombs test (extremely unusal in an adult)
29
How do PCH and PNH differ?
PCH: is extrinsic and have anitbody. Extracorpuscular defect (outside RBC) PNH: intrinsic acquired, sensitive to complement (genetic and inside RBC)
30
in which condition is the Donath-Landsteiner antibody found?
PCH
31
What is the difference between an intrinsic (intracorpuscular defect) and and extrinsic (extracopuscular) defect?
* Intrinsic-something in the cell is causing hemolysis | * extrinsic-something outside the cells is causing hemolysis
32
what RBC abnormality is responsible for the formation of burr cells and thorn cells?
membrane abnormalities
33
which globin chain is present during embryonic development?
epsilon and zeta
34
what is the major hemoglobin of the newborn?
F
35
what hemoglobin is insoluble when reduced?
S
36
What hemoglobin is resistant to alkali?
F
37
what are the normal mobilities of hemoglobins A, C, F and S on hemoglobin electrophoresis at pH 8.6?
c-crawls s-slow f-fast a-accelerates (faster than fast)
38
what is poikilocyte is the "common denominator" of peripheral blood smears of patients with hereditary hemoglobinopathies?
target cells
39
what specific amino acid substitution is in hemoglobin S?
valine substitutes in for glutamin acid on the #6 or beta chain
40
what specific amino acid substitution is in hemoglobin C?
lysine at the same time for c only on beta chain
41
What are the clinical manifestations of Hemoglobin C disease?
* frequent crises like aplastic and thrombotic * sickled cells * decreases osmotic fragility due to target cells
42
why does the hemoglobin combinaion of S and D create a problem in the lab diagnosis of hemoglobinopathies?
S and D migrate together
43
what does the peripheral blood smear usually show in IDA?
micorcytic hyperchromic
44
what doe the serum iron and TIBC show in a peripheral blood smear?
serum iron decrease | TIBC increased
45
green coloration of skin in hypochromic anemia
chlorosis
46
G-6-P-D deficiency
favism
47
spoon shaped nails found in iron deficiency
koilonychia
48
eating weird stuff
pica syndrome
49
what are some causes of IDA?
* chronic bleeding * hookwork * menstral problems * bleeding ulcers
50
what is the specific cause of the thalassemias?
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
what is another name for beta thalassemia?
coolys anemia | meditterania anemia
52
what hemoglobins are increased in thalassemia major? Why are they increased?
F (alpha 2, gamma 2) A2 (alpha 2, delta 2) can not make the beta chain
53
homozygous alpha thalassemia
barts disease
54
beta thalassemia minor
cooleys trait
55
congenital aplastic anemia
fanconis anemia
56
heterozygous alpha thalassemia
Hemoglobin H disease
57
what are the characterisitcs of siderblastic anemia?
microcytic hypochromic increased iron stores increased ringed sideroblasts
58
what is the RBC inclusion most frequently associated with lead poisoning?
basophilic stippling
59
what blood cell parameters are increased in polycythemia vera?
all cells are increased | plasma volume is normal
60
what is the cause of secondary polycythemia?
over production of erythropoeitin
61
what parameters are increased in polycythemia?
red cell parameters
62
what are some possible causes of relative polycythemia?
stress dehydration burns
63
how do hemachromatosis and hemosiderosis differ?
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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