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Hematology > Exam 2 (general info) > Flashcards

Exam 2 (general info) Flashcards

1
Q

What method is used to determine the Hb concentration?

A

cyanmet-Hb method

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2
Q

What are the 3 structures of Hb that can affect the function of Hb?

A

heme | iron | polypeptide

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3
Q

What is MCV?

A

(mean corpuscular volume) | indicates RBC SIZE patient has | fempto liter (fl) (10^-15)

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4
Q

What is MCH?

A

(mean corpuscular Hb) | indicates AMOUNT Hb per EACH RBC | pictogram (pg)

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5
Q

What is MCHC?

A

(mean corpuscular Hb concentration) | indicates AMOUNT Hb per VOLUME of RBC | in %

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6
Q

What are the first 5 things to look for while examining a patient’s blood? (to determine if something is wrong)

A

increased anisocytosis | increases poikilocytosis | increased reticulocytes | presence of inclusion bodies | Hb content

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7
Q

What is serum bilirubin?

A

breakdown product of Hb from lysed RBCs

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8
Q

What is an elevated level of serum bilirubin indicate?

A

increase RBC hemolysis

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9
Q

How can you determine the amount of bilirubin in urine and feces?

A

will be darker in color

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10
Q

What happens to the heme after RBC lysis?

A

degraded and excreted out as bilirubin by the liver and spleen

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11
Q

What indices help with determining the category of anemia a person has?

A

MCH, MCV, MCHC indices

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12
Q

What happens if a person’s immune system creates Abs against TCBII-F?

A

no TCBII-F &raquo_space;> no B12 transported into BM from intestines &raquo_space;> delay DNA synthesis &raquo_space;> increases size of RBCs and WBCs

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13
Q

What is the occult blood test used for?

A

check feces for internal bleeding

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14
Q

From the occult blood test, what does dark oreo-cookie color blood in the stool indicate?

A

upper GI bleeding

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15
Q

From the occult test, what does bright red blood in the stool suggest?

A

lower GI bleeding

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16
Q

What is an increased number of reticulocytes indicate?

A

increased erythropoiesis

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17
Q

What is polychromasia?

A

pre-mature RBCs released early from BM (abnormal) | bluish color in RBC compared to normal pink

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18
Q

What are the 6 pieces of evidence detected in peripheral blood smear that indicates increased erythropoiesis?

A

anisocytosis | polychromasia | basophilic stippling | Howell-Jolly bodies | nucleated RBC | reticulocytosis

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19
Q

What are the 5 pieces of evidence detected in bone marrow that indicates increased erythropoiesis?

A

increased cellularity | decreased hemosiderin | low M:E | high C:F | high reticulocyte level

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20
Q

How to determine for impaired erythropoiesis in the BM and peripheral blood?

A

opposite of the findings of increased erythropoeisis

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21
Q

What is transferrin?

A

transports iron from intestines to BM or to other places

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22
Q

What is ferritin?

A

apoferritin + iron | in intestines | H2O soluble | not detectable in stained smear or light microscope

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23
Q

What is hemosiderin?

A

ferritin aggregates | H2O INsoluble | detectable in BM smear

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24
Q

What do low hemosiderin and ferritin levels indicate and why?

A

iron deficiency anemia | don’t have iron = no Hb synthesis

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25
Q

What is the only way to lose iron and why?

A

donating blood (or bleed out) | cannot excrete metals out of body

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26
Q

What are the 3 molecules involved in blood cells that are toxic by themselves?

A

bilirubin | iron | hemoglobin

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27
Q

What is jaundice?

A

elevated bilirubin causing yellow pigmentation on skin

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28
Q

What are the 2 types of jaundice?

A

physiological = w/in 24h after delivery (normal) | pathological = asap after delivery

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29
Q

Which cell types are most affected by jaundice?

A

nerve cells

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30
Q

Where does bilirubin come out of?

A

macrophages

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31
Q

What neutralizes bilirubin?

A

albumin (plethora of these proteins in plasma)

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32
Q

What are the characteristics of bilirubin-albumin?

A

pre-hepatic bilirubin | indirect reacting | H2O INsoluble | unconjugated

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33
Q

What are the characteristics of bilirubin-glucuronide?

A

post-hepatic bilirubin | direct reacting | H2O soluble | conjugated

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34
Q

What are the glucuronide causes of an increased level of bilirubin-albumin?

A

infection | hemolytic anemia | incompatible blood transfusion | increase old RBC lysis

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35
Q

Where does bilirubin-glucuronide go to?

A

intestines

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36
Q

What neutralizes Hb?

A

haptoglobin

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37
Q

How abundant is haptoglobin?

A

very limited

38
Q

What do macrophages convert free Hb into?

A

bilirubin

39
Q

What gives rise to hematin?

A

breakdown of methemoglobin | by-product of globin

40
Q

What are the 4 places in the body is iron stored in? (low levels of this indicate Fe-def anemia)

A

Hb | ferritin | hemosiderin | transferrin saturation

41
Q

What protein is responsible for the absorption into or loss of iron from the body?

A

transferrin

42
Q

How much % of total body iron is in Hb?

A

65%

43
Q

How much % of total body iron is in ferritin and hemosiderin?

A

30%

44
Q

What is heme composed of?

A

iron and protoporphyrin

45
Q

In which organs are ferritin and hemosiderin commonly found?

A

liver and spleen

46
Q

How does lead affect hemoglobin synthesis?

A

inhibits heme and Hb synthesis

47
Q

What is transferrin saturation?

A

when iron binds to transferrin

48
Q

What is serum iron?

A

iron bound to transferrin

49
Q

What transferrin saturation indicates iron deficiency anemia?

A

under 15%

50
Q

What is TIBC?

A

total iron binding capacity

51
Q

What does TIBC consist of?

A

sum of serum iron and UIBC

52
Q

What is UIBC?

A

unsaturated iron binding capacity | transferrin NOT bound to iron

53
Q

What is the equation for transferrin saturation?

A

serum iron / TIBC

54
Q

Would the TIBC of a person with an infection be high or low? Why?

A

low | person will not absorb too much iron to help fight off pathogen

55
Q

What does a transferrin saturation of >33% indicate?

A

body wants more iron in order to increase RBC production

56
Q

What is the main site of protoporphyrin synthesis?

A

mitochondria

57
Q

What happens to protoporphyrin if there is no iron present or unusable?

A

protoporphyrin accumulates

58
Q

What are the 6 things that blood transfusion can lead to?

A

change T-cell subpopulations (less Th cells) | produce idiotypic Abs (ie: anti-FAB Abs) | induce B-cell tolerance = less Ab production | suppress cell-mediated immunity (monocytes and NK cells) | less macrophage-lymphocyte interaction | IL2 production

59
Q

What are the 3 things that can affect immunity?

A

stress | less cytokine production | pregnancy

60
Q

What are anti-idiopathic Abs?

A

Abs that bind to other Abs to neutralize them = inactivating them

61
Q

How does blood transfusion decrease Ab production?

A

constant blood transfusions can decrease sensitivity

62
Q

How does B12 and folate get absorbed into the body?

A

absorption sites have receptors for the vitamins

63
Q

What does the stomach need to produce in order to absorb B12?

A

intrinsic factor in the parietal cells of the stomach

64
Q

What is asynchrony?

A

decreased number of cell division due to folate and B12 deficiency, gives rise to macrocytes

65
Q

What is Crohn’s disease?

A

inflammation of small intestine | malabsorption of nutrients due to the inflammation interfering with the receptors

66
Q

What is the role of intrinsic factor?

A

to transport B12 from stomach to small intestines

67
Q

What is the role of Transcobalamin II (TCBII)

A

shuttles B12 to BM for erythropoiesis

68
Q

What is the end result needed from B12 and folate?

A

synthesis of thymidine for DNA synthesis

69
Q

What are the 2 things that affect the increase or decrease the number of circulating RBCs?

A

hormones and physiological stimulus

70
Q

What are the 4 physiological stimulus that increase (or decrease) the number of RBCs ciruculating?

A

emotion | exercise | eating | thinking

71
Q

What hormone influences the increase or decrease in number of RBCs circulating?

A

erythropoietin

72
Q

What is the role of erythropoietin and where is it made?

A

stimulates RBC production in BM | produced by kidneys

73
Q

What controls erythropoietin production?

A

pO2 in the blood | pO2 < normal = increase erythropoietin

74
Q

What is Blood Doping? Its effect on erythropoietin? How can it be detected?

A

injecting O2-blood into body before athletic event | decreases erythropoietin levels | can be detected via hematocrit measuring erythropoietin

75
Q

What are the 3 conditions in which individual naturally has more erythropoietin?

A

asthma | lung problems | smokers

76
Q

What shuts down erythropoietin production?

A

high RBC level

77
Q

What are the 3 things that low pO2 can be due to?

A

loss of RBC | high altitude | lung diseases

78
Q

What are the 2 minerals needed for erythropoiesis?

A

cobalt and iron (ferrous 2+)

79
Q

How does the stomach affect hematopoiesis?

A

produces IF and HCl | HCl = provides acidic environment for efficient absorption of iron

80
Q

How is the small intestine involved in hematopoiesis?

A

contains receptor for B12, folate, and iron

81
Q

How is the liver involved in hematopoiesis?

A

stores vitamin K, B12, and iron

82
Q

How is the kidney involved in hematopoiesis?

A

where erythropoietin is made

83
Q

How are the endocrine glands involved in hematopoiesis?

A

production of hormones that affect body physiologically which may affect levels of RBC production

84
Q

What color is Oxy-Hb?

A

bright red

85
Q

What color is met-Hb?

A

chocolate

86
Q

What color is Hb (reduced)?

A

purple red

87
Q

What color is carboxy-Hb?

A

cherry pink

88
Q

Which Hb derivatives are unable to carry O2? Is it reversible or irreversible?

A

Sulf-Hb and hematin | irreversible

89
Q

Which Hb derivatives function as a O2 carrier? Is it reversible or irreversible?

A

Met-Hb and carboxy-Hb | reversible

90
Q

Which Hb polypeptide variants are not good?

A

HbS and HbC

91
Q

Which Hb polypeptide variants are good?

A

HbA, HbA2, HbF

92
Q

What kind of Hb derivative does a patient have with food poisoning and consumption of germicide?

A

sulf-met Hb

Hematology (20 decks)

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