Exam Practicum C Flashcards
Define hematocrit
Measurement that represents % of RBCs in whole blood. It’s spun down to separate different cellular components of whole blood in capillary tube.
Describe Buffy coat
Thin, light colored layer formed between packed RBCs and plasma after centrifugation. It is composed of WBCs and platelets
Describe polychromasia
Presence of young RBCs called r eticulocytes in peripheral blood that exhibit bluish tint when stained with Wright’s stain. Observed frequently in hemolytic anemias during periods of increased demand for RBC production
Purpose of EPO?
Cytokine responsible for stimulating erythropoiesis. Produced in the peritubular cells of kidneys in response to hypoxia. EPO acts on. Erythroid progenitor cells in the bone marrow, promoting proliferation, differentiation, and maturation into RBCs.
What are the growth factors and cytokines that influence erythropoiesis?
EPO, IL-3, and GM-CSF
How does IL-3 influence erythropoiesis?
Stimulates growth and differentiation of multiple hematopoietic cell lineages, including erythroid progenitor cells. It plays a supportive role in erythropoiesis by promoting the survival and proliferation of erythroid precursors.
How does GM-CSF help the body with erythropoiesis?
Stimulates the production and differentiation of multiple blood cell types, including RBCs. It acts on erythroid progenitor cells, promoting their maturation and proliferation.
What is iron deficiency anemia?
Impaired RBC production due to insufficient iron levels from poor dietary intake, chronic blood loss, or impaired absorption
What would lab results look like for iron. deficiency anemia?
Low hemoglobin, hematocrit, serum iron, ferritin, and increased TIBC
What would peripheral blood smear look like in iron deficiency anemia?
Microcytic and hypochromic RBCs
Describe anemia from vitamin B12/B9 deficiency
Decrease intrinsic factor of B12/B9 leads to insufficient RBCs and poor quality RBCs. These RBCs die. Sooner.
Describe pernicious anemia
Insufficient RBC production due to antibodies targeting parietal cells.
What do labs for Vitamin B12 / B9 deficiency anemia look. Like?
Low Hgb, HCT, increased MCV, and decreased B12
What do peripheral blood smears look like from a patient with vitamin B12/B9 deficiency anemia or pernicious anemia?
Macrocyclic RBCs, hyper-segmented neutrophils
Describe hemolytic anemia
Increased destruction of RBCs, whether by mechanical issues (heart valve, repeated impact), autoimmune, or chemically induced.
What do labs look like in hemolytic anemia?
Decreased hgb, HCT, increased LDH, relics, and indirect bilirubin
What would a peripheral blood smear look like in a patient with hemolytic anemia?
Polychromasia, spherocytes, and relics
Describe aplastic anemia
Pancytopenia due to bone marrow failure
Describe labs of a patient with aplastic anemia
Low hgb, HCT, and retic count
What would peripheral blood smear look like from a patient with aplastic anemia?
Panocytopenia
What kind of hemoglobin affects sickle cell patients?
Hgb S
What is the appropriate course. Of action to be taken when numerous nRBCs are present?
Evaluate bone marrow. Do a corrected WBC count calculation. Grade peripheral blood smear
What conditions will have increased retic in peripheral blood smears?
Hemolytic anemias, blood loss, or hemorrhage
What conditions will have decreased retics in peripheral blood smears?
Aplastic anemia / bone marrow failure, chronic kidney disease (due to decrease EPO from liver), iron deficiency anemia, B12 or folate deficiency, and of course in in healthy adults.
What kind of RBC is associated with myeloid metaplasia?
Teardrop cells (dacrocytes) are prominent in patients with myelofibrosis
Spherocytes is associated with what condition?
hemolytic anemia, jaundice, or splenomegaly
Cold agglutinins is associated with what condition?
Hemolytic anemia, acrocyanosis, or raynaud’s phenomenon
Elliptocytosis is associated with what condition?
Hemolytic anemia, or jaundice
A patient with alcohol abuse would have what kind of labs? What organ in his body could be dysfunctional?
Liver disease
Lab: decrease clotting factors and potentially be anemic.
What causes sickle cell to farm?
A single base - pair point mutation in beta globin gene resulting in valine switched for glutamic acid.
What is spleenic sequestration in sickle cell patients?
Excessive amount of blood becomes trapped in the spleen causing a dangerous drop in the circulating blood volume.
What is vaso-occlusive crisis in sickle cell patients?
Occurs
Patients with iron deficiency anemia will have what kind of labs?
Decreased Hgb, Hct, MCV, serum iron, and ferritin. Increased TIBC and FEP
Patients with sideroblastic anemia will have what kind of labs?
Variable anemia, increased serum ferritin, serum iron, and iron stores in BM. Normal or decreased TIBC
Describe sideroblastic anemia.
Ineffective erythropoiesis and impaired iron utilization in the mitochondria of developing RBCs. Leads to iron accumulation in mitochondria, forming ringed sideroblasts.
What would the peripheral blood smear look like in a patient with B12 / Folate deficiency?
Macrocytic ovalocytes, aniso, poikilo, and hypersegmented neutrophils
Describe Hgb C disease.
Hb C disease where Hb C instead of Hb A is present. Hb C forms crystals within RBCs leading to their distortion and the formation of target cells.
What would blood smear look like from a patient with Hgb C disease?
Target cells and Hb C crystals may be present
What could cause a patient to develop aplastic anemia?
Failure of BM (acquired or transplanted), autoimmune reactions, infections, medications, radiation, chemotherapy, and exposure to toxins
RBCs of a patient hemolyzes when exposed to oxidative stress. Some RBCs have heinz bodies, what could this patient have?
G6PD deficiency. Its an inherited enzyme deficiency that affects RBCs ability to handle oxidative stress, like breaking down peroxide into water. Avoid fava beans, certain medications, and infections. Cells undergo hemolysis due to accumulation of ROS.
How can a patient develop myelophthisic anemia?
Occurs when bone marrow is infiltrated or replaced by non-hematopoietic cells, such as tumor cells, fibrosis, or granulomas. This disrupts normal hematopoiesis, leading to anemia and the release of immature or abnormal cells into blood.
What would labs look like in a patient with lead poisoning?
Microcytic, RBCs with basophilic stippling, increased FEP, and anemia
