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Hematology > Exam2 > Flashcards

Exam2 Flashcards

1
Q

How is anemia classified according to cause?

A

Increased red cell destruction is hemolytic

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2
Q

How is anemia classified according to morphology?

A

macrocytic normochromic anemia means they are low on iron,, normocytic normochromic anemia both are normal, microcytic hypo chromic anemia

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3
Q

What are the symptoms of anemia?

A

weak, pallored, shortness of breath, hypotension, fatigue, increased cardiac output, syncope

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4
Q

Diagnoses of increased MCV and normal MCHC

A

liver disease, B12 deficiency, folate deficiency, pernicious anemias, alcoholism

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5
Q

Diagnosis of normal MCV and MCHC

A

aplastic anemia, thyroid deficient hemoglobinopathies, hemolytic anemias

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6
Q

Diagnoses of decreased MCV and MCHC

A

iron deficiency anemia, sideroblastic anemia, thalassemia, lead poisoning

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7
Q

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

A

pancytopenia, oval macrocytes, hypersegs

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8
Q

What does pancytopenia mean?

A

all cells decreased

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9
Q

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

A

giant bands, megaloblasts, M:E ratio lower

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10
Q

What deficiency disease causes megaloblastic erythropoiesis?

A

vitamin B12 and folic acid

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11
Q

What cellular constituents are affected in megaloblastic erythropoiesis?

A

DNA and RNA

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12
Q

What specifically causes pernicious anemia?

A

lack of intrinsic factor

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13
Q

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

A

neurological symptomes relating to the myelin sheath

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14
Q

What conditions can produce non-megaloblastic macrocytic anemia?

A

alcoholism and liver disease, round macrocytes

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15
Q

What poikilocytes are often seen in liver disease?

A

round macrocytes, target cells, acanthocytes

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16
Q

What parameters are decreased in aplastic anemia?

A

all precursor cells

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17
Q

What bone marrow precursor cells are decreased in aplastic anemia?

A

all cells

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18
Q

What is the peripheral blood picture in aplastic anemia?

A

normocytic normochromic cells; no signs of increased red cell formation decreased bone marrow; no Howell-Jolly bodies, no Heinz bodies, no NRBCs

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19
Q

What would the reticulocyte count be expected to be in aplastic anemia?

A

decreased

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20
Q

What are the most common causes of aplastic anemia?

A

chemical exposure (benzene and chlorophenicol) and radiation

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21
Q

Name several causes of myelophthisic anemia.

A

metastatic carcinoma, multiple myeloma, leukemia, lymphoma

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22
Q

What poikilocyte is especially associated with myelophthisic anemia because it indicates extramedullary hematopoiesis?

A

tear drop cells

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23
Q

What is the blood picture in chronic renal disease?

A

normocytic/normochromic; burr cells, helmet cells, schistocytes

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24
Q

What is the main cause of anemia due to renal disease?

A

failure of erythropoietin production

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25
Q

What kidney function test is the anemia frequently proportional?

A

decreased EPO and BUN

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26
Q

What are the characteristics of anemia due to chronic disorders?

A

begins as normocytic/normochromic then becomes microcytic hyper chromic; can look similar to iron deficiency but iron stores are increased

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27
Q

What is the common characteristic of all hemolytic anemias?

A

increased RBC destruction

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28
Q

What type of RBC abnormality results in hereditary spherocytosis?

A

membrane abnormality

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29
Q

How does hereditary spherocytosis affect the shape and osmotic fragility of the RBC?

A

small and round rather than biconcave; osmotic fragility is increased

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30
Q

What biochemical pathway involves the enzyme glucose-6-phosphate dehydrogenase (G6PD)?

A

hexose monophosphate shunt (HMP)

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31
Q

What usually precipitates a hemolytic crisis in G6PD deficiency?

A

exposure to oxidizing drugs

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32
Q

What RBC inclusions does G6PD deficiency produce?

A

Heinz bodies

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33
Q

What makes up Heinz bodies?

A

denatured hemoglobin

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34
Q

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

A

spherocytes

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35
Q

What is the most unusual characteristic laboratory finding in AIHA?

A

positive Direct Coombs Test

36
Q

What does AIHA stand for?

A

autoimmune hemolytic anemia

37
Q

What are the characteristics of PCH?

A

extrinsic, have an antibody, extracorpuscular defect

38
Q

What are the characteristics of PNH?

A

intrinsic, acquired, sensitive to complement, genetic, intracorpuscular defect

39
Q

What does extracorpuscular defect mean?

A

extrinsic, outside of the RBC; something outside the cell is causing hemolysis

40
Q

What does intracorpuscular defect mean?

A

intrinsic, inside of the RBC; something in the cells is causing hemolysis

41
Q

In which condition is the Donath-Landsteiner antibody found?

A

PCH

42
Q

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

A

membrane abnormality

43
Q

What globin chains are found in A2 hemoglobin?

A

2 alpha and 2 delta

44
Q

What globin chains are found in F hemoglobin?

A

2 alpha and 2 gamma

45
Q

What globin chains are found in H hemoglobin?

A

4 beta

46
Q

What globin chains are found in Bart’s hemoglobin?

A

4 gamma

47
Q

What globin chains are found in Gower 1 hemoglobin?

A

Epsilon

48
Q

What globin chains are found in Gower 2 hemoglobin?

A

Zeta

49
Q

Which hemoglobin chains are present only during embryonic development?

A

Epsilon and Zeta

50
Q

What is the major hemoglobin of the newborn?

A

F

51
Q

What hemoglobin is insoluble when reduced?

A

S

52
Q

What hemoglobin is resistant to alkali?

A

F

53
Q

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

A

Target cells

54
Q

What is the specific amino acid substitution in hemoglobin S?

A

valine substitues in for glutamic acid on #6 position on the beta chain

55
Q

What is the specific amino acid substitution in hemoglobin C?

A

lysine substitues in for glutamic acid on #6 position on the beta chain

56
Q

What are the clinical manifestation of sickle cell anemia?

A

frequent crises like plastic and thrombotic, sickled cells, decreased osmotic fragility

57
Q

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

A

hemoglobin electrophoresis

58
Q

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

A

occasional target cell

59
Q

What are the characteristics of hemoglobin C disease?

A

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

60
Q

What are the characteristics of hemoglobin SC disease?

A

SC crystals, positive tube solubility test, some sickle cells

61
Q

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

A

the migrate together in an alkaline pH (8.6)

62
Q

What does the peripheral blood smear usually show in IDA?

A

microcytic hyperchromic

63
Q

What does IDA stand for?

A

iron deficiency anemia

64
Q

What does the serum iron and TIBC show in IDA?

A

serum iron decreased and TIBC increased

65
Q

What is chlorosis?

A

green coloration of skin

66
Q

What is favism?

A

G6PD deficiency

67
Q

What is koilonychia?

A

spoon shaped nails found in iron deficiency

68
Q

What is pica syndrome?

A

eating weird stuff

69
Q

What are some causes of IDA?

A

chronic bleeding, hookworm infections, menstrual problems, bleeding ulcers

70
Q

What is the specific cause of the thalassemias?

A

decreased rate of synthesis of either the alpha or beta chain

71
Q

What is another name for beta thalassemia?

A

Cooley’s anemia, Mediterranean anemia

72
Q

What hemoglobins are increased in thalassemia major?

A

A2 and F

73
Q

Why are the A2 and F increased in thalassemia major?

A

can’t make beta chain

74
Q

What is Bart’s disease?

A

homozygous alpha thalassemia

75
Q

What is Cooley’s trait?

A

beta thalassemia minor

76
Q

What is Fanconi’s anemia?

A

Congenital aplastic anemia

77
Q

What is hemoglobin H disease?

A

heterozygous alpha thalassemia

78
Q

What are the characteristics of sideroblastic anemia?

A

microcytic/hypochromic, increased iron stores, increased ringed sideroblast

79
Q

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

A

basophilic stippling

80
Q

What blood cell parameters are increased in polycythemia vera?

A

all are increased, plasma volume normal

81
Q

What is the cause of secondary polycythemia?

A

overproduction of erythropoietin

82
Q

What parameters are increased in secondary polycythemia?

A

red cell parameters

83
Q

What are some possible causes of relative polycythemia?

A

stress, dehydration, burns, decreased plasma volume

84
Q

Describe hemachromatosis.

A

excess iron deposited in functional cells where they should not be placed causing tissue damage

85
Q

Describe hemosiderosis.

A

excess iron in the normal cells of the liver and spleen

86
Q

What is increased MCV and normal MCHC classified as?

A

macrocytic/normochromic

87
Q

What is decreased MCV and MCHC classified as?

A

microcytic/hypochromic

Hematology (8 decks)

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