Hematologic System Flashcards
Regarding polycythemia vera, the kidney senses an __________ red cell mass and ____________ erythropoietin production.
- Increased
- Decreased
In regards to anemia, the kidneys sense a ___________ red cell mass and in turn ___________ erythropoietin production.
- Decreased
- Increases
With hypoxia, the kidney senses ___________ arterial oxygen saturation and in turn __________ erythropoietin production.
- Decreased
- Increases
Anemia is associated with a ___________ in the number of circulating erythrocytes.
- Decrease
List 3 ways in which anemia can occur:
- Impaired erythrocyte production
- Acute/chronic blood loss
- Increased erythrocyte destruction
The major physiologic manifestation of anemia is:
- Decreased oxygen carrying capacity
Common symptoms of anemia:
- fatigue
- pallor
- weakness
- dyspnea
Macrocytic- normochromic anemia is also know as? And is characterized by (in regards to MCV)?
- megaloblastic anemia
- MCV > 100 (unusually large stem cells)
The pathology behind Macrocytic-Normochromic anemia:
- Defective DNA synthesis
- Deficient in Vit B 12 and folate
- RNA processes are normal
Name one type of Macrocytic-Normochromic anemia:
- Pernicious anemia
Name the anemia in which this pathophysiology correlates:
- lack of IF from parietal cells
* can occur from decreased Vit B 12 absorbtion
* or can be from a Vit B 12 deficieny
- Pernicious anemia
Name the major clinical relevance of Pernicious anemia:
- neurologic demyelination (d/t decreased oxygen reaching the neurons)
Ways to evaluate Pernicious anemia (2):
- assess if there are parietal cells/ IF antibodies
- gastric biopsy (total achlorhydria)
Treatment for Pernicious anemia:
- Vit B12 replacement (Cobalamin)
Name 4 types of Microcytic Hypochromic anemia:
- Iron deficiency anemia
- Sideroblastic anemia
- Thalassemia
- Sickle cell anemia?
What are the characteristics of Microcytic Hypochromic anemia:
- RBCs are abnormally small and contain reduced Hgb
Disorders of:
- iron metabolism
- porphyrin and heme synthesis
- globin synthesis
* can all lead to which type of anemia?
- Microcytic Hypchromic anemia
What are the 2 major pathophysiologic indicators of iron deficiency anemia?
- nutritional iron deficiency (inadeq intake/blood loss)
- metabolic or functional deficiency (insuff iron delivery)
Hgb levels characterisitic of Iron deficiency anemia:
- Hgb 7-8 g/dL
Physical manifestations of:
- brittle, coarse, thin, spoon shaped nails
- beefy red tongue
- pallor
- describe which type of anemia?
- Iron deficiency anemia
Evaluation of Iron deficiency anemia includes:
- decreased hgb/hematocrit
- serum ferritin levels (1ug/L - 8-10mg of storage iron/kg)
- rule out sources of blood loss
Treatment for iron deficiency anemia:
- Iron replacement therapy (ferrous)
Which anemia is correlated with altered mitochondrial metabolism leading to iron overload and deposits -> which in turn causes dysfunctional Hgb synthesis in the BM
- Sideroblastic anemia
What is the clinical relevance of Sideroblastic anemia:
- increased iron tissue levels
- splenomegaly/hepatomegaly
What is a diagnostic indicator for Sideroblastic anemia:
- ringed sideroblasts within the BM
Pyridoxine therapy is treatment specific for which type of anemia?
- Sideroblastic anemia
Which type of anemia is associated with increased RBC destruction (hemolysis) resulting in decreased survival rates?
- assoc with mutant genes that suppress the rate of globin chain synthesis
Thalassemia
Thalassemia is classified by which type of polypeptide chains with deficient synthesis?
- alpha and beta
- blood transfusion
- splenectomy
- chelation therapy
- BM transplant
- Genetic counseling
- all of these treatments are characteristic for which type of anemia?
- Thalassemia
Sickle cell anemia is a genetically recessive or dominant disorder?
- homozygous recessive
What anemia is associated with a genetically determined defect of hgb synthesis causing hgb instability -> that can cause vascular occlusion?
- Sickle cell anemia
Treatment for sickle cell anemia (1):
- stem cell transplant
Name 3 types of Normocytic-Normochromic anemia:
- Aplastic anemia
- Hemolytic anemia
- Anemia of Chronic Disease (ACD)
Normocytic-normochromic anemia is associated with:
- insufficient number of normal RBCs
Aplastic anemia is characterized by:
- pancytopenia
Pancytopenia is known as:
- decrease/absence of all 3 blood types
- (usually d/t BM failure/suppression in production)
Faconi anemia (which occurs d/t defects in DNA repair) is associated with which type of anemia?
- Aplastic anemia
Evaluation of Aplastic anemia -> a BM will show:
- high fat content (increased yellow marrow)
- hypocellular
Treatment for Aplastic anemia:
- BM transplant/peripheral blood stem cell tx
- Immunosuppression
The Hapten model, Immune complex formation and the Autoimmune model are all associated with which type of anemia?
- Hemolytic anemia
Which anemia is associated with premature/accelerated destruction of RBCs with BM compensation?
- Hemolytic anemia