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Pathophys sem2 > Hematology > Flashcards

Hematology Flashcards

1
Q

Definition of Anemia

A

decrease in the number of circulating RBC mass/ Oxygen carrying capacity.

*almost always a secondary disorder

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2
Q

cut off points for RBC, Hb & Hct in Male and Female

A

RBC:
male < 4.4 T/L
female < 3.8 T/L

Hb:
male < 140 g/L
female < 120g/L

Hct
male < 42%
female < 37%

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3
Q

Symptoms of Anemia depend on?

A

Severity of the Anemia

Rapidity of onset

Patient’s age and cardiovascular status

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4
Q

examples of symptoms of Anemia

A

Cardiovascular and Respiratory
- tachycardia, palpitation, dyspnoe, angina

Neurologic
- headache, dizziness, fatigue

Skin
- pallor of skin, mucous membrane, nail beds

Gastrointestinal
- anorexia, nausea, diarrhoea, constipation

Genitourinary
- menstrual irregularity, amenorrhoea, loss of libido/potency

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5
Q

Classification of anemias based on MCV (mean corpuscular volume)

A

microcytic, Normocytic, Macrocytic

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6
Q

classification of anemias based on MCHC/MCH (mean corpuscular haemoglobin / mean corpuscular haemoglobin concentration)

A

hypochromic, normochromic, Hyperchromic

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7
Q

Decreased RBC production could be due to?

A
  • defects in myeloid stem cells
  • defects in erythropoietin
  • defects in RBC maturation (e.g altered Hb synthesis or altered DNA synthesis)
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8
Q

Increased Loss / excess destruction could be due to?

A

Haemorrhage

Hemolysis

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9
Q

Factors that control erythropoiesis

A

IL-3

IL-9

GSF (granulocyte stimulating factor) GM-CSF

EPO (erythropoietin)

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10
Q

Where is EPO produced and what stimulates it’s secretion?

A

Kidney (90%) Liver (10%)

in response to cellular HYPOXIA

but there is a constant low level (10mU/mL) released for RBC turnover

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11
Q

Aplastic anemia definition

A

characterised by an Acellular or Hypocellular bone marrow which causes Pancytopenia (RBC, WBC, platelets)

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12
Q

Pathogenesis of Aplastic anemia

A
  • qualitative or quantitative abnormalities of the pluripotent stem cells
  • abnormal humoral or cellular control of hematopoiesis (GM-CSF, IL-3)
  • abnormal or “hostile” hematopoietic microenvironment (e.g damaged stromal cells)
  • immunologic suppression of hematopoiesis (e.g humoral/antibody mediated, cell mediated/T-cell abnormalities, lymphokine mediated)
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13
Q

Pathogenesis of anemia in Chronic renal failure

A

Renal excretory failure =

  • Lower Hematocrit caused by Hydremia (excessive fluid volume)
  • Reduced RBC survival (metabolic or mechanical)
  • Direct marrow suppression (uremic toxins)
  • Deficiencies of certain nutrients ( iron, folate chronic dialysis)
  • impaired platelet function (bleeding tendencies)
  • decreased EPO production!
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14
Q

pathogenesis of anemia in Cirrhosis

A
  • alteration in the lipid composition of RBC membranes
  • increased plasma volume associated with cirrhosis
  • enlarged Spleen - portal hypertension
    • Acanthocytes*
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15
Q

what is MCV and it’s normal range?

A

The average volume of a RBC in a specimen

= 80-99 fL

** Hct / RBC No. = Volume **

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16
Q

what is MCH and it’s normal range?

A

The average content of Hb per RBC

= 27-34 pg

** Hb / RBC No. = MCH **

17
Q

what is MCHC and it’s normal range?

A

The average content of Hb per unit volume of RBC (concentration)

= 315-360 g/L

** Hb / Hct = MCHC ** OR ** MCH / MCV **

18
Q

List Anemia of endocrine diseases with a brief description

A

Hypopituitarism - normochromic, normocytic
- androgens & groth hormone
(TSH & GH)

Hypothyroidism - micro- , macro- & normo-cytic
Thyroid hormones stimulate the proliferation of erythrocyte precursors both directly and via EPO production enhancement.
= adaptation of decreased BMR (less O2 needed), Hypoplastic anemia, menorrhagia/malabsorption of iron, Pernicious anemia

Hyperparathyroidism - normocytic, normochromic
= PTH down regulates EPO receptors on progenitor cells in the bone marrow

19
Q

List Anemias involving altered haemoglobin synthesis

A
  • microcytic, Hypochromic *
  • Iron deficiency
  • Anemia of chronic disease (some)
  • Thalassemias
  • Hemoglobinopathy
  • Sideroblastic anemias (lead toxicity)
20
Q

What is the major difference with Iron stores in the body during Iron Deficiency Anemia?

A

The Stored Iron = 0mg
instead of 1000mg

The absorption is changed to 2-10 mg/day
instead of the normal 1mg/day

21
Q

What results do you expect to see in the blood test and blood smear for Iron deficiency anemia?

A
  • Decreased FERRITIN
  • Decreased serum Fe
  • Decreased Sat%
  • Decreased Hgb, Hct & RBC
  • Decreased MCV, MCH, MCHC
  • Increased Transferrin/TIBC
  • Increased sTfR
  • Increased RDW
  • Increased Platelet count

blood smear
= Microcytes + Anisopoikilocytosis + Target Cells!

22
Q

list some possible causes that would be underlying the Iron Deficiency Anemia

A
  1. ) Chronic bleeding e.g GI bleeding, uterine bleeding
  2. ) von Willebrand disease
  3. ) Myoma
  4. ) Growth / Pregnancy
  5. ) Strong menstruation
  6. ) Malabsorption (Celiac Disease)
  7. ) low intake / gastrectomy
  8. ) Parasite infection (worms)
23
Q

List some symptoms specific to Iron Deficiency Anemia

A

Oral Lesions - angular cheilosis, Glossitis, Stomatitis

Dysphagia

Nail Lesions - flattening, brittle, spoon shaped (koilonychia)

Pica - compulsive ingestion of nonnutritive substances e.g clay, dirt, paint, Ice, laundry starch

Pathophys sem2 (1 decks)

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