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Neonate > Hematology > Flashcards

Hematology Flashcards

1
Q

This occurs when the red cell life span is reduced

A

Hemolytic anemia

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2
Q

Increased number of red blood cells

A

Polcythemia

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3
Q

Cells derived from erythroblast in the bone marriow

A

Red blood cell

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4
Q

Cell does not have a nucleus with a life span of 120 days

A

RBC

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5
Q

Symptoms of anemia include:

A
  1. tiredness
  2. shortness of breath
  3. poor concentration
  4. palpitations
  5. pallor
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6
Q

Anemia is classified by the:

A
  1. Red cell volume
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7
Q

MCV < 80 is considered what type of anemia

A 
Microcytic
sub class Fe Deficiency and Thalassemia
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8
Q

MCV 80-95 is classified as:

A

Normocytic anemia: Chronic infection, renal disease, marrow disease

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9
Q

MCV > 85 is classified as:

A

Macrocytic anemia: Vitamin B12 or folate deficiency

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10
Q

how many grams of iron are in the body

A

4-5 grams

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11
Q

Intake of iron through food is:

A

10-20 mg

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12
Q

Heme iron is eaten in what kinds of food?

A

Meat and vegetables

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13
Q

Which form of iron is most readily absorbed by the intestinal cells?

A

Ferrous

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14
Q

What is the amino-acid involved in the synthesis of iron

A

Glycine

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15
Q

What is the second major cause of microcytic anemia?

A

Thalassemia

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16
Q

Thalassemia gets its name because it was common where?

A

In the Mediterranean

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17
Q

Thalassemia is due to an imbalance in what?

A

Alpha or beta globin

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18
Q

α-thalassemia results from deficiency where?

A

α-thalassemia is a result of a deficiency in the α-chains

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19
Q

b-thalassemia results from a deficiency where?

A

b-thalassemia is a result of a deficiency in b-chain

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20
Q

What causes the hemopoietic tissue to expand in people with B-thalassemia?

A

inadequately treated anemia makes the bone marrow expand

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21
Q

Expansion within the bone marrow gives what type of appearance on an x ray?

A

Hair on end appearance

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22
Q

When there is inflammation in the body, what effect does this have on iron?

A

When there is inflammation in the body, they sequesters iron within macrophages

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23
Q

When the body sequesters iron within the macrophages what happens to the iron levels?

A

reduced iron levels with no increase in iron binding capacity

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24
Q

A decrease in red cell production may be a result of a bone marrow disorder, some of those disorders are?

A
  1. Leukemia
  2. Proliferative disease
  3. infiltration
  4. Aplasia
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25
Q

the iron-binding storage protein. Its purpose is to store iron in a non-toxic form. Bone marrow macrophages are one of the storage

A

Ferritin

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26
Q

: Iron that is bound to transferrin; transferrin is the binding protein for iron in the blood and is synthesized in the

A

Serum iron

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27
Q

This is the concentration of transferrin.

A

Total iron binding capacity

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28
Q

Percentage of available binding sites on transferrin

A

Iron saturation

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29
Q

During inflammatory disease the liver produces a protein called?

A

Hepcidin

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30
Q

What does Hepcidin do?

A

It works to stop iron absorption in the duodenum and prevents iron recycling by inhibiting the breakdown of old RBCs.

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31
Q

An anemia that occurs due to the abnormalities in the synthesis of protoporphyrin

A

Sideroblastic anemia

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32
Q

This type of anemia the mean corpuscular volume is greater than 96 nm

A

Megaloblastic anemia

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33
Q

What is the most common form of macrocytic anemia

A

Megaloblastic anemia

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34
Q

what causes the red blood cells to be large with megaloblastic anemia

A

The vitamin deficiency limits the ability of the cell to divide and replicate due to a deficiency of B12 or folate

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35
Q

What is a pernicious anemia

A

an autoimmune disease in which antibodies are made against gastric parietal cells and intrinsic factor

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36
Q

Where is B12 absorbed

A

in the terminal ileum

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37
Q

What numbness disorder can B12 deficiency lead to

A

neuropathy

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38
Q

How is vitamin B12 deficiency treated

A

B12 injections

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39
Q

Why does Folate and a B12 Deficiency cause the same effect of megaloblastic anemia

A

Folate and B12 use the same pathways

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40
Q

If there is hemolysis of red blood cells what does the bone marrow do in response?

A
  1. increase reticulocyte production
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41
Q

What causes the mean corpuscular volume to increase with hemolytic anemia?

A

Reticulocytes are larger that red blood cells

42
Q

How long can the bone marrow keep up with a shortened RBC life span?

A

15 days

43
Q

Why are patients with hemolytic anemia jaundiced?

A

Protoporphin as a result of a break down and destruction of RBC’s

44
Q

What are the two groups of hemolytic anemia?

A
  1. Inherited

2. Acquired

45
Q

Hereditary spherocytosis is treated how

A

Splenectomy

or folic acid

46
Q

Glucose 6 phosphate dehydrogenase (G6PD) is a what type of linked disease?

A

X linked

47
Q

Where is G6PD most common?

A

The Mediterranean

Africa

48
Q

G6PD is what type of red blood cell disorder

A

Red Cell Enzyme Disorder

49
Q

What are the three inherited hemolytic anemia’s?

A
  1. G6PD
  2. Pyruvate Kinase Deficiency
  3. Sickle Cell
50
Q

How is sickle cell treated?

A

RBC transfusions

hydroxycarbamide

51
Q

What are acquired hemolytic anemia’s

A

IgG

IgM

52
Q

What type of bilirubin will be increased in the blood of a patient with hemolytic anemia?

A

Unconjugated and total bilirubin

53
Q

What is the name of the molecules that anchor the spectrin molecule

A

Band 3 protein Band 4.1 Ankyrin

54
Q

What is the etiology of hemolytic crisis in G6PD deficiency?

A
  1. Increased oxidative stress
55
Q

What are complications of polycythemia?

A

Blood clots
lethargy
pruritus

56
Q

Primary polycythemia can be related to?

A

Myeloproliferative disorder

57
Q

Secondary polycythemia can be caused by?

A

Secondary to an increase in erythropoietin due to lung disease, smoking, altitude due to a tumor that is secreting EPO (rare)

58
Q

Secondary polycythemia is treated how

A

By correcting the underlying condition

59
Q

In a patient with polycythemia, the red cell mass is _____ and the plasma volume is___?

A
  1. Red cell mass increased

2. Plasma volume is normal

60
Q

What is anemia?

A

Decrease in total number of RBC’s, HGB or circulating RBC mass

61
Q

Anemias are classified as?

A
  1. Microcytic (MCV < 80) 80-99
  2. Macrocytic (MCV >100)
  3. Normocytic (MCV 80-100)
62
Q

Microcytic anemia is a RBC count of

A

less than 80 m

63
Q

Normocytic anemia range is

A

80-100

64
Q

Disease that cause non megoblastic anemia?

A

Liver Disease
Alcoholism
Reticulocytosis
Drugs

65
Q

Immature blood cell

A

Blast

66
Q

Macrocytic anemia ranges are

A

> 100

67
Q

Where is the grave site for a RBC

A

The spleen

68
Q

If you can’t make red blood cells how do you destroy RBC’s?

A

You can’t non hemolytic anemia

69
Q

Diseases that are non hemolytic anemia specific are?

A
  1. Blood loss < 1 week
  2. Early stage Fe deficiency
  3. Early stage anemia of chronic disease
  4. Aplastic anemia
  5. Renal disease
  6. Malignancy
70
Q

What is aplastic anemia?

A

A condition in which the body stops producing RBC’s

71
Q

What is an immature RBC called

A

Reticulocyte

72
Q

Do you do iron studies with macrocytic and microcytic anemias

A

yes

73
Q

Iron in it’s primary form is stored in the cells as?

A
  1. Ferritn
74
Q

Increased serum iron results in a decreased?

A

TIBC

75
Q

The average volume of red blood cells and is reflective of RBC size

A

Mean Corpuscular Volume

76
Q

The bio-chemical component of RBC’s that is responsible for binding with oxygen?

A
  1. Hemoglobin
77
Q

The measure of the total volume of % of RBC’s in the blood?

A

Hematocrit

78
Q

Normal HCT value for men is?

A

45%

79
Q

Normal HCT for women is?

A

40&

80
Q

A metalloprotein with iron being the metal attached to the globular protein?

A

HGB

81
Q

Normal MCV is?

A

80-96

82
Q

Accodring to the WHO anemia in non-pregnant women and otherwise healthy people is characterized by a HGB lower than?

A

12.5

83
Q

lack of iron results in a decreased synthesis of____which results in a reduction in_____?

A

HBG

The size of RBC’s

84
Q

Why can infants less than 6 months develop anemia

A

Lack of iron in breast milk

85
Q

What is anemia from increased iron demand in the body?

A

During rapid growth phases and pregnancy due to increase in blood volume and the need to produce more Hgb

86
Q

Blood loss in males resulting in anemia is usually the result of what disease?

A

Peptic ulcer

87
Q

This type of anemia is strongly associated with inflammatory diseases?

A

Anemia of chronic disease

88
Q

This type of anemia occurs due to abnormalities in the synthesis protoporphyrin, which results in decreased synthesis of hemoglobin?

A

Sideroblastic anemia

89
Q

Iron along with protoporphyrin makes what?

A

heme

90
Q

In sideroblastic anemia iron accumulates in the cells because its not being utilized to make heme due to the absence of protoporphyrin, which gives RBC’s a__ around the cell?

A

Ring

91
Q

In sideroblastic anemia the serum ferritin level is (1), serum iron is (2) and saturation is (3), the total iron binding capacity is (4).

A
  1. Increased
  2. Increased
  3. Increased
  4. decreased
92
Q

Why does alpha thalassemia occur?

A

Because of gene deletion

93
Q

non-megaloblastic anemia is less common cause of macrocytic anemia. Diseases associated with non-megaloblastic anemia are:

A

ETHOH abuse and drugs like 5-fluorouracil

94
Q

If the reticulocyte count is more than 3% it is indicative of?

A
  1. Bone marrow functioning normally, therefore in this case anemia is not due to underproduction of RBC’s
95
Q

If the reticulocyte is less than 3% is indicative of?

A
  1. Abnormality in the bone marrow, therefore there is an underproduction of RBC’s leading to anemia
96
Q

What are the 3 conditions normocytic anemia occurs under?

A
  1. Acute blood loss: Reticulocyte count <3%
  2. Intrinsic defect of RBC: Retic count <3%
  3. Extrinsic defect of RBC: Retic count >3%
97
Q

IgG or IgM mediated destruction of RBC’s, direct and indirect Combs test are used for diagnostic purposes?

A

Immune hemolytic anemias

98
Q

RBC’s getting damaged due to micro or macro thrombi, resulting in schistocytes, diseases include thrombotic thrombocytopenic purpura, hemolytic uremic syndrome DIC?

A

Micro/macroangiopathic hemolytic anemias

99
Q

Destruction of RBC’s by plasmodium species transmitted by the female anopheles mosquito?

A

Malaria

100
Q

What are clinical findings of extrinsic defect in RBC’s

A
  1. Anemia
  2. Jaundice due to increased destruction of RBC’s by the spleen
  3. Splenomegaly due to increased burden on the spleen to destroy so many abnormal RBC’s

Neonate (6 decks)

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