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Patho > Hematology: Red Blood Cell Disorders > Flashcards

Hematology: Red Blood Cell Disorders Flashcards

1
Q

Transferrin

A

carries iron to bone marrow where Hgb synthesized

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2
Q

What do the liver and spleen do to the old RBCs?

A

phagocytize (ingest) andTota

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3
Q

Reticulocyte count

A

shows if bone marrow is working

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4
Q

Hemoglobin

A

protein that delivers oxygen to the cells

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5
Q

Mean Corpuscular Hemoglobin (MCH)

A

average amount of hemoglobin found in RBC in body

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6
Q

Erythropoietin

A

made by kidneys, stimulates the proliferation of red blood cells

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7
Q

stage of Reticulocyte in RBC

A

last immature stage of RBC

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8
Q

what is the most reliable measure of RBC production

A

Reticulocyte count

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9
Q

what is a good indicator of bone marrow function?

A

Reticulocyte count

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10
Q

Hematocrit

A

% of RBC

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11
Q

what happens to MCV, MCH and vit B12 levels with iron deficiency anemia?

A

everything is low

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12
Q

anisocytosis description and cause

A

abnormal size, caused by severe anemia

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13
Q

poikilocytosis description and cause

A

abnormal shape, caused by severe anemia

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14
Q

Target cells description and cause

A

cells dark center + periphery & clear ring inbetween, caused by liver disease

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15
Q

sickle cell description and cause

A

cresent-shaped red blood cell, caused by sickle cell anemia

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16
Q

lysis

A

cell destruction

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17
Q

macrocytic

A

large RBCs (Increased MCV)

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18
Q

normocytic

A

normal size RBCs

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19
Q

microcytic

A

small RBCs (decreased MCV)

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20
Q

hyperchromic

A

too much Hgb

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21
Q

Normochronic

A

normal amounts of Hgb

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22
Q

hypochromic

A

too little Hgb (decreased MCHC)

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23
Q

Production defect

A

lack of necessary building blocks to make RBCs

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24
Q

Destruction defect

A

bone marrow destruction or hemolysis

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25
Q

genetic defects in Hemoglobin

A

sickle cell anemia

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26
Q

Anemias caused by Red cell production disorders

A

Deficiency of essential elements, bone marrow disease, nutritional deficiencies

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27
Q

Anemias caused by an excessive loss of RBCs

A

chronic blood loss, acute blood loss, excessive cell lysis

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28
Q

examples of excessive cell lysis (destruction)

A

hemodialysis, hypersplenism, hemoglobinopathies, intravascular hemolysis

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29
Q

what is the normal response of a reticulocyte count to be in the presence of anemia?

A

high

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30
Q

Iron deficiency anemia labs

A

MCV decreased
MCHC decreased
Hgb decreased
Normal/increased RDW

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31
Q

average amount of Fe in diet

A

10-20 mg

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32
Q

how much of Fe is absorbed in intestines?

A

1-2mg

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33
Q

500-1500mg of Fe is stored as what?

A
  • Ferritin in liver, spleen and bone marrow

- Myoglobin in muscle

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34
Q

what is iron necessary for?

A

hemoglobin production

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35
Q

what does a serum iron test measure?

A

iron bound to transferrin

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36
Q

what is the gold standard for iron stores?

A

bone marrow exam

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37
Q

a low serum ferritin rules in or out iron deficiency anemia?

A

rules in

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38
Q

a high serum ferritin essentially rules in or out iron deficiency?

A

rules out **only in the absence of inflammatory condition

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39
Q

is ferritin levels affected by blood transfusions?

A

no

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40
Q

how long does it take to increase ferritin levels with iron supplements?

A

2-3 weeks po and 24 hours IV

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41
Q

what affects transferrin?

A

inflammation, loss of protein, nutritional status and liver disease

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42
Q

Transferrin concentration

A

globulin in the blood that binds and transports iron. 1/2 life = 1 week

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43
Q

Transferrin saturation and is this increased of decreased with iron deficiency anemia?

A

the sites on transferrin that are attached to iron. This is decreased in iron deficiency anemia because there isnt alot of iron to go around since its deficient

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44
Q

normal transferrin saturation

A

20-50%

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45
Q

Iron deficiency anemia cause

A
  • impaired production of RBC
  • low iron intake
  • problems with iron absorption
  • chronic blood loss
46
Q

poorly understood s/s of iron-deficiency anemia

A

brittle nails,, glossitis (smooth red sore tounge), web in upper esophagus, pica

47
Q

key sign of iron-deficiency anemia

A

hypoxemia

48
Q

what will labs look like in iron deficiency anemia?

A

Decreased:
MCV, MCHC, serum ferritin & transferrin saturation

Increased:
serum transferrin & total iron binding capacity

49
Q

Megaloblastic Anemias

A

impaired synthesis of DNA resulting in enlarged RBC (Macrocytic)

50
Q

megaloblastic anemias are most often d/t what?

A

vit B12 deficiency or folate deficiency

51
Q

Are megaloblastic anemias RBcs small or large?

A

large with a decreased lifespan and few in number

52
Q

where is vit B 12 absorbed

A

terminal ileum

53
Q

Vit B 12 is only absorbed when in complex with what?

A

intrinsic factor which is secreted by parietal cells of gastric mucosa

54
Q

large store of vit B 12 is located where

A

liver

55
Q

are MMA and homocysteine increased or decreased with vit B 12 deficiency?

A

increased

56
Q

which is more specific MMA or homocysteine in vit B 12 deficiency?

A

MMA

57
Q

causes of Vit B12 deficiency

A

pernicious anemia, total gastrectomy (removes intrinsic factor), atropic gastritis, vegetarian diet, chronic alcoholism, sprue & celiac disease, resection of ileum

58
Q

what deficiency is seen with myeloproliferative disorders, liver disease & bacterial overgrowth syndrome?

A

Vit B12

59
Q

normal vit B12

A

100-700pg/ml

60
Q

pernicious anemia

A

inadequate production of intrinsic factor

61
Q

the presence of antiparietal cell antibodies does not rule in what?

A

do not rule in pernicious anemia

62
Q

s/s of vit B12 deficiency

A

hypoxemia, premature grey hair, vitiligo, low BP, lemon colored skin, low grade fever, yelloe-blue color blindness

63
Q

early neurologic signs of vit B12 deficiency

A

inability to preform fine movements, Loss of vibratory sense

64
Q

progressive neurologic signs of vit B12 deficiency

A

paresthesias (numbness & tingling), weakness, uncoordination, ataxia, personality changes

65
Q

late neurologic signs of vit B12 deficiency

A

urinary/fecal incontinence, spastic paralysis, confusion psychosis

66
Q

vit B 12 deficiency lab values

A

macrocytic (increased MCV), normochromic (normal amount of Hgb), decreased B12

67
Q

folic acid deficiency causes

A

alcohol use, pregnancy, certain folic acid antagonists

68
Q

folic acid deficiency lab values

A

macrocytic (increased MCV), normochromic (normal amount of Hgb), decrease in serum folate

69
Q

do you have neurologic symptoms with folic acid deficiency?

A

no

70
Q

treatment for folic acid deficiency

A

1mg daily for 1-4 months

71
Q

what else do you test when looking at folate (folic acid)deficiency

A

B12 deficiency

72
Q

causes of aplastic anemia?

A

radiation, chemo, tumor cells, myelodysplatic syndromes

73
Q

normocytic anemia

A

anemia in which RBC are normal

74
Q

Normocytic anemia examples

A

aplastic, cut blood loss, anemia of inflammation, hemolytic anemia, hemoglobinopathies

75
Q

s/s of aplastic anemia

A

hypoxemia, decreased bone marrow, decreased WBC & PLT

76
Q

what is most important treatment for chronic anemia?

A

treat the cause!

77
Q

anemia with inflammation (normocytic anemia example) is seen with what problems?

A

malignancy, chronic infection or inflammation

78
Q

therapy for anemia of inflammation?

A

no known therapy

79
Q

what other diseases are associated with anemia of inflammation?

A

renal insufficiency, liver disease, chronic inflammation, Endocrinopathies, acute bacterial infection, ICU pts

80
Q

Hemolytic anemia ( Normocytic anemia example) that is inherited causes

A

sickle cell, thalassemia, G6PD

81
Q

Hemolytic anemia (Normocytic anemia example) that is acquired causes

A

drugs-sulfas, infection, transfusion rxn

82
Q

s/s of Hemolytic anemia (normocytic anemia example )

A

hypoxemia, jaundice, splenomegaly, organ damage, hepatomegaly

83
Q

treatment for hemolytic anemia (normocytic anemia example)

A

increase fluids, steroids, remove spleen, oxygen therapy

84
Q

what does a direct coombs test looks for?

A

antibodies attached to RBCs

85
Q

what is a direct coombs test used for?

A

to confirm a diagnoses of hemolytic anemia

86
Q

what does an indirect coombs test look for?

A

presence of antibodies in the patients serum

87
Q

what is a indirect coombs test used for?

A

to screen for Rh factor

88
Q

Hemoglobinuria definition and when is it elevated?

A

excretion of free hemoglobin in urine–its elevated if hemolysis is intravascular

89
Q

Bilirubin

A

made from hemoglobin which is carried to liver to be excreted

90
Q

sickle cell anemia is what kind of genetic order

(recessive/dominant?

A

autosomal recessive disorder

91
Q

autosomal

A

any chromosome other than the sex (X& Y)

92
Q

sickle cell anemia has what kind of abnormal hemoglobin?

A

hemoglobin S

93
Q

life span of a sickle cell

A

15-20 days

94
Q

what makes a sickle cell anemia pt symptomatic?

A

hypoxia
dehydration
acidosis

95
Q

Hgb F in sickle cell pts

A

don’t have a problem with sickling until 6 months of age

96
Q

why is sickle cell anemia painful?

A

blood vessels become occluded

97
Q

sickle cell anemia complications

A 
stroke
splenic sequestration
avascular necrosis
aplastic crisis
 cardiomegaly(enlarged heart)
98
Q

aplastic crisis in sickle cell anemia

A

bone marrow shuts down and pt becomes anemic

99
Q

what is used to confirm sickle cell anemia?

A

hemoglobin electrophoresis, increase in bilirubin

100
Q

hemoglobin electrophpresis

A

looking for hemoglobin S

101
Q

Hereditary Spherocytosis anemia is what kind of genetic disorder? (recessive or dominate?

A

autosomal dominate hemolytic anemia

102
Q

s/s polycythemia vera

A

purplish skin, mucous membranes very red, bloodshot eyes, splenomegaly (huge spleen)

103
Q

treatment for polycythemia vera

A

bloodletting, radiation

104
Q

polycythemia vera

A

overproduction of RBCs

105
Q

If Iron stores are decreased what happens to Transferrin levels?

A

increase

106
Q

If Iron stores are increased what happens to Transferrin levels?

A

decreased

107
Q

Total Binding Capacity

A

The amount transferrin in the blood, this is increased because your body tries to compensate by making more iron carrying capacity

108
Q

Serum ferritin and will this be increased or decreased in iron deficiency anemia?

A

iron stores; decreased

109
Q

RBC

A

cytotic

110
Q

Hgb

A

chromic

Patho (20 decks)

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