Hematology, TBP Flashcards
Most important RBC index
MCV
Mechanism of anemia in an enlarged spleen
Increased sequestration
Mechanism of anemia: Hereditary spherocytosis
Defect in cytoskeleton
Mechanism of anemia: Paroxysmal nocturnal hemoglobinuria
Phosphatidylinositol glycan A (PIGA, needed for synthesis of glycosylphosphatidylinositol or GPI that anchors CD55 and CD59 that degrade complement) is lost, hence RBC is more prone to lysis by complement
CD55 is aka
Decay accelerating factor (DAF)
CD59 is aka
Membrane inhibitor of reactive lysis
Complication of PNH
Venous thrombosis
Organs most susceptible to venous thrombosis in PNH
1) Hepatic
2) Portal
3) Cerebral
Organs involved in extravascular hemolysis
1) Spleen
2) Liver
Complications of extravascular hemolysis
1) Hemosiderin deposition
2) Gallstones
3) Jaundice
Jaundice and gallstones in extravascular hemolysis is due to
Elevated unconjugated bilirubin
Complications of intravascular hemolysis
1) Unconjugated hyperbilirubinemia (jaundice and gallstones)
2) Hemoglobinemia
3) Hemoglobinuria
4) Hemosiderinuria
Hemoglobinemia causes what renal disease
ATN
Cell-associated condition: Spherocytes (2)
1) Hereditary spherocytosis
2) Immune hemolysis
Cell-associated condition: Schistocytes (2)
1) Microangiopathic hemolytic anemia (TTP)
2) HUS
Cell-associated condition: Target cells (2)
1) Hemoglobinopathies
2) Obstructive liver disease
Cell-associated condition: Teardrop cells
Myelofibrosis
Cell-associated condition: Rouleaux formation (2)
1) Increased glob ins (MM)
2) Decreased albumin
Corrected reticulocyte count
Reticulocyte count x Hct / Normal Hct
Decreased reticulocyte count is seen in
1) Primary bone marrow disorder
2) Iron deficiency
3) Vitamin B12 or folate deficiency
Increased reticulocyte count is seen in
1) Hemolysis
2) Blood loss
IDA: Ferritin
Decreased
IDA: Serum iron
Decreased
IDA: TIBC
Increased
IDA: Transferrin saturation
Decreased
Thalassemia: Ferritin
Normal
Thalassemia: Serum iron
Normal
Thalassemia: TIBC
Normal
Thalassemia: Transferrin
Normal
Anemia of chronic disease: Ferritin
Increased
Anemia of chronic disease: Serum iron
Decreased
Anemia of chronic disease: TIBC
Decreased
Anemia of chronic disease: Transferrin saturation
Increased
IDA: MCV
Microcytic
Anemia of chronic disease: MCV
Microcytic
Mechanism of IDA in pregnancy
Increased demands
Ratio of serum iron to TIBC
Transferrin saturation
Normal transferrin saturation
> 20%
RBC morphology-associated anemia: Pencil cells
IDA
Deficient production of Hgb due to mutation or complete loss of a glob in chain
Thalassemia
Condition due to complete loss of one or more of the four copies of the α-globulin chain gene
α-Thalassemia
