Hematology Week 1: Introduction to Anemia Flashcards
The mature Red Blood Cell is ___% hemoglobin
95%
Anemia Definition
Reduction of total mass of circulating red cells below normal limits
Identify
Symptoms of Anemia
5 listed
- Fatigue
- Dizziness
- Headache
- Shortness of breath
- Pallor
The amount of oxygen delivered by the blood is monitored by?
the kidney
if levels are low then the kidney will release EPO
Erythroid Maturation Sequence
ways to identify a reticulocyte?
3 listed
The presence of adequate reticulocytes indicates?
That the bone marrow production of red blood cells is intact
Identify
Identify Reticulocytes
Question 1
C
Increased reticulocyte count
Causes of Anemia
3 listed
- Acute Bleeding
- Decreased production of RBCs in the bone marrow
- Decreased survival of RBCs in the blood
Causes of decreased RBC production in the BM
2 listed
Issues with
- Nuclear maturation
- Cytoplasmic maturation
Question 2
Macrocytic cells
Question 3 & 4
- microcytic cells
- increased pallor (hypochromic)
Hypochromic meaning
Pale color
Question 5
A
Decreased MCV
and
Decreased MCHC
Hemolysis Definition
Premature destruction of RBCs
Extrinsic anemia example immune hemolysis
antibodies to RBC cell surface causes the RBCs destruction
Extrinsic anemia example fragmentation hemolysis
microangiopathic hemolytic anemia
Schistocytes
RBC fragments
Intrinsic Hemolysis Examples
4 listed
Free Hemoglobin is ______ to the body
Toxic
Haptoglobin
binds to free hemoglobin
Haptoglobin bound to free hemoglobin is then processed by?
Macrophages into unconjugated bilirubin (can cause jaundice)
Unconjugated bilirubin can cause
Jaundice
Unconjugated bilirubin is taken up by?
by the liver and is then conjugated and then is excreted into the bile and can then be excreted
When there is excess free hemoglobin intravascularly that cannot be bound by haptoglobin
the excess free hemoglobin reaches the kidney where it is filtered out into the urine causing hemoglobinuria and urine hemosiderin which is the deposition into the parenchyma
LDH results from
free hemoglobin intravascularly from intravascular hemolysis
LDH AKA
Lactate dehydrogenase
Extravascular hemolysis is?
hemolysis occurring outside of a vessel
Common site of Extravascular hemolysis
Spleen
Extravascular hemolysis in the spleen
- macrophages in the spleen pick up abnormal RBCs
- unconjugated bilirubin is produced
- Spherocytes produced from parts eaten away from macrophages
- A little bit of free hemoglobin and a little bit of LDH but not as much as from intravascular hemolysis
*
Spherocytes are produced by?
nibbling of macrophages taken some membrane and cytoplasm making small RBCs
How to differentiate intravascular and extravascular hemolysis
6 listed
Measure
- LDH
- unconjugated bilirubin
- haptoglobin level in the blood
- see if the patient is jaundiced
- do we see schistocytes or spherocytes
- hemoglobinuria
Question 6
A
Haptoglobin
because it will bind free hemoglobin
Unconjugated Bilirubin AKA
Indirect Bilirubin
As RBC reach end of lifespan
- is not as deformable and gets stuck in splenic sinuses
- gets gobbled up by macrophages
