Hematopathology Flashcards

1
Q

hematopathology is the study of what

A

diseases of res blood cells, white blood cells and coagulated disorders

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2
Q

what is hematopoiesis?

A

process of stem cells coming from the bone marrow to make blood cells

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3
Q

what is hemoglobin?

A

hemoglobin is the gram percentage of red blood cells in blood

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4
Q

what is hematocrit?

A

the percentage of red blood cells in blood

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5
Q

when should you be worried about the hemoglobin range?

A

7g or lower patient should not be moved out of the bed

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6
Q

anemia is?

A

shortage of red blood cells

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7
Q

what are three mechanisms of anemia

A
  • blood loss
  • decreased production of RBC
  • increased destruction of RBC- hemolysis
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8
Q

what is the morphology of anemia?

A

-reticulocyte count
high count= bone marrow is responding to anemia by producing more rbc
low count= production problem
size of RBC
amount of hemoglobin (Hb)

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9
Q

what are reticulocytes?

A

immature RBCs - In the process of erythropoiesis, develop and mature in the bone marrow, circulate for about a day in the blood stream before developing into mature red blood cells

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10
Q

must know: what numbers of a MCV make a microcyte

A

mcv <80fL

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11
Q

must know: what numbers of a MCV make a macrocyte

A

MCV> 95 fL

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12
Q

what is MCV

A

mean cell volume
it is the measure of average volume of RBCs

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13
Q

what does MCH mean

A

mean cell hemoglobin

it is a measurement of the average weight of hemoglobin in individual erythrocytes

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14
Q

what does MCHC mean?

A

mean cell hemoglobin concentration

it is the average concentration of hemoglobin in erythrocytes

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15
Q

must know: what is a normal MCH level?

A

30 picograms

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16
Q

must know: what is a normal MCV level?

A

90 fL or 90u3

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17
Q

must know: what is a normal MCHC level?

A

30 gram/100ml of RBC

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18
Q

what is the mechanism of aplastic anemia

A

bone marrow failure

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19
Q

what is the mechanisms of anemia in reference to blood loss?

A

Acute – trauma
Chronic – bleeding from GI pathology or menstruation

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20
Q

what is the mechanisms of anemia in reference to decreased production of RBC?

A

-Disturbance of stem cells
-Defective heme production
-Defective DNA production
-Destruction of bone marrow

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21
Q

what is the mechanisms of anemia in reference to increased destruction of RBC due to external factors?

A

Autoimmune
Trauma
Infection

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22
Q

what is the mechanisms of anemia in reference to Increased Destruction of RBCs due to Hereditary Internal Factors?

A

Hemoglobin structural abnormality
Enzyme deficiencies

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23
Q

what is the normal shape of red blood cells

A

Round, biconcave, flexible

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24
Q

what shape is a spherocyte shaped red blood cell?

A

sphere shaped RBC vs round

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25
Q

what shape is a schistocytes shaped red blood cell?

A

fragmented red blood cells that can take on different shapes

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26
Q

what is the adaptation that occurs with target cells?

A

an abnormal form of red blood cell which appears as a dark ring surrounding a dark central spot, excessive cell membrane & reduced hemoglobin

27
Q

what is the adaptation that occurs with skickle cells?

A

an inherited form of anemia — a condition in which there aren’t enough healthy red blood cells to carry adequate oxygen throughout your body

28
Q

what is the adaptation that occurs with Rouleaux cells?

A

stacks or aggregations of red blood cells (RBCs) that form because of the unique discoid shape of the cells in vertebrates. The flat surface of the discoid RBCs gives them a large surface area to make contact with and stick to each other

29
Q

clinical presentation of anemia

A
  • pale skin
  • fatigue
  • chest pain
  • syncope
  • dizziness
  • dyspnea or exertion
30
Q

Must know: what component is the functional unit for oxygen carry ing RBC?

A

heme

31
Q

what is the normal amount of Hbg to RBC

A

~280 Million Hbg per 1 RBC

32
Q

1 hbg is how many globuluin chains?
how many globulin Chans are heme units?
how 4 heme units make how many oxygen carrying molecules?

A

1 Hbg = 4 globulin chains = 4 Heme/Iron = 4 Oxygen Molecule

33
Q

what is hemoglobin?

A

Protein molecule in red blood cells that carries oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues back to the lungs.

34
Q

what is hypochromaic anemia

A

a generic term for any type of anemia in which the red blood cells (erythrocytes) are paler than normal

hypo- less chromic- color

35
Q

what is the most common cause of microcytic anemia

A

iron deficiency

36
Q

what are the causes of iron deficient anemia

A

GI Hemorrhage ➔ chronic blood loss
Menstruation➔ blood loss and/or decreased production of RBC
Dietary ➔ Iron Deficiency, malabsorption of iron, or increased demands

37
Q

what are the findings with blood analysis in an individual with microcytic anemia

A

Decreased ferritin ➔ storage form of iron
Decreased serum iron
Decreased iron in bone marrow biopsy

38
Q

what is the morphology of red blood cells with microcytic anemia

A

Pale appearance of RBC due to reduction and quality of hemoglobin ➔ size and distribution

39
Q

what are some examples of chronic disease anemia?

A

neoplasms, autoimmune conditions or chronic infections

40
Q

what does deficiency in iron look like in chronic disease?

A

Typically iron storage levels are elevated ➔ unable to transfer iron storage form to hemoglobin due to elevated levels of immune system mediators (interlueukin-1, tumor necrosis factor)

41
Q

what is macrocytic anemia?

A

usually large red blood cells with low hemoglobin levels

MCV>95fL

42
Q

what is the mechanism of hemolytic anemia

A

Congenital or Internal Factors ➔ enzyme deficiencies, defects of RBC cytoskeleton
Acquired or External Factors ➔ Antibody-induced

43
Q

what does hemolysis mean

A

red blood cells are destroyed faster than they can be made

44
Q

all hemolytic anemias will have

A
  1. increased RBC destruction
  2. increased erythropoiesis
  3. increased iron deposition in tissues
    mainly noticed in the spleen and liver
45
Q

A patient has
RBC: 3.7X106/UL
hB: 8.0G/DL
mcv: 62 Fl
MCH: 19 pg

A

microcytic hypochomic anemia

46
Q

what is seen as a cause of hereditary destruction of RBCs

A
  1. defects in the cytoskeleton- spherocytosis is most common
  2. structurally abnormal hemoglobins - sickle cell anemia
  3. enzyme defines - glucose-6 phosphate dehydrogenase
47
Q

what is the genetic percentage of hereditary spherocytosis

A

75% are autosomal dominant

48
Q

what are the clinical manifestations of hereditary spherocytosis

A

mild anemia
jaundice- due to hemolysis
gallstones

49
Q

why does hemoglobin become sticky?

A

valine is hydrophilic and can cause the hemoglobin to become sticky

50
Q

what is the mutation in sickle cell anemia

A

Mutation➔ Valine is exchanged for glutamic acid in the globulin chain within hemoglobin ➔ point mutation leaves abnormal valine

51
Q

what may cause abnormal hemoglobin in sickle cell anemia

A

Abnormal hemoglobin ➔ valine has replaced glutamic acid causing the hemoglobin to become less soluble ➔ results in crystal formation that distort the red blood cells into a sickle shape

52
Q

Hereditary enzyme deficiencies: g6pd deficiency has what inheritance pattern?

A

x-linked recessive

53
Q

what is the mutation in Hereditary enzyme deficiencies: g6pd deficiency

A

RBC unable to regenerate glutathione due to reduced G6PD which is needed in NADP/NADPH cycle

54
Q

how can exercise help acute anemia

A

temporary result of an injury or disease process or may need ongoing treatments to maintain an adequate supply of oxygen in the blood stream

55
Q

how can exercise help chronic anemia

A

long term maintenance

56
Q

what are some signs a patient may experience when exercising with anemia

A

Clients with anemia may experience fatigue, dyspnea, and weakness, which will limit their daily activities.

57
Q

Under normal conditions, hematocrit composes approximately what percentage of whole blood?

A

45%

58
Q

talk about more of the changes that occur to not exercising when a patient has anemia?

A

limited mobility
secondary reconditioning on cardiovascular and nueromusculosketal systems

59
Q

anemia is defined by hemoglobin levels of

A

<12 g/100 dL for females
<14 g/100 dL for males

be causes at 9 and the threshold for getting out of the bed is 7.

60
Q

complete blood counts should be

A

Men 4.5 – 5.9 million cells/mcL
Women 4.1 – 5.1 million cells/mcL

61
Q

counts of red blood cells indices?

A

MCV should be 80 to 95 femtoliters
MCH should be 27 to 32 picograms per cell

62
Q

what vitamin can stimulate RBC production

A

Vitimin b12

63
Q

recommended baseline testing for patients with anemia is?

A

submax testing

64
Q

what is the FITT principle for exercise dosing a patient with anemia

A

Frequency: Daily as tolerated
Intensity: Low levels
Time: Short durations, 10–20-minute bouts with rest periods
Type: Walking, cycling, arm ergometer, and aquatic activities