Hematopoiesis (Part II)

Question 1

What are the components of plasma?

Answer 1

it is the liquid portion of blood; water, proteins, electrolytes, and hormones

Question 2

what is the buffy coat?

Answer 2

the WBCs and the platelets

Question 3

What is serum?

Answer 3

the liquid portion of the clotted blood; there is no fibrinogen and it lacks clotting factors

Question 4

What is pancytopenia?

Answer 4

a decrease of all cell lines (RBCs, platelets, WBCs)

Question 5

what is absolute number?

Answer 5

the actual number of cells in a sample, not just a percentage

Question 6

What does MCV stand for?

Answer 6

mean corpuscular volume

Question 7

what is the MCV? and what is it important for?

Answer 7

the average volume of a red blood cell; important when you are trying to determine what type of anemia a patient has

Question 8

What is the MCV value for microcytic anemia?

Answer 8

MCV less than 80

Question 9

what is the MCV value for normocytic anemia?

Answer 9

80-100

Question 10

what is the MCV value for macrocytic anemia?

Answer 10

greater than 100

Question 11

What does MCHC stand for?

Answer 11

mean corpuscular hemoglobin concentration

Question 12

What does the MCHC calculate?

Answer 12

the concentration of hemoglobin in a given volume

Question 13

what is the hemoglobin concentration in a normal RBC?

Answer 13

about 1/3 the cell

Question 14

what if we have increased central pallor?

Answer 14

hypochromia

Question 15

what if we have decreased central pallor?

Answer 15

hyperchromia (we have a higher concentration of HGB)

Question 16

what does the RPI stand for?

Answer 16

reticulocyte production index

Question 17

what does the RPI calculate?

Answer 17

the reticulocyte count based on the current RBC volume

Question 18

what if you have an increased RPI?

Answer 18

there is increased RBC destruction happening

Question 19

what if you have a decreased RPI?

Answer 19

there is an issue with the production of RBCs

Question 20

what is anisocytosis?

Answer 20

variation in size; increased RDW (red cell distribution width)

Question 21

what is poikilocytosis?

Answer 21

variation in shape

Question 22

what is the likely diagnosis of a patient with anemia- microcytic hypochromic?

Answer 22

iron deficiency anemia

Question 23

What are some signs of symptoms of iron deficiency anemia? (7)

Answer 23

fatigue, weakness, headaches, dizziness, pale, irregular heartbeats, SOB

Question 24

3 causes of iron deficiency anemia?

Answer 24

1) dietary lack of iron or decreased absorption 2) impaired absorption 3) chronic blood or iron loss

Question 25

what could cause impaired absorption of iron?

Answer 25

sprue, partial gastrectomy (acid increases solubility and uptake)

Question 26

What could cause chronic blood loss or iron loss?

Answer 26

tumor, ulcer, menometrorrhagia, extreme distance running

Question 27

When should iron deficiency anemia be suspected?

Answer 27

if there is hypochromic microcytic anemia with an elevated RDW but no consistent shape changes in RBC

Question 28

anytime someone is thought to have anemia, what should be done first?

Answer 28

CBC and reticulocyte count

Question 29

if a person is diagnosed with anemia, what should be done next?

Answer 29

look at MCV

Question 30

after looking at laboratory values, what should be done next when diagnosing a patient with anemia?

Answer 30

examination of the peripheral smear to confirm diagnosis

Question 31

what are three causes of microcytic anemia?

Answer 31

iron deficiency, thalassemia, anemia of chronic disease

Question 32

what could cause normocytic anemia with a low reticulocyte count?

Answer 32

renal failure, anemia of chronic disease, marrow failure, aplastic anemia, leukemia/metastasis

Question 33

what could cause normocytic anemia with a high reticulocyte count?

Answer 33

sickle cell anemia, G6PD deficiency, hereditary spherocytosis, autoimmune hemolytic anemia

Question 34

what could cause macrocytic anemia?

Answer 34

megaloblastic anemia due to B12 or folate deficiency; alcoholic liver disease

Question 35

What is marked erythroid hyperplasia?

Answer 35

anemia caused by increased red cell loss or reduced red cell life span–> generates elevated reticulocyte counts in the peripheral blood and erythroid hyperplasia in the bone marrow

Question 36

what is the normal myeloid: erythroid ratio? (M:E ratio)

Answer 36

2:1 to 4:1

Question 37

what is the M:E ratio seen in cases of erythroid hyperplasia?

Answer 37

it decreases as the erythroid precursors begin to predominate over the myeloid precursors

Question 38

what are 5 examples of diseases that cause marked erythroid hyperplasia?

Answer 38

sickle cell anemia, G6PD deficiency, Beta Thalassemia, hereditary spherocytosis, autoimmune hemolytic anemia

Question 39

What cause of microcytic anemia has an increased reticulocyte count?

Answer 39

Thalassemia

Question 40

in cases of severe and chronic anemia where red blood cell destruction is taking place and erythropoietin is elevated, not only are reticulocytes being released into the peripheral blood but sometimes what else?

Answer 40

even more early precursors can be seen such as nucleated red blood cells

Question 41

besides severe anemia and chronic hypoxemia, what else could cause the release of nucleated RBCs?

Answer 41

hyposplenia and asplenia

Question 42

besides trauma, what could cause asplenia?

Answer 42

sickle cell anemia–> leads to autosplenectomy