Hemeonc 2

Question 1

Genetic disorder where the RBC’s cannot make either the alpha chain or the beta chain of hemoglobin resulting in less hemoglobin per RBC

Answer 1

Thalassemia

Question 2

What is the term for lots of “bands” in the peripheral blood smear? and what does it indicate?

Answer 2

“left shift”, indicates severe bacterial infection because the body is rapidly producing more neutrophils and “bands” are the immature neutrophils.

Question 3

RBC’s that have decreased amounts of hemoglobin and appear pale, and washed out on smear

Answer 3

Hypochromic

Question 4

Causes of microcytic anemia:

Answer 4

THALASSEMIA! IRON DEFICIENCY ANEMIA, Also lead poisoning, sideroblastic anemia

Question 5

Causes of macrocytic anemia:

Answer 5

hypothyroidism, chemo, MDS (myodysplastic syndrome, aka preleukemia), hemolysis with reticulocytosis, megaloblastic anemia

Question 6

Causes of normocytic anemia

Answer 6

acute blood loss, chronic disease, hypersplenism, bone marrow failure, hemolysis

Question 7

What population is most affected by Thalassemia?

Answer 7

Asians, Africans, Mediterraneans

Question 8

What is most common anemia? What would those labs look like?

Answer 8

Iron deficiency.
LOW: iron, ferritin, %sat, MCV
HIGH: transferrin, TIBC, RDW

Question 9

Causes for iron deficiency anemia (IDA)

Answer 9

blood loss (menses, ulcers, GI bleed)
Poor iron intake (less common in USA--from pregnancy, malabsorption, gastric bypass)

Question 10

First priority for management of IDA? Second?

Answer 10

1) Eval for blood loss

2) Replace iron

Question 11

What thalassemia is incompatible with life

Answer 11

Alpha Thal Major. alpha chain production problem (excess beta chains)

Question 12

What is treatment of Beta Thal major

Answer 12

lifelong transfusions. beta chain production problem (normal alpha chains)

Question 13

What does lead do to RBC’s? What does it look like on a PBS? How is it treated?

Answer 13

1) Impairs ability to produce heme
2) Basophilic stippling
3) Eliminate source of lead, chelation therapy

Question 14

Rare disorder of hematopoietic stem cells and defective heme synthesis. This disorder sometimes looks like IDA (iron def anemia)

Answer 14

Sideroblastic anemia

Question 15

How do you distinguish b/t Sideroblastic anemia and IDA?

Answer 15

sideroblastic anemia will have high ferritin and serum iron

Question 16

What is your diagnosis if you have a microcytic anemia with a low ferritin

Answer 16

IDA

Question 17

This is a condition associated with the development of abnormal, dilated, blood vessels within the wall of the bowel that bleed easily

Answer 17

Angiodysplasia

Question 18

The mechanism for ___________ appears to be a defect in the ability of the body to deliver iron from storage sites to the bone marrow where it can be used for RBC production

Answer 18

Anemia of Chronic Disease

Question 19

glycoprotein required for normal absorption of B12 by the ileum

Answer 19

Intrinsic factor