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Hematology > Ineffective and Insufficient Erythropoiesis > Flashcards

Ineffective and Insufficient Erythropoiesis Flashcards

1
Q

It is the term used for marrow erythroid proliferative activity

A

Erythropoiesis

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2
Q

Normal erythropoiesis occurs in bone marrow and is under the control of the hormone _____________ (produced by the kidney) and other growth factors and cytokinesis

A

erythropoietin

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3
Q

refers to the production of erythroid precursor cells that are defective

A

Ineffective erythropoiesis

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4
Q

defective precursors often undergo _________________ (programmed cell death) in the bone marrow before they have a chance to mature to the reticulocyte stage and be released into the peripheral circulation

A

apoptosis

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5
Q

It is an impaired deoxyribonucleic acid [DNA] synthesis as a result of vitamin B12 or folate deficiency

A

megaloblastic anemia

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6
Q

It is a deficient globin chain synthesis

A

thalassemia

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7
Q

It is a deficient protoporphyrin synthesis

A

sideroblastic anemia

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8
Q

Several conditions such as megaloblastic anemia, thalassemia, and sideroblastic anemia involve _____________________ as a mechanism of anemia

A

ineffective erythropoiesis

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9
Q

When peripheral blood hemoglobin concentration
is low, it triggers an increase in ____________________ leading to increased erythropoietic activity

A

erythropoietin production

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10
Q

refers to a decrease in the number of erythroid precursors in the bone marrow, resulting in decreased RBC production and anemia

A

Insufficient erythropoiesis

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11
Q

Factors that can lead to a decreased RBC production

A
  1. deficiency of Iron (inadequate intake, malabsorption, excessive loss from chronic bleeding)
  2. deficiency of erythropoietin (renal disease)
  3. loss of the erythroid precursors as a result of an autoimmune reaction (aplastic anemia, acquired pure red cell aplasia) or infection (parvovirus B19)
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12
Q

Erythropoiesis can also be suppressed by ___________

A

infiltration of the bone marrow space with leukemia
cells or with nonhematopoietic cells (metastatic tumors, granulomas, or fibrosis)

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13
Q

________________ with characteristic teardrop RBCs are formed with nonhematopoietic cells

A

myelophthisic anemia

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14
Q

Anemia can also develop as a result of ____________ (such as a traumatic injury) or _____________ (such as an intermittently bleeding colonic polyp)

A

acute blood loss. chronic blood loss

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15
Q

Increased hemolysis results in a shortened _____________, thus increasing the risk for anemia

A

RBC life span

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16
Q

Chronic blood loss induces ____________ as a cause of anemia

A

iron deficiency

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17
Q

With ________________, the bone marrow takes a few days to increase production of RBCs

A

acute blood loss and excessive hemolysis

18
Q

A complete blood count (CBC) is performed using an ________________ to determine the RBC count, hemoglobin concentration, hematocrit, RBC indices, white blood cell count, and platelet count to detect the presence of anemia.

A

automated blood cell analyzer

19
Q

The RBC indices include the ________________.

A

mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC)

20
Q

The most important in the RBC indices is the _______________, a measure of the average RBC volume in femtoliters.

A

MCV

21
Q

It is an index of variation of cell volume in an RBC population

A

red cell distribution width (RDW)

22
Q

An RBC volume frequency distribution curve with the relative number of cells plotted on the ordinate and RBC volume (fL) on the abscissa

A

RBC histogram

23
Q

Reading RBC histogram:
In healthy individuals the distribution is ______________.

A

In healthy individuals the distribution is approximately Gaussian

24
Q

Reading RBC histogram:
Abnormalities include a shift in the curve to the _____________ (smaller cell population or microcytosis) or to the __________ (larger cell population or macrocytosis)

A

left, right

25
Q

It is the coefficient of variation of RBC volume expressed as a percentage

A

RDW

26
Q

It indicates the variation in RBC volume within the population measured

A

RDW

27
Q

An increased RDW correlates with

A

anisocytosis (variation in RBC diameter) on the peripheral blood film

28
Q

It serves as an important tool to assess the bone marrow’s ability to increase RBC production in response to an anemia

A

reticulocyte count

29
Q

young RBCs that lack a nucleus but still contain residual ribonucleic acid (RNA) to complete the production of hemoglobin

A

reticulocytes

30
Q

Reticulocyte count is determined by ________________

A

multiplying the percent reticulocytes by the RBC count

31
Q

A patient with a severe anemia may seem to be producing ___________ numbers of reticulocytes if only the percentage is considered

A

increased

32
Q

There are how many successive corrections that are made to the reticulocyte count to obtain a better representation of RBC production

A

2

33
Q

To obtain a corrected reticulocyte count, one corrects for the degree of anemia by ___________

A

multiplying the reticulocyte percentage by the patient’s hematocrit and dividing the result by 45 (the average normal hematocrit)

34
Q

It is a better indication of the rate of RBC production than is the corrected reticulocyte count.

A

reticulocyte production index (RPI)

35
Q

state-of-the-art automated blood cell analyzers determine the fraction of immature reticulocytes among the total circulating reticulocytes, called the _____________

A

immature reticulocyte fraction (IRF)

36
Q

It is helpful in assessing early bone marrow response
after treatment for anemia

A

IRF

37
Q

Plays a crucial role in determining whether an anemia is due to an RBC production defect or to premature hemolysis and shortened survival defect

A

Analysis of the reticulocyte count

38
Q

If there is shortened RBC survival, as in the hemolytic anemias, the bone marrow tries to compensate by increasing RBC production to __________ into the peripheral circulation

A

release more reticulocytes

39
Q

Although an increased reticulocyte count is a hallmark
of the hemolytic anemias, it can also be observed after __________________

A

acute blood loss

40
Q

Chronic blood loss does not lead to an appropriate increase in the reticulocyte count, but rather leads to _____________________________________

A

iron deficiency and a subsequent low reticulocyte count

41
Q

An inappropriately low reticulocyte count results from _____________________

A

decreased production of normal RBCs

Hematology (6 decks)

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