Intro To Anaemia Flashcards

1
Q

Anaemia can be described as a

1)decrease in ____________
2) decrease in ___________
3)decrease in ____________
4)decrease in ____________
5)decrease in ____________

A

Red cell mass

Oxygen carrying capacity of the blood

Hb conc of the blood

Pcv of the blood
Red cell count of that blood

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2
Q

In adult male, oxygen delivery is impaired when Hb conc is less than _________

In adult female , oxygen delivery is impaired when Hb conc is less than _________

A

13g/dl

12g/dl

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3
Q

In children between 6-14 of both sexes, oxygen delivery is impaired when Hb conc is less than _________

A

12g/dl

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4
Q

In children between 30days- 6yrs of both sexes, oxygen delivery is impaired when Hb conc is less than _________

A

11g/dl

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5
Q

In children between 0-30days of both sexes, oxygen delivery is impaired when Hb conc is less than _________

A

13.5g/dl

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6
Q

1g of Hb would bind to ____ml of oxygen

A

1.34

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7
Q

Hb conc of 15g/dl would contain ____ml of oxygen

Meaning that,

For every ____ml of blood, there is __g of Hb
Which means that for every ____ of blood, ___ml of oxygen

A

20-1

100;15
100;20.1

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8
Q

___ml = 1dl

A

100

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9
Q

Hb conc of 10g/dl would contain ____ml of oxygen

A

13.4

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10
Q

Oxygen tension of blood is the __________

A

Amount of oxygen present in 100ml of blood

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11
Q

Normal oxygen tension of blood is _______

A

20 volume %

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12
Q

With decrease in Hb conc of blood, oxygen tension of blood __________

A

reduces

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13
Q

When oxygen tension of blood is 20volume% , the partial pressure of oxygen in the blood is ____mmHg

A

100

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14
Q

When the oxygen tension of blood is 15volume%, the partial pressure of the blood is only ____mmHg

A

40

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15
Q

Arterial blood has oxygen tension of _____ and partially pressure of ——-

Venous blood has oxygen tension of _____ and partially pressure of ——-

A

20; 100

15; 40

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16
Q

In terms of oxygen tension, the arteriovenous difference sub??

A

5volume%

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17
Q

4 Physiological adaptations of Anaemia

1)modulation of ______
2)_______ mechanism/______ mechanism
3)________ of blood flow from___ to ____
4)Mechanism to widen the narrowed ________ by bringing down the ____

A

Hb’s Oxygen affinity
Cardiovascular adaptive/compensatory
Redistribution;less o2 sensitive organs to more o2 sensitive organs

Arteriovenous oxygen difference ; venous oxygen blood tension

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18
Q

Modulation of Hb’s oxygen binding affinity

By oxygen affinity Hb, we mean the ____/_____ with which Hb binds/complexes with oxygen

A

Avidity
Tenacity

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19
Q

The normal haemoglobin is created in such a way that under ___ partial pressure of oxygen , it avidly combines with oxygen and under ____ partial pressure of oxygen, it readily parts with oxygen

A

high

low

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20
Q

High oxygen affinity haemoglobin

They bind with oxygen at _________ partial pressure and ____________

A

High and low

Do not part with oxygen

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21
Q

Low oxygen affinity haemoglobin bind with oxygen at _________ partial pressure of oxygen

A

Only very high

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22
Q

Low oxygen affinity haemoglobin readily picks up oxygen from the lungs

T/F

A

F

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23
Q

In anaemic conditions , the love of oxygen by normal haemoglobin is (increased or decreased?)

A

Decreased

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24
Q

Reduction of oxygen’s affinity by normal Hb is pathological

T/F

A

F

Physiological

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25
Q

In glycolytic/ _________ pathway, G3P is broken down to _____ which is broken down to _____ so as to generate ____ but ____ is not interested in doing that

A

Embden-Meyerhoff

1,3PG

3PG

Anaemic Rbc

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26
Q

Anemic rbc converts 1,3 DPG to ______ using _____ enzyme

A

2,3 DPG

1,3 DPG mutase

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27
Q

A proton is usually emitted when _____________ happens

A

Hb complexes with oxygen

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28
Q

HHb + o2 ——> ______ + ____

A

Hbo2-

H

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29
Q

Hbo2- is known as _______

A

Oxyhemoglobin

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30
Q

Oxyhemoglobin is found in the acidic or alkaline milleiu?

A

Acidic

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31
Q

The mechanism by which 1,3 DPG is converted to 2,3 DPG is called ____________ pathway or _________ shunt

A

Energy clutch

Rapoport lubering

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32
Q

Rapoport lubering shunt generates ATP

T/F

A

F

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33
Q

In Anaemic rbcs, Hb exists as ???

HHb or Hbo2-

A

HHb

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34
Q

________ stimulates 1,3 DPG mutase

A

Alkalinity of the cytoplasm of the anaemic rbc

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35
Q

2,3 DPG is that molecule that is capable of complexing with ____ and allow ____ to be ________at ______ partial pressure of oxygen and permits oxygen to be ____

A

Hb

O2
Detached from Hb
Low
Moved into the tissue

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36
Q

We say that ______________ is the most important adaptive mechanism to anemia

A

Generation of 2,3 DPG

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37
Q

The hypoxia of blood vessels results in ___________

A

Vascular dilatation

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38
Q

Hypoxia of blood vessels leads to ____eased peripheral resistance

A

Decr

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39
Q

The HR changes in anemia to as high as ___ or ____ bpm or more

A

90

100

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40
Q

In Anaemia, CO is affected

T/F

A

T

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41
Q

Cardiac output = ___ x ___

A

SV

HR

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42
Q

Normal

CO?
SV?
HR?

A

5L
70ml
72bpm

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43
Q

What is the oxygen carrying capacity of the normal CO of the body?

A

1000ml

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44
Q

Out of the 1000ml of oxygen that reaches the body at each pump,the body only requires about ____ml of oxygen per minute

A

250

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45
Q

Out of the essential 250ml of oxygen that the body needs per minute, the brain alone consumes about __ml of it, the heart consumes about __ml of it, while the muscle mass consumes about __ml of it

A

60

50

60

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46
Q

The oxygen sensitive tissues of the body includes the ____,_____, and ____

A

Heart
Brain
Skeletal muscle

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47
Q

Cardiovascular adaptive mechanism is equally vital as a survival mechanism as much as the modulation of Hb’s oxygen affinity

T/F

A

T

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48
Q

The cardiovascular adaptive mechanism has no energy implications

T/F

A

F
It does

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49
Q

The cardiovascular adaptive mechanism will easily fail if the Hb conc falls to the extreme

T/F

A

T

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50
Q

The failure of ______ is usually the cause of death in severe anaemic conditions

A

The cardiovascular adaptive mechanism

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51
Q

The cardiovascular adaptive mechanism is effective when the Hb conc is between ______ g/dl

A

7 and 8

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52
Q

With the Hb conc of ______ , the cardiovascular adaptive mechanism will fail

A

Less than 7g/dl

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53
Q

We define severe Anaemia in adults as Hb conc being ______because at this level , _________ would appear and at __________ the whole thing would fail

A

Less than 8g/dl

Features of failure of cardiovascular adaptive mechanism

7g/dl

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54
Q

In children less than ____ years, The cardiovascular adaptive mechanism may not fail until the Hb conc level is ____ or below

A

5

5g/dl

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55
Q

The feature of The cardiovascular adaptive mechanism is :

  1. Very high ________
  2. ______ failure
  3. _______ failure
A

Heart rate

Right ventricular heart

Left ventricular heart

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56
Q

Right ventricular heart failure usually manifests as:

  1. Raised ———-
    2.________/________
    3._______
  2. _____ dependent ______
A

Jugular venous pressure

Hepatomegaly/hepatoplenomegaly

Ascites

Gravity; leg edema

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57
Q

Ascites = excess ________

A

Abdominal fluid

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58
Q

Left ventricular heart failure results in _____ edema which basically ______ the anemic patient to death

A

Pulmonary

Chokes

59
Q

_____ murmurs in the lungs occurs as a result of Anaemia

A

Haemic

60
Q

The kidney requires ___ml of oxygen per minute to stay alive even though the blood delivered to it per minute is as much as ____ml but this su for the purpose of _____

A

4

100

Filtration

61
Q

In Anaemia, which is more,

Plasma or red cell mass?

A

Plasma

62
Q

If the cause of the anemia is not due to bone marrow failure , another adaptive mechanism is _________

A

Increase in erythropoiesis

63
Q

Anaemia is classified broadly into 2

1) ________ classification
2)___________ classification

A

Morphological
Etiological

64
Q

MORPHOLOGICAL CLASSIFICATION
3 types

1)________________
2)__________________
3)_______________

A

Macrocyctic normochromic
Microcytic hypochromic
Normocytic normochromic

65
Q

Macrocyctic normochromic

-Cell size is ________
-cell Hb content is ______
-impairment in ________ and not ________
-aka_________

A

Large
Normal
DNA synthesis; rna transcription
Megaloblastic Anaemia

66
Q

Microcytic hypochromic

-Cell size is ________
-cell Hb content is ______
-impairment in ________ and not ________

A

Small
Small
Heme synthesis; dna synthesis

67
Q

Normocytic normochromic

-Cell size is ________
-cell Hb content is ______
-usually associated with ______ disorders
-AKA __________

A

Normal
Normal
Chronic
Anaemia of chronic disorders

68
Q

ACD

_________

A

Anaemia of chronic disorders

69
Q

Etiological classification

1) Anaemia of _______ / _____ Anaemia
2) Anaemia of decreased _______/ ____ Anaemia
3)Anaemia of __________ failure

A

Blood loss; hemorrhagic

Cell survival; hemolytic

Bone marrow

70
Q

Hemorrhagic Anaemia can be either _____ or ______

A

Acute or chronic

71
Q

Commonest cause of acute hemorrhagic Anaemia is ____________

A

Ghastly road traffic accident

72
Q

Acute obstetric Hemorrhage : include obstetric conditions such as

1)______
2)______
3)_____
4)_________

A

Placenta previa
Abruptio placenta
Ectopic gestation
Uterine rupture

73
Q

Placental retention can lead to bleeding which is an example of ___________ hemorrhage

A

Post partum

74
Q

In Post partum hemorrhage due to placenta retention, the woman has given birth , but ___________ due to ————

A

The placenta doesn’t come out

It’s adherence

75
Q

Bleeding as a result of snake poison or another poisonous animal

Acute or chronic hemorrhagic Anaemia?

A

Acute

76
Q

Vomiting of blood is ______
Coughing out blood is ______
Sneezing out blood is ______

A

Hematemesis
Hemoptysis
Epistaxis

77
Q

DIC = ___________

A

Disseminated intravascular coagulopathy

78
Q

DIC

Acute or chronic haemorragic anemia?

A

Acute

79
Q

Causes of hematemesis

Mention 4

A

Gastric ulcerations
Gastric carcinoma
Duodenal ulcers
Esophageal varices

80
Q

Epistaxis is usually a phenomenon associated with ______/_____

A

Weakened blood vessels

Loss of integrity of blood vessels

81
Q

Causes of hemoptysis includes:
1) chronic chest infections such as _____
2)____ disorders such as _______
3)____/_____ cancer
4)______ failure
5)pulmonary _______

A

TB
Collagen;wegners granulomatosis
Lung; bronchial
Heart
Infarctions

82
Q

Epistaxis may be a feature of

________________

Systemic diseases such as _________

Impairment of ___________

A

Severe hypertension

Thrombocytopenia

Platelet functions

83
Q

Bleeding into the stool

Aka

————

A

Haematochezia

84
Q

Haematochezia may be as a result of _________ or ________

A

Upper GIT bleeding

Lower GIT bleeding

85
Q

Haematochezia of upper GIT bleeding usually presents with ______ stooling

A

Malena

86
Q

Malena stooling is the passage of ___ colored, _____ smelling faeces

A

Dark

Foul

87
Q

The causes of upper GIT Haematochezia is the same as the causes of hematemesis

T/F

A

T

88
Q

Haematochezia of lower GIT bleeding may be as a result of:

1) _______
2)colonic ______
3) colonic _______
4)colonic ______
5)_______

A

Bleeding hemorrhoids
Polyposis
Diverticulosis
Carcinoma
Anal tear

89
Q

Haematochezia

Inapparent GIT blood loss can also be caused by ________ eg ______

A

Intestinal parasite

Hookworm

90
Q

Bleeding from/into the urethra is called _______

A

Hematuria

91
Q

Hematuria may be as a result of a pathology in ____,_____,_____ or _____

A

Kidney
Ureter
Urethra
Bladder

92
Q

Hematuria as a result of pathology in kidney could be caused by :

___________

Renal ________

Kidney ______

A

Pyelonephritis

Papillary necrosis

Cancer

93
Q

Renal Papillary necrosis occurs in patients with ______ disease

A

Sickle cell

94
Q

Example of a kidney Cancer

A

Wilm’s tumor

95
Q

Hematuria as a result of pathology in ureter could be caused by :

________ resulting in ______

A

Ureteric stones

Ureteric surface erosions

96
Q

Hematuria as a result of pathology in bladder could be caused by :

1)infestations such as _________
2)bladder _____
3)___________

A

Schistosoma hematobium

Cancer

Erosion due to stones

97
Q

Hematuria as a result of pathology in urethra could be caused by :

Urethral ________/______ as a result of ____________

A

Destruction

Fibrosis

Post gonococcal infections

98
Q

In urethral fibrosis, a ______________ is inserted to dislodge and open the fibrosis. This is done using (short or long?) acting but deep anaesthesia such as _______

A

Bougienage

Short
Epontol

99
Q

Menorrhagia is as a result of

____itis / ____itis

_____ /_______ cancer

Bleeding __________

Dysfunctional _________

A

Cervicitis; vaginitis

Cervical; endometrial

Endometrial fibroid

Uterine bleeding

100
Q

Haemathrosis is _______

Hematoma is _______

A

Bleeding into joints

Bleeding into soft tissues

101
Q

Haemathrosis and Hematoma are seen in patients with ______ disorders or ________ deficiencies

Eg, a patient with ______

A

Coagulation

Coagulant protein

Hemophilia

102
Q

Bleeding into the skin is referred to as ______

A

Purpura

103
Q

Purpura could be as a result of :

1)_______ disorders (both ____ and ___)
2)________ disease
3)vascular collagen disorder like _____

A

Platelets; qualitative and quantitative

Von willebrand

Ehler danlos syndrome

104
Q

2 causes of hemolytic Anaemia?

A

Intra corpuscular pathology

Extra corpuscular pathology

105
Q

Intra corpuscular pathology( as a result of ______)

Extra corpuscular pathology(as a result of ________)

A

The red cell itself

The red cell environment

106
Q

Intra corpuscular pathology is of 2 types

List them

A

Red cell membrane pathology

Cytoplasmic pathology

107
Q

Red cell membrane pathology is of 2 types

List them

A

Acquired membrane pathology

Inherited membrane pathology

108
Q

Acquired membrane pathology usually leads to ________________, as a result of deficiency of _______

A

Parapxysmal nocturnal hemoglobinuria

Decay attack mechanisms

109
Q

In Acquired membrane pathology , __________ proteins which are capable of ________ the ____ that make up the rbc membrane

A

Perforator

Lysin/dissolving

Lipids

110
Q

Perforator proteins are usually a product of _________

A

Complement protein activation

111
Q

There are some mechanisms on the rbcs membrane that is able to to see and neutralize the activated complement proteins and causing them to decay

T/F

A

T

112
Q

Acquired membrane pathology is as a result of _________

A

Zeid’s triad

113
Q

Zeid’s triad consists of ???

A

Alcoholic liver disease
Hyperlipidemia
Hemolytic Anaemia

114
Q

Severe alcoholics are those who take atleast ___g of alcohol everyday for atleast _____ years

A

80

10

115
Q

Zeid’s triad

In severe alcoholics , the liver is unable to properly _________ hence they _______ , causing __________ which then migrated to the ________, which leads to that cell to be _________ leading to ____

A

Biodegrade lipids

move back into the plasma

Hyperlipidemia
Membrane of rbcs

Permanently removed from the circulation

Anaemia

116
Q

5% of alcohol = ____

A

5g of alcohol in 100ml

117
Q

Inherited membrane pathologies

List 6

A

Inherited membrane pyropoikilocytosis

Inherited membrane acanthocytosis

Inherited membrane spherocytosis

Inherited membrane stomatocytosis

Inherited membrane ovalocytosis

Inherited membrane elliptocytosis

118
Q

There are 2 types of cytoplasmic pathologies

List them

A

Enzymopathies

Hemoglobinopathies

119
Q

Enzymopathies and Hemoglobinopathies would result in _______ Anaemia

A

Hemolytic

120
Q

Enzymopathies are of 2 types

1)deficiency of enzyme in the ______ pathway
2) deficiency of enzyme in the _______ pathway

A

Glycolytic

HMP

121
Q

Glycolytic pathway enzyme deficiency only includes some of the enzymes in the pathway

T/F

A

F

Involves all

122
Q

The commonest enzymes deficient in the Glycolytic pathway enzyme deficiency group is ????

A

Hexokinase

Putivate kinase

123
Q

Glycolytic pathway enzyme deficiency eventually leads to ________ of the red cell

A

Osmotic lysis

124
Q

The reducing power of the red cell is ____?

A

NADPH2

125
Q

Deficiency of enzyme reducing power:

NADPH2 is required by the red cell to ___________ macromolecules , including membrane ________ and _____

A

Reduce oxidized membrane

Proteins and Lipids

126
Q

When the valency points of carbon atom is fully occupied by ___ atoms, they can get detached if you bring _____ like _____ near it, leading to the formation of _______ which allows for way breakage between the carbon atoms

Hence , with each oxidation of the carbon skeleton of membrane protein or lipids, it’s gets closer to its destruction point

A

Oxidant; H2o2

Double of triple bonds

127
Q

What the rbc uses to reduce oxidized macromolecules is ??

A

Glutathione (GSH)

128
Q

Glutathione is a ___peptide consisting of ??

A

Tri

Glutamine
Cysteine
Methionine

129
Q

The 2 enzymes involved in Glutathione formation are

1) _____________ in the rbc which helps to link ________

2)________ in the rbc which links _____ to form _____

A

Gamma-glutamyl-cysteinyl transferase

Glutamic acid to cystein

Glutathione synthase

Methionine; Glutathione

130
Q

Glutathione is written as ____ to show that there’s a presence of a ____ containing amino acid which has a _______ attached to it and can be used to _______________________ from membrane macromolecules

A

GSH; sulfur

hydrogen atom

replace any H atom that has been detached

131
Q

Reduced state of carbon means when carbon is ______

A

Fully hydrogenated

132
Q

GSH, when used to replenish H atoms becomes ___ which is _____. Therefore 2 glutathione link together to become a stable compound ‘ _____ ’ with the help of __________ enyme.

A

GS; unstable

GSSG

glutathione peroxidase

133
Q

_____ is oxidized glutathione

A

GSSG

134
Q

GSSG must be reduced to ____ because __________________. This is where we need the red cell ______ which is _____

A

GSH

the red cell doesn’t have unlimited capacity to keep synthesizing GSH

reducing power

NADPH

135
Q

One GSSG is reduced to _________ by ____ enzyme with the help of NADPH2

A

2 GSH

Glutathione reductase

136
Q

Nadp has to be recycled to NADPH2

T/F

A

T

137
Q

Nadp has to be recycled to NADPH2. For this to happen, we need a molecule of ______ to be converted to ______ (instead of ________) using ________ enzyme .

This is done using ________ pathway

A

glucose 6 phosphate

6phosphogluconate

fructose 6 phosphate

glucose 6 phosphate dehydrogenase

Hexosmonophosphate shunt pathway

138
Q

Bone marrow fat (BMF) is located in the bone marrow cavity and accounts for ___% of adult bone marrow volume.

A

70

139
Q

O2 tension 15% ; partial pressure =____mmHg

A

40

140
Q

1g of Hb= ____ml of oxygen

10g/dl pf Hb =____ ml of oxygen

15g/dl pf Hb =_____ ml of oxygen

100 ml of blood= ___g of Hb

A

1.34

13.4

20.1

15

141
Q

Anaemia occurs if Hb levels drop below these

5yr old- ___g/dl
0-30 days- ____g/dl
30days-6yrs- ___g/dl
6-14 yrs old- ____g/dl
Adult male- _____g/dl
Adult female-____ g/dl

A

5; 13.5

11; 12

13;12

142
Q

Normal Hb levels

For adult males: _____ to ____ grams per deciliter (g/dL) of blood

For adult females:____ to ____ g/dL of blood

A

13.5 to 17.5

12.0 to 15.5

143
Q

Burr cell - occurs due to _____ defecienccy

Schistocytes- occurs in ___,_____,____

Macro-ovalocytes- occurs in ______

Target cells occurs in ????

A

Pyruvate kinase

HUS, TTP, DIC

Megaloblastic anaemia

HALT( HbC Asplenia, liver disease , thalassemia)

144
Q

Burr cell - AKA _______

Schistocytes- AKA _______

Spur cells AKA _______

Target cells AKA _______

A

Echinocyte

Helmet cells

Acanthocyte

Codocyts