Intro to Anemia

Question 1

Define anemia

Answer 1

decreased O2 carrying capacity of the blood

symptom of other diseases, not a disease itself

Question 2

How to we measure/test for anemia?

Answer 2

decreased Hb concentration of blood

Question 3

Main Functional consequences of anemia?

Answer 3

decreased oxygen delivery to tissue

tissue hypoxia in severe cases

Question 4

6 compensatory mechanisms in anemia

Answer 4

increased 2,3 DPG
shunting of blood from non-vital to vital areas
increased CO
increased RR
increased red cell production
increased plasma volume

Question 5

Main Symptoms

Answer 5

weakness, fatigue, marrow expansion/bony abnormalities, pallor, tachycardia, DOE
*symptoms more severe with rapid onset

Question 6

Functional Classification of Anemias

Answer 6

blood loss
decreased production
accelerated destruction

Question 7

Morphologic Classification of Anemias

Answer 7

microcytic (normo or hypochromic)
Normochromic/normocytic
macrocytic

Question 8

Measurements related to red cell mass (3)

Answer 8

Hb, Hematocrit, RBC count

Question 9

Measurements related to characteristics of the red cells (RBC “indices”)

Answer 9

MCV, MCH, MCHC, RDW

Question 10

Microcytic anemia DD (3)

Answer 10

iron deficiency, thalassemia, ACD

Question 11

Macrocytic anemia DD (2)

Answer 11

megaloblastic (impaired DNA synthesis)
-B12/folate defic, drugs, MDS
non-megaloblastic
-reticulocytosis, liver disease, hypothyroidism, drugs

Question 12

Causes of spherocytes

Answer 12

hereditary spherocytosis, autoimmune hemolytic anemia

Question 13

causes of target cells

Answer 13

liver disease, splenectomy, hemoglobinopathies

Question 14

causes of elliptocytes (ovalocytes)

Answer 14

hereditary elliptocytosis, megaloblastic anemia, iron deficiency, myelofibrosis

Question 15

causes of teardrop cells

Answer 15

megaloblastic anemia, myelofibrosis, extramedullary hematopoiesis

Question 16

causes of sicked cells

Answer 16

sickle cell disease

Question 17

causes of fragments/schistocytes

Answer 17

TTP, DIC, malignant HTN

Question 18

causes of bite cells

Answer 18

oxidant hemolysis (ie/G6PD deficiency)

Question 19

term for red cell size variablility

Answer 19

anisocytosis

Question 20

anisocytosis, microcytosis, hypochromia

Answer 20

iron deficiency anemia

Question 21

causes of howell-jolly bodies (nuclear fragments)

Answer 21

splenectomy, megaloblastic anemia

Question 22

causes of pappenheimer bodies (iron granules)

Answer 22

splenectomy, iron overload

Question 23

causes of basophilic stippling (coarse)

Answer 23

talassemias, MDS, lead poisoning

Question 24

causes of Hb C crystals

Answer 24

HbCC disease, HbSC disease

Question 25

Cause of rouleaux

Answer 25

decreased repulsive forces between RBCs | occurs w/increased serum proteins

Question 26

Causes of aggluination

Answer 26

IgM RBC antibodies (cold agglutinins)

Question 27

Causes of hypersegmented neutrophil

Answer 27

megaloblastic anemia

Question 28

After blood loss when does reticulocyte count increase and peak?

Answer 28

increases after 2-3 days | peaks after 7-10 days

Question 29

RBC production sites throughout developments

Answer 29

embryo:yolk sac fetus: liver shortly after birth-rest of life: bone marrow

Question 30

Where do normoblasts obtain iron from?

Answer 30

plasma transferrin for Hb synthesis

Question 31

What gives reticulocytes their blueish tinge?

Answer 31

residual RNA

Question 32

What are causes of decreased RBC production?

Answer 32

ineffective erythropoeisis decreased RBC precursors anemia of chronic disease

Question 33

Ineffective erythropoiesis examples

Answer 33

iron deficiency megaloblastic MDS

Question 34

Ineffective erythropoiesis features

Answer 34

increased RDW dysmaturation of precursors in marrow decreased RC inappropriately increased iron absorption from gut

Question 35

Decreased RBC precursors features

Answer 35

defects in proliferation, stem cell defects with adequate erythropoietin

Question 36

Decreased RBC precursors causes

Answer 36

congenital or acquired red cell aplasia or pan aplasia amrrow replacement, decreased EPO

Question 37

Normal RBC destruction

Answer 37

after ~120 days intravascular: breach of membrane in circulation, low freq under normal conditions extravascular: clearance in reticuloendothelial system as a result of RBC senescence

Question 38

Does hemolysis always cause anemia?

Answer 38

No, can have hemolysis wihout anemia if bone marrow is able to compensate

Question 39

Why does extravascular hemolysis occur?

Answer 39

due to decreased RBC deformability, can't traverse slits in splenic cords and sinusoids, damaged by splenic cordal env, phogcytized by cordal macrophages