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SBL Exam 1 > L2 - Pathology Of RBCs > Flashcards

L2 - Pathology Of RBCs Flashcards

1
Q

What is the MCV?

A

Mean corpuscular volume

Hct/RBC

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2
Q

What is the MCH?

A

Mean corpuscular hemoglobin

Hgb/RBC

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3
Q

What is the MCHC?

A

Mean corpuscular hemoglobin concentration

Hgb/Hct

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4
Q

What does a low MCV indicate?

A

Microcytic anemia

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5
Q

What does a high MCV indicate?

A

Macrocytic anemia

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6
Q

What does a low MCH indicate?

A

Hypochromic anemia

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7
Q

How do reticulocytes appear on a peripheral smear?

A

Polychromatic with a purple grey tinge in larger cells

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8
Q

What is the RDW?

A

Red cell distribution width

Measure of variability in size of circulation erythrocytes

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9
Q

Increased RDW can be seen in many conditions including what?

A

Iron deficiency anemia

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10
Q

What are normal adult hemoglobins?

A 
Hemoglobin A (97%) 
Hemoglobin A2 (2-3%)
Hemoglobin F (<1%)
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11
Q

If you are heterozygous for S you have what?

A

Sickle cell trait

1 in 12 persons of African descent

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12
Q

If you are homozygous for S you have what?

A

Sickle cell disease

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13
Q

Populations with high incidence of HbS may have other variant hemoglobins such as?

A

HbC

Beta thalassemia

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14
Q

What are the effects of chronic hemolysis?

A

Jaundice and gallstones

Anemia

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15
Q

What are the effects of vascular occlusion?

A

Stroke, retinopathy, acute respiratory distress, acute chest syndrome, cor pulmonale, hepatic sequestration, hematuria and polyuria, autosplenectomy and infections, aseptic bone necrosis and osteomyelitis, placental failure in pregnancy, leg ulcers

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16
Q

What are the effects of absence of all alpha globin genes?

A

Anemia and tissue hypoxia
Massively enlarged placenta leading to maternal complications, heart failure leading to large heart, pericardial effusion, edema, ascites and pleural effusion, congenital anomalies, large liver and spleen

17
Q

What is a direct antiglobulin test (DAT) (Coombs test)?

A

Detects the presence of Ab bound to the red cell surface

  1. Autoimmune hemolytic anemia
  2. Hemolytic disease of newborn
  3. Transfusion reactions
18
Q

What is the indirect antiglobulin test (IAT)?

A

Detects abs in the plasma

  1. Ab screen in pretransfusion testing
  2. Screening in pregnancy for abs that may cause hemolytic disease of newborn
19
Q

What is warm hemolytic anemia?

A

IgG (most typical Ig subtype) binds stably at 37C
These opsonized cells are phagocytosed in the spleen or gradually lose membranes
Autoimmune or drugs

20
Q

What is cold hemolytic anemia?

A

IgM
Stronger affinity at low temps
More likely to manifest in nose and fingertips (Raynaud)
IgM leads to C3b deposition and the liver, spleen and bone marrow remove the cells

21
Q

What labs should be performed to evaluate vessel wall abnormalities?

A

Labs dont really help

22
Q

Which labs should be performed to evaluate reduced platelet numbers?

A

CBC for platelet count

23
Q

Which labs should be performed to evaluate defective platelet function?

A

Platelet function test, morphology

24
Q

Which test should be performed to evaluate clotting factor abnormalities?

A

PT and PTT

25
Q

What is the presentation of platelet disorders?

A 
Superficial mucosal bleeding 
Petechiae 
Small superficial bruises 
Rare for hemarthroses
Bleeding after minor cutes
26
Q

What is the presentation for coagulation disorders?

A 
Deep soft tissue bleeding 
Minimal petechiae 
Large deep bruises 
Common hemarthroses 
Delayed bleeding after cuts
27
Q

Factor deficiencies or dysfunction will result in what?

A

Prolongation of aPTT and/or PT

28
Q

Describe SC disease

A

Milder than sickle cell disease
Hb C can crystallize but doesn’t polymerize (although dehydration can result in polymerization)
Same general complications and risks but less severe
More likely to see Target cells than true sickle cells (poikilocytes)

29
Q

What are the stages of iron deficiency?

A
  1. Reduced ferritin
  2. Iron deficiency
  3. Iron deficiency anemia
30
Q

Described the reduced ferritin stage of iron deficiency

A

Decreased serum ferritin <50-70
Decreased bone marrow iron
Hb normal
Sx start

31
Q

Describe the stage of iron deficiency

A

Decreased serum ferritin <30
Absent bone marrow iron
Hb low/normal range
Sx accelerate

32
Q

Describe the factor VIII-vWF complex

A

vWF carries Factor VIII to a platelet so that it can contribute to the clotting cascade
vWF then goes and contributes to the repair of the endothelial defect

SBL Exam 1 (8 decks)

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