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BIOCHEM FINALS** > L24- Anemias (#6) > Flashcards

L24- Anemias (#6) Flashcards

1
Q

What is anemia defined as?

A

Abnoramlly low red blood cell mass

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2
Q

How is anemia determined?

A

Measuring the packed cell volume (PCV) or hematocrit (HCT) in a whole blood sample

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3
Q

Describe plasma vs serum.

A

Plasma: watery, straw-colored fluid protion that results after removal of blood cells

Serum: clear, thin, sticky fluid that remains after coagulation of the plasma sample- contains no blood cells or coagulation factors

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4
Q

Anemia is a ________________, but not a disease itself1

A

Sign of a disease

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5
Q

The most useful approach in the classification of anemia is to determine whether or not evidence of a ___________- response is present in the blood.

A

Bone marrow

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6
Q

There are two main groups of anemia- what are they?

A

Regenerative anemias

Non-regenerative anemias

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7
Q

What is regenerative anemias?

A

Where the body is able to respond appropriately to the decreased red cell mass by increasing RBC production

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8
Q

What is non-regenerative anemia?

A

Where the body is unable to respond adequately to the increased need for RBCs

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9
Q

what is erythropoiesis?

A

Production of RBCs in the bone marrow

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10
Q

RBCS are _________- by resident macrophages but _________________ by erythropoiesis (in bone marrow)

A

Continually destroyed

Continually replaced

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11
Q

When RBCs are in demand, the pluripotent stem cell will receive certain signals that trigger differentiation into a ___________________cell

A

Erythroid colony-forming unit (CFU)

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12
Q

With each division, the blast cell undergoing multiple rounds of cell divisions gets _______

A

Smaller

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13
Q

Although the blast cell gets smaller with each dvision, it is however _____________________

A

Increasing its Hb content

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14
Q

The final stage before becoming an erythrocyte is termed the _____________

A

Reticulocyte

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15
Q

What are three features of reticulocytes?

A
  1. Contain 80% of total Hb present in a mature RBC
  2. Do not contain nucelus
  3. 20% larger than mature RBCs due to presence of ribosomes, mitochondria, RNA
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16
Q

When are reticulocytes released when a) in normal condition, and b) in cases of anemia?

A

Normal condition: takes about 2-4 days for reticulocytes to mature into RBCs

Anemia: Reticulocytes can be released early from the bone marrow

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17
Q

Reticulocytopenia indicates what?

A

A low number of circulating reticulocytes

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18
Q

What protein hormone stimulates the process of red cell blood produciton?*

A

Erythropoietin (EPO)

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19
Q

Where is EPO produced? In response to what?

A

EPO is a growth factor produced in the kidney in response to renal hypoxia

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20
Q

The EPO receptor is located where?

A

In the bone marrow

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21
Q

EPO levels are ________ in the case of anemia

A

Increased

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22
Q

Clinical note: at least _____________ is needed to produce EPO

A

one healthy kidney

23
Q

EPO exerts its effects in the following 5 ways:

A
  1. Increase number of erythroid CFU cells thru inhib of CFU-E cell programmed death (apoptosis)
  2. Increased rate of Hb synthesis
  3. Increased iron absorption
  4. Increased rate of erythroid differentiation
  5. Stimulated production and premature release of reticulocytes from bone marrow into circulation (reticulocytosis)
24
Q

What are the two nutrients especially needed to adequate cell division (DNA Synthesis)?

A
  1. Folic acid

2. Vit B12

25
Q

What are 4 nutrients especially needed for adequate Hb synthesis (protein synthesis)?

A
  1. Dietary protein (AA)
  2. Iron
  3. Copper, since one of the iron transporteres req copper
  4. Vit B6, needed for syn of heme group
26
Q

All anemias will result in increased levels of what 2 things?

A

Erythropoietin and 2,3 BPG

27
Q

What does the corrected reticulocyte percentrage (CR or CRP) indicate when it is increased?*

A

Indicates that the body is ABLE to prod RBCs in response to an elevated EPO level. Thus, anemia is REGENERATIVE

28
Q

Regenerative anemia is likely to be caused by what kind of examples?

A

RBC lysis or loss

29
Q

What does the corrected reticulocyte percentrage (CR or CRP) indicate when it is decreased or remains within reference range?*

A

Indicates that the body is unable to produce erythrocytes in spite of having an elevated EPO level. Anemia is NONREGENERATIVE

30
Q

What is non-regenerative anemia likely to be caused by?

A

Insufficient erythrocyte production

31
Q

If HCT levels are within range, what does that say?

A

No anemia

32
Q

If HCT levels are out of range, what does that indicate?

A

Anemia is present

33
Q

In the Complete Blood Count, what is RBC, HGB, and HCT?

A

RBC: red blood cell count
HGB: Hb concentration
HCT: Hematocrit aka packed red cell volume

34
Q

How is HCT calculated?

A

Using the MCV equation and RBC count

35
Q

How is PCR determined by?

A

Centrifuging blood and determining the percentage- % of lenght of entire RBCs in column is the PCV

36
Q

What is corpuscular indices used for?

A

Determining the morphological classification of the anemia

37
Q

what is the Mean corpuscular volume (MCV)? Equation?

A

Average volume of erthryocytes

MCV = (HCT/RBC) *10 [fL units]

38
Q

By comparing MCV values with average, we can definite three things and their ranges- what are thye?

A

MICROCYTIC when MCV 77 (larger than avg)

39
Q

What is Mean corpuscular hemoglbin (MCH)? Equation?

A

MCH is the quantity of Hb in the average circulating erythrocyte

MCH= (HGB/RBC) * 10 [pg units]

40
Q

What is Mean corpuscular Hb concentration (MCHC)? equations?

A

Concentration of Hb in the avg circulating erythrocyte

MCHC= HGB/HCT *100  [%]
MCHC = MCH/MCV *100  [%]
41
Q

By comparing MCHC values with average, we can definite three things and their ranges- what are they?

A

NORMOCHROMIC when MCHC is within the 31-37% range

HYPOCHROMIC when MCHC

42
Q

What are examples of non-regenerative anemia (cases)

A
  • Anemia of chronic disease
  • Renal failure
  • Vit deficiency
  • Iron deficiency (can also be regenerative)
43
Q

What are 2 categories of examples of regenerative anemia (cases)?

A
  1. Hemorrhage/ Loss

2. Hemolysis/ Lysis

44
Q

What are examples of hemorrhage cases of regenerative anemia?

A

Trauma, GI ulceration, hemostasis defect, neoplasia, parasitism

45
Q

What are examples of hemolysis cases of regenerative anemia?

A

PFK deficiency, PK deficiency, toxicity, immune mediated

46
Q

Study Q: What is anemia?

A

Low HCT or PCV level in a whole blood sample

47
Q

Study Q: What lab value distinguishes anemia due to premature loss of red cells from those resulting form insufficient RBC production?

A

Corrected reticulocyte percentage (CR)

48
Q

Study Q: What is the meaning of a normal corrected reticulocyte count with low HGB, HCT and RBC?

A

Anemia w/ impaired red cell production

49
Q

Study Q: What would happen to the reticulocyte count after administration of iron supplements to a puppy with iron deficiency anemia?

A

It would increase to well above normal

50
Q

What breeds has Vit B12 malabsorption been reported in?

A

Border collie, Beagle, Giant Schnauzer dogs, and also in cats

51
Q

What causes Vit B12 malabsorption?

A

Hereditary absence of Intrinsic Factor receptor

52
Q

Study Q: What Vit B12 containing protein will have decreased activity?

A

Methylmalonyl-CoA mutase, and 1-methyl malonyl0CoA will be elevated in urine

53
Q

Study Q; What Tx would be recommened?

A

Parenteral (not oral) injections of Vit B12

BIOCHEM FINALS** (8 decks)

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