Lecture 10 Chapter 18 Flashcards

1
Q

What characteristics have a low reticulocyte and high/increased MCV

A

Megaloblastic/macrocytic

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2
Q

Macrocytic anemias effect

A

Production of DNA

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3
Q

What is the first step when examining a blood smear

A

Look at reticulocytes and MCV

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4
Q

What happens if you cannot synthesize thymine

A

Cannot produce thymidine → cannot make DNA → cells grow extra because they want to divide but cannot without enough thymidine

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5
Q

What WBC commonly cannot divide due to lack of thymidine

A

Hypersegmented neutrophil

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6
Q

What is a common cause of macrocytic anemias

A

Vitamin deficiency of b-12 and folic acid

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7
Q
A

Hypersegmented neutrophil

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8
Q

What do you do if you are uncertain if a segmented neutrophil is hypersegmented

A

Do not report it unless certain

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9
Q

Symptoms/signs of megaloblastic anemia

A

Hypersegmented neutrophil
Ovalocytes
Decreased MCH
MCV may be 120
MCHC normal

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10
Q

Where are vitamins stored in your body

A

Liver

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11
Q

How much folate do you normally have stored

A

About enough for 1 week

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12
Q

How long is b-12 stored for

A

About 1 year

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13
Q

What food has the highest source of folate

A

Vegetables

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14
Q

What is the only source of b-12

A

Animal products, red meat, meat

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15
Q

Why must a pregnant woman take folate supplements

A

Folic acid deficiency in a pregnant woman will severely effect the fetus. Prevents the spinal cord from closing, most likely paralyzing the child

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16
Q

What disease do you have it you cannot absorb b-12 but have plenty of it

A

Pernicious anemia

17
Q

What happens right after you absorb folate acid

A

It gets methylated

18
Q

Where does methyl-b12 come from

A

Folate acid

19
Q

H4-folate produces

A

Thymidine which allows for DNA synthesis

20
Q

What is the difference between homocysteine and methionine

A

Methionine has a methyl group

21
Q

Where does methionine get its methyl group

A

Methyl - b12

22
Q

What happens if you are deficient of b12

A

Homocysteine adds up/increases
Increase can cause cardiovascular disease
Methylmalonyl-coa adds up and can become methylmatonic acid
Cannot make DNA and RNA

23
Q

If you have microcytic anemia and your MMA (methylmalonic acid) increases, what is your conclusion

A

B12 deficiency
Increased homocysteine

24
Q

What is acetyl choline

A

A neurotransmitter in the brain

25
Q

What can cause folate deficiency

A

Lifestyle stressors
Standard American diet
Aging

26
Q

Folate deficiency causes what

A

Neural tube defects
Infertility (sperm)
Reduced methylation

27
Q

For b-12 deficiency what is the:
MCV
Smear
Pernicious anemia?
Homocystine
Methylmalonic acid

A

> 100
Macrocytosis with hypersegmented neutrophils
Yes
Elevated
Elevated

28
Q

For folate deficiency what is the:
MCV
Smear
Pernicious anemia?
Homocystine
Methylmalonic acid

A

> 100
Macrocytosis with hypersegmented neutrophils
No
Elevated
Normal

29
Q

What is pernicious anemia

A

B-12 goes into stomach → binds within intrinsic factor → travels to intestines → gets absorbed in the ileum

30
Q

What happens if b-12 does not bind to an intrinsic factor

A

It does not get absorbed in the ileum and travels through the feces

31
Q

What type of disease is pernicious anemia

A

Autoimmune
It attacks the intrinsic factor and parietal cells

32
Q

What does gastric analysis look at

A

Acidity of stomach
B-12 must be able to break off from food to bind with intrinsic factor

33
Q

What does your smear have to have to be megaloblastic

A

Hypersegmented neutrophils
Ovalocytes