MLT 120 Exam II Flashcards by Alex Olsen

How are anemias classified according to cause?

Increase red cell destruction - hemolytic

decrease red cell production

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How are anemias classified according to morphology?

Macrocytic/normo
Normocytic/normochromic
Microcytic/hypo

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What are the symptoms of anemia?

depends on rate of onset of the anemia
reduction of O2 transport to tissues
reduction in blood volume
increase cardiac output
hypotension, fatigue

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What is the peripheral blood picture in vitamin B12 and folate deficiency?

oval macrocyte
hypersegs
pacytopenia-increase plt, wbc, rbc

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What do you see in the bone marrow of B12 and folate deficiency?

megaloblast
giant bands
WBC presursors
M:E ratio is lowered

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What specifically causes pernicious anemia?

lack of intrinsic factor (IF)

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What main clinical manifestations distinguishes vitamin B12 deficiency from folic acid deficiency?

neurological symptoms; B12 needed to make myelin sheaths

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What conditions can produce non-megaloblastic macrocytic anemia?

liver disease

alcoholism

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What poikilocytes are often seen in liver disease?

round macrocytes and target cells

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What parameters are decreases in aplastic anemia and what bone marow precursor cells are decreased?

All

panctyopenia

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What is the peripheral blood picture in aplastic anemia and what would the retic count be expected to be?

Normo/Normo
no howell-jolly bodies
basophilic stippling
nRBC
*no signs of increased RBC production*

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shift to the left - bands

shift to the right - hyperseg

retic

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What are the most common causes of aplastic anemia?

chemicals - benzene
drugs - chlorophenocol
decrease retic

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Name several causes of myelophthisic anemia.

leukemia
metastatic carcinoma
lymphoma
multiple myeloma

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What poikilocyte is especially associated with myelophthisic anemia because it indicates extramedullary hematopoiesis?

tear drop cels

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What is the blood picture in chronic renal disease?

burr cell
helmet cell
Normo/Normo

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What is the main cause of anemia due to renal disease and to what kidney function test is the anemia frequently proportional?

decrease erythropoietin production

BUN

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What is the common characteristics of ALL hemolytic anemias?

increase red cell destruction

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What are the characteristics of anemia due to chronic disorders?

Increase iron stores
N/N to M/H b/c iron not utilized properly
decrease serum iron
normal TIBC

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What type of RBC abnormality result in hereditary spherocytosis and how does it affect the shape and OF of the RBC?

cell membrane abnormality

round but not concave; no room to take on extra liquid

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What biochemical pathway involves the enzyme glucose-6-phosphate dehydrogenase (G-6-P-D)?

HMP shunt

** hexose monophosphate pathway

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What usually precipitates a hemolytic crisis in G6PD deficiency?
What inclusion does this deiciency produce?

presence of oxidizing agent

Heinz bodies-denucleated Hgb

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What is the most unusual characteristic lab finding in ABO erythroblastosis of the newborn?
In AIHA?

spherocytes

Positive direct Coombs

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How do PCH and PNH differ?

In which conditions is the Donath-Landsteiner antibody found?

PCH;cold hemoglobinuria is Not genetic-extracorpuscular; Ab extrinsic
PNH;nocturnal hemoglobinuria;genetic-intracorpuscular; Ab intrinsic-sensitive to complement

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What RBC abnormality is responsible for the formation of burr cells and thorn cells?

cell wall membrane

A2 globin chains

alpha 2 delta 2

F globin chains

alpha 2 gamma 2

H globin chains

4 beta

Bart's globin chains

4 gamma

Which globin chains are present only during embryonic development?

zeta and epsillon | Gower

Major hgb of newborns

Hgb F

Hgb that is insoluble when reduced

Hgb S

Hgb resistant to alkaline

Hgb F

Hgb C

crawls

Hgb S

slow

Hgb F

fast

Hgb A

accelerates, faster than fast

Hgb H

hell on wheels, fastest

What poik is the "common denominator" of peripheral blood smears of patients with hereditary hemoglobinopathies?

target cells

What is the specific amino acid substitution in hgb S? | In hgb C?

Valine-for glutamic acid in the 6 position on beta chains | Lysine-for glutamic acid in the 6 position on beta chains

What are the clinical manifestations of sickle cell anemia?

aplastic and thrombotic crises OF is decreased due to target cells infection of salmonella

What is the best test to use to differentiate sickle cell anemia and sickle cell trait?

hemoglobin electrophoriesis

What does the peripheral blood smear usually show in sickle cell trait?

normal red cell morphology except for occasional target cell

What are the characteristics of hemoglobin C disease? | Hemoglobin SC disease?

target, mild hemolytic, rod shape crystals, envelope cells bird or washing monument crystals, + solubility test

Why does the hemoglobin combo of S and D create a problem in the lab diagnosis on hemoglobinopthaies?

they migrate together on alkaline *pH6 and citrate agar used to separate

What does the peripheral blood smear usually show in IDA? | What does the serum iron and TIBC show?

``` Microcytic/Hypochromic ovalocytes target cells tear drop cells no signs of increase RBC production ``` decrease serum iron; increase TIBC

IDA yellow-green skin

Chlorosis

G6PD deficiency

Favism

Spoon shaped nails in IDA

Koilonychia

Eat weird stuff

Pica syndrome

What are some causes of IDA?

``` chronic bleeding hookworm bleeding ulcer menstruation issues babies on table food too soon ```

What is the specific cause of Thalassemias?

decrease rate of synthesis of one of the polypeptide chains

Mediterraneans | Cooleys

beta thalassemia

What hgb are increased in thalassemia major? | Why?

hgb A2 and hgb F | to compensate because they can not make A beta chain

homozygous alpha thal

Bart's disease

thal minor- less severe

Cooley's

congenital aplastic anemia

Fanconi's anemia

heterozygous alpha thal

Hgb H disease

What are the characteristics of sideroblastic anemia?

Micro/Hypo increase iron stores BM: ringes sideroblast, nRBC with iron

What is the RBC inclusion most frequently associated with lead poisoning?

basophilic stippling

What blood cell parameters are increased in polycythemia vera?

pancytopenia; increase RBC, WBC, plts

What is the cause of secondary polycythemia? | What parameters are increased in this condition?

increase secretion of erythropoietin | increase RBC

What are the possible causes of relative polycythemia?

decrease plasma volume dehydration stress severe burns

How do hemachromatosis and hemosiderosis differ?

hema-organ damage occurs;iron accumulation | hemo-iron in norm storage areas

B12 deficiency folate deficiency alcoholism liver PK

Macrocytic/Normochromic | MCV increase

IDA Thalassemia Sideroblastic anemia Pb poisoning

Microcytic.Hypochromic | decrease MCH;MCV;MCHC

hemobloinopathies - inherited sickle cell sickle cell trait Hgb SC disease

Normocytic/Normochromic | normal MCV;MCHC