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MLT 120- Hematology > MLT 120 Exam II > Flashcards

MLT 120 Exam II Flashcards

1
Q

How are anemias classified according to cause?

A

Increase red cell destruction - hemolytic

decrease red cell production

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2
Q

How are anemias classified according to morphology?

A

Macrocytic/normo
Normocytic/normochromic
Microcytic/hypo

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3
Q

What are the symptoms of anemia?

A 
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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4
Q

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

A

oval macrocyte
hypersegs
pacytopenia-increase plt, wbc, rbc

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5
Q

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

A

megaloblast
giant bands
WBC presursors
M:E ratio is lowered

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6
Q

What specifically causes pernicious anemia?

A

lack of intrinsic factor (IF)

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7
Q

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

A

neurological symptoms; B12 needed to make myelin sheaths

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8
Q

What conditions can produce non-megaloblastic macrocytic anemia?

A

liver disease

alcoholism

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9
Q

What poikilocytes are often seen in liver disease?

A

round macrocytes and target cells

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10
Q

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

A

All

panctyopenia

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11
Q

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

A 
Normo/Normo
no howell-jolly bodies
basophilic stippling
nRBC
*no signs of increased RBC production*
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12
Q

shift to the left - bands

shift to the right - hyperseg

A

retic

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13
Q

What are the most common causes of aplastic anemia?

A

chemicals - benzene
drugs - chlorophenocol
decrease retic

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14
Q

Name several causes of myelophthisic anemia.

A

leukemia
metastatic carcinoma
lymphoma
multiple myeloma

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15
Q

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

A

tear drop cels

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16
Q

What is the blood picture in chronic renal disease?

A

burr cell
helmet cell
Normo/Normo

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17
Q

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

A

decrease erythropoietin production

BUN

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18
Q

What is the common characteristics of ALL hemolytic anemias?

A

increase red cell destruction

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19
Q

What are the characteristics of anemia due to chronic disorders?

A

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

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20
Q

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

A

cell membrane abnormality

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

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21
Q

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

A

HMP shunt

** hexose monophosphate pathway

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22
Q

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

A

presence of oxidizing agent

Heinz bodies-denucleated Hgb

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23
Q

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

A

spherocytes

Positive direct Coombs

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24
Q

How do PCH and PNH differ?

In which conditions is the Donath-Landsteiner antibody found?

A

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

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25
Q

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

A

cell wall membrane

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26
Q

A2 globin chains

A

alpha 2 delta 2

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27
Q

F globin chains

A

alpha 2 gamma 2

28
Q

H globin chains

A

4 beta

29
Q

Bart’s globin chains

A

4 gamma

30
Q

Which globin chains are present only during embryonic development?

A

zeta and epsillon

Gower

31
Q

Major hgb of newborns

A

Hgb F

32
Q

Hgb that is insoluble when reduced

A

Hgb S

33
Q

Hgb resistant to alkaline

A

Hgb F

34
Q

Hgb C

A

crawls

35
Q

Hgb S

A

slow

36
Q

Hgb F

A

fast

37
Q

Hgb A

A

accelerates, faster than fast

38
Q

Hgb H

A

hell on wheels, fastest

39
Q

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

A

target cells

40
Q

What is the specific amino acid substitution in hgb S?

In hgb C?

A

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

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

41
Q

What are the clinical manifestations of sickle cell anemia?

A

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

42
Q

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

A

hemoglobin electrophoriesis

43
Q

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

A

normal red cell morphology except for occasional target cell

44
Q

What are the characteristics of hemoglobin C disease?

Hemoglobin SC disease?

A

target, mild hemolytic, rod shape crystals, envelope cells

bird or washing monument crystals, + solubility test

45
Q

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

A

they migrate together on alkaline

*pH6 and citrate agar used to separate

46
Q

What does the peripheral blood smear usually show in IDA?

What does the serum iron and TIBC show?

A 
Microcytic/Hypochromic
ovalocytes
target cells
tear drop cells
no signs of increase RBC production

decrease serum iron; increase TIBC

47
Q

IDA yellow-green skin

A

Chlorosis

48
Q

G6PD deficiency

A

Favism

49
Q

Spoon shaped nails in IDA

A

Koilonychia

50
Q

Eat weird stuff

A

Pica syndrome

51
Q

What are some causes of IDA?

A 
chronic bleeding
hookworm
bleeding ulcer
menstruation issues
babies on table food too soon
52
Q

What is the specific cause of Thalassemias?

A

decrease rate of synthesis of one of the polypeptide chains

53
Q

Mediterraneans

Cooleys

A

beta thalassemia

54
Q

What hgb are increased in thalassemia major?

Why?

A

hgb A2 and hgb F

to compensate because they can not make A beta chain

55
Q

homozygous alpha thal

A

Bart’s disease

56
Q

thal minor- less severe

A

Cooley’s

57
Q

congenital aplastic anemia

A

Fanconi’s anemia

58
Q

heterozygous alpha thal

A

Hgb H disease

59
Q

What are the characteristics of sideroblastic anemia?

A

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

60
Q

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

A

basophilic stippling

61
Q

What blood cell parameters are increased in polycythemia vera?

A

pancytopenia; increase RBC, WBC, plts

62
Q

What is the cause of secondary polycythemia?

What parameters are increased in this condition?

A

increase secretion of erythropoietin

increase RBC

63
Q

What are the possible causes of relative polycythemia?

A

decrease plasma volume
dehydration
stress
severe burns

64
Q

How do hemachromatosis and hemosiderosis differ?

A

hema-organ damage occurs;iron accumulation

hemo-iron in norm storage areas

65
Q

B12 deficiency
folate deficiency
alcoholism
liver PK

A

Macrocytic/Normochromic

MCV increase

66
Q

IDA
Thalassemia
Sideroblastic anemia
Pb poisoning

A

Microcytic.Hypochromic

decrease MCH;MCV;MCHC

67
Q

hemobloinopathies - inherited
sickle cell
sickle cell trait
Hgb SC disease

A

Normocytic/Normochromic

normal MCV;MCHC

MLT 120- Hematology (5 decks)

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