MLT 120 Exam II Flashcards
How are anemias classified according to cause?
Increase red cell destruction - hemolytic
decrease red cell production
How are anemias classified according to morphology?
Macrocytic/normo
Normocytic/normochromic
Microcytic/hypo
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
What is the peripheral blood picture in vitamin B12 and folate deficiency?
oval macrocyte
hypersegs
pacytopenia-increase plt, wbc, rbc
What do you see in the bone marrow of B12 and folate deficiency?
megaloblast
giant bands
WBC presursors
M:E ratio is lowered
What specifically causes pernicious anemia?
lack of intrinsic factor (IF)
What main clinical manifestations distinguishes vitamin B12 deficiency from folic acid deficiency?
neurological symptoms; B12 needed to make myelin sheaths
What conditions can produce non-megaloblastic macrocytic anemia?
liver disease
alcoholism
What poikilocytes are often seen in liver disease?
round macrocytes and target cells
What parameters are decreases in aplastic anemia and what bone marow precursor cells are decreased?
All
panctyopenia
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*
shift to the left - bands
shift to the right - hyperseg
retic
What are the most common causes of aplastic anemia?
chemicals - benzene
drugs - chlorophenocol
decrease retic
Name several causes of myelophthisic anemia.
leukemia
metastatic carcinoma
lymphoma
multiple myeloma
What poikilocyte is especially associated with myelophthisic anemia because it indicates extramedullary hematopoiesis?
tear drop cels
What is the blood picture in chronic renal disease?
burr cell
helmet cell
Normo/Normo
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
What is the common characteristics of ALL hemolytic anemias?
increase red cell destruction
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
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
What biochemical pathway involves the enzyme glucose-6-phosphate dehydrogenase (G-6-P-D)?
HMP shunt
** hexose monophosphate pathway
What usually precipitates a hemolytic crisis in G6PD deficiency?
What inclusion does this deiciency produce?
presence of oxidizing agent
Heinz bodies-denucleated Hgb
What is the most unusual characteristic lab finding in ABO erythroblastosis of the newborn?
In AIHA?
spherocytes
Positive direct Coombs
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
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