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HEMA 337 > Module 1: An Introduction to the Anemias > Flashcards

Module 1: An Introduction to the Anemias Flashcards

1
Q

anemia

A

reduced Hb below normal reference range

Below 140g/L in Males
below 120g/L in Females

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2
Q

most anemias are accompanied by

A

low hematocrit and/or RBC count

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3
Q

Polycythemia

A

RBC count (and usually also hematocrit) are increased above ref range

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4
Q

2 types of anemias

A

absolute and relative

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5
Q

Absolute anemia

A

hb concentration is decreased due to

  • decreased absolute # of RBC in blood
  • Decreased Hb inside the RBC
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6
Q

Absolute anemia results in

A

decrease in oxygen carrying capacity of blood due ti decrease in red cell mass
Mild to severe hypoxia

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7
Q

Symptoms of absolute anemia

A 
pallor of mucous membranes
shortness of breath on mild excertion
weakness
lethargy
palpitations
headaches
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8
Q

2, 3 BPG in relation to most anemias

A

level of 2, 3 BPG in red cells in increased
Oxygen dissociation curve is shifted to the right
Oxygen is release more easily and completely to hypoxic tissue

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9
Q

Relative anemia

A

Hb concentration decreased by increasing plasma volume (by dilution)
No decrease in Red cell mass or any loss of oxygen carrying capacity
Often seen in third trimester pregnancy

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10
Q

Only sure way of differentiating absolute from relative

A

measure red cell volume (RCV) and/or plasma volume (PV) using radioisotope techniques

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11
Q

3 causes of absolute anemias

A

Decreased or Ineffective erythropoiesis (RBC production is decrease; decreased # of cells survive)

Increased Hemolysis (increased destruction or decreased survival of RBC in circulation)

Blood loss

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12
Q

relation between rate of production and hemolysis/loss

A

Rate of production IS LESS THAN rate of hemolysis/loss

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13
Q

Most useful classification of anemia is

A

morphologic/etiologic classification

based on red cell indices and rbc morphology

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14
Q

4 types of absolute anemia

A

Hypochromic
Macrocytic
Normochromic Normocytic
Hemolytic

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15
Q

Hypochromic anemia lab results

A

Red cell indices are decreased (MCV, MCH, MCHC)

Red cell morphology: Hypochromic and often microcytic

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16
Q

Macrocytic anemia lab results

A

Red cell indices are variable (MCV increase, MCH variable, MCHC normal)
Red cell morphology: Macrocytic

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17
Q

Normochromic normocytic anemia lab results

A

Red cell indices are normal

Red cell morphology: normal

18
Q

Hemolytic anemia lab results

A

Red cell indices are often normal

Red cell mophology: poikilocytosis (abnormal variation in shape)

19
Q

3 questions to answer for physician

A

Is an anemia present?
If yes, what kind is it?
What is its cause?

20
Q

Hemoglobin is based on

A

colorimetric measurement manually or by automated instrumentation

21
Q

Hematocrit (pcv) is based on

A

centrifugation of blood or calculated on an automated instrument

22
Q

RBC indices

A

Mean Cell Volume (MCV) indicates size

Mean Cell Hb (MCH) indicates Hb mass

Mean cell Hb concentration (MCHC) in an average RBC

RBC distribution width (RDW) which is an index of size variation which indicates amount of anisocytosis (variation in size) present

23
Q

Mean Cell volume (MCV)

A

indicates volume in femtoliters (fL; x10^-15) of an average red cell in a blood sample
From histogram or can be calculated

MCV=Hct/RBC

Normal range 80-100fL

24
Q

Normal MCV indicated

A

RBC of normal size present (normocytes present)

25
Q

Increased MCV indicates

A

at least some cells with increase volume
Due to greatly increased # of young cells polychromatophilic erythrocytes (reticulocytes) or enlarged mature cells (macrocytes)

26
Q

Decreased MCV indicates

A

smaller than normal erythrocytes (microcytes) present

27
Q

Mean Cell Hemoglobin (MCH)

A

indicates weight of Hb inside an average RBC in picograms (pg; x10^-12)

MCH = Hb/RBC

Normal range is 27-32pg

28
Q

Mean Cell Hemoglobin Concentration (MCHC)

A

indicates the Hb concentration inside the RBC expressed as grams of Hb per L of RBC (g/L)

MCHC = Hb/Hct

Normal range is 320-360g/L

29
Q

Normal MCHC indicates

A

normal concentration of Hb within the RBC

Normochromic

30
Q

Decreased MCHC indicates

A

presence of red cells lacking normal amounts of Hb in blood

Hypochromia

31
Q

Increased MHCH

A

Typically erroneous because volume of RBC usually increased to accommodate greater amounts of Hb (thus MCH may be increased but MCHC remains normals due to increased volume of the cell; Term hyperchromia is NOT used)

MCHC May be truly increased: Spherocytes present in blood (used term spherocytosis NOT hyperchromia), Lipemia or cold agglutinins (considered an interference)

32
Q

Red cell distribution width (RDW)

A

indicates the amount of RBC volume/size variation (anisocytosis) in a sample
Obtained by calculating coefficient of variation (CV) of red cell volumes from red cell volume histogram (Expressed as %)

Normal range is 11.5-14.5%

33
Q

Lab results:
RDW normal
MCV increased

A

Interpretation:
No anisocytosis present
All macrocytes

34
Q

Lab results:
RDW increased
MCV increased

A

Interpretation:
Anisocytosis present
Macrocytes and normocytes, or macrocytes, normocytes and microcytes

35
Q

Lab results:
RDW Normal
MCV Normal

A

Interpretation:
No Anisocytosis present
Normal cells

36
Q

Lab results:
RDW Increased
MCV Normal

A

Interpretation:
Anisocytosis present
Equal amounts of microcytes and macrocytes (average out to be normal)

37
Q

Lab results:
RDW increased
MCV decreased

A

Interpretation:
Anisocytosis present
Microcytes and normocytes, or microcytes, normocytes and macrocytes

38
Q

Lab results:
RDW normal
MCV decreased

A

Interpretation:
No Anisocytosis present
All microcytes

39
Q

MCV, MCH and MCHC act as quality control check on

A

RBC count, hematocrit, and Hb results

40
Q

RDW allows easier interpretation of the

A

MCV

HEMA 337 (11 decks)

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