Normocytic and Hemolytic Anemia Lecture Powerpoint

Question 1

Anemia signs and symptoms

Answer 1

Fatigue, dyspnea/SOB, weakness, palpitations, pallor, tachycardia, low Hct and low Hgb

Question 2

Icterus or jaundice is often associated with what type of anemia?

Answer 2

Hemolytic

Question 3

Decreased reticulocytes could indicate a ___ deficiency

Answer 3

Nutritional

Question 4

Reticulocyte appearance under smear

Answer 4

Slightly larger than mature RBC and contain cytoplasmic remnants of RNA that stains blue

Question 5

A mean corpuscular volume (MCV) must be taken with consideration of presence of these 2 pathologies

Answer 5

Macro and microcytic anemias (avg out to normal appearing volume)

Question 6

A RDW will have a large distribution with presence of these 2 pathologies

Answer 6

Macro and microcytic anemias

Question 7

Normocytic anemia

Answer 7

Normal sized RBC’s with low hematocrit/hemoglobin or hemodilution, a sign of a disease presence

Question 8

Target, spherocyte, schistocyte, acanthocyte, echinocyte definitions

Answer 8

Target - dark center light colored ring dark periphery
Spherocytes - thickened rounded, microcytic hyperchromatic
Schistocytes - irregular RBC fragments
Acanthocytes - multiple spike like projections
Echinocytes - multiple smaller spiked projections

Question 9

3 classifications of anemia: cytometric, erythrokinetic, and bicohemical schemes and their definition

Answer 9

Cytometric - cell size and chromaticity
erythrokinetic - Rates of RBC production and destruction
Biochemical - genetic vs acquired

Question 10

Sickle cell anemia cytometric, erythrokinetic, and biochemical scheme classifications

Answer 10

• normochromic normocytic with production of sickle shaped cells
• Hemolytic
• DNA point mutation producing amino acid substituion on hemoglobin B chain

Question 11

Iron deficiency anemia cytometric, erythrokinetic, and biochemical scheme classifications

Answer 11

• microcytic, hypochromic
• Impaired production
• Blood loss or insufficient dietary iron

Question 12

Most frequently encountered class of anemia

Answer 12

Normocytic

Question 13

Normocytic anemia is a ___ not a ____

Answer 13

sign, disease

Question 14

Nearly all anemias initially present as ___

Answer 14

normocytic

Question 15

Normal size pneumonic for normocytic anemia etiology

Answer 15

Normal pregnancy
Over hydration
Renal disease
Marrow problems
Acute blood loss
Lysis
Systemic Inflammation
Zero production (aplastic)
Endocrine disorderr (thyroid, adrenal)

Question 16

Anemia of chronic disease (ACD) definition

Answer 16

Most common type of normocytic anemia, derived from autoimmune disorders, cancer, CKD, lliver disease, or other infections

Question 17

Anemia of renal disease often has ___ cells appear on a smear

Answer 17

Burr

Question 18

4 sources of pathophysiology of normocytic and hemolytic anemia and some examples

Answer 18

1) decreased RBC production (autoimmune, cancer, renal failure, aplastic bone marrow)
2) destruction or loss of RBC’s (bleeding, hemolysis)
3) uncompensated increase in plasma volume (overhydration, pregnancy)
4) mixed micro/macrocytic anemia (look for elevated RDW because MCV gonna be normal!)

Question 19

Iron is metabolized to ___

Answer 19

Bilirubin

Question 20

Unconjugated bilirubin nickname and definition

Answer 20

AKA indirect, goes to liver

Question 21

Conjugated bilirubin nickname and defintion

Answer 21

AKA direct bilirubin, occurs in the liver

Question 22

Very high levels of bilirubin can harm the brain, in a disease state called

Answer 22

Kernicterus

Question 23

Direct coombs test is testing a response that occurs ___ the body

Answer 23

Inside

Question 24

Indirect coombs test is testing a response that occurs ___ the body

Answer 24

outside (in vitro)

Question 25

Sickle cell crisis

Answer 25

Acute painful attack of the back abodmen and joints that results in fever, dehydration and pulmonary distress due to sickling cells claudicating

Question 26

G6PD deficiency definition

Answer 26

An enzyme that protects the RBC from oxidative damage, a deficiency in G6PD can result in hemolysis in sudden episodic periods despite normal health between episodes

Question 27

3 triggers for G6PD deficiency episode

Answer 27

Sulfonamides
febrile illness
Fava beans

Question 28

G6PD deficiency appearance on peripheral smear

Answer 28

Heinz bodies (small blue dots) of denatured hemoglobin in the cells and bite cells due to macrophages removing heinz bodies