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Hematology 2 Lec > NORMOCYTIC NORMOCHROMIC ANEMIA > Flashcards

NORMOCYTIC NORMOCHROMIC ANEMIA Flashcards

1
Q

APLASTIC ANEMIA
-Otherwise known as

A

“ Hypoplastic anemia”

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2
Q

APLASTIC ANEMIA
Characterized by:

-reduction of (?) due to (?) resulting to deficient production of (?)

A

hematopoietic tissues

hypocellular marrow

blood cells

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3
Q

APLASTIC ANEMIA
Common signs:

A

Anemia, infection and bleeding -No splenomegaly and lymphadenopathy

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4
Q

APLASTIC ANEMIA
Pathogenesis:

A.Direct damage to (?)
B.Immune mediated destruction of (?)
C.Decreased effectiveness/production of (?)

A

hematopoietic stem cells and progenitor cells

marrow cell

EPO

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5
Q

APLASTIC ANEMIA Types:

A

a) Idiopathic Aplastic Anemia

b) Acquired Aplastic Anemia

c) Constitutional Aplastic Anemia

*Familial Aplastic anemia

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6
Q
  • with more insidious onset/ unknown origin
A

a) Idiopathic Aplastic Anemia

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7
Q
  • exposure to certain physical and chemical agents, some drugs like antimicrobials, anticonvulsants, analgesics, and radiation (Benezene)
A

b) Acquired Aplastic Anemia

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8
Q

**Benzene effect:
(a) metabolism of benzene in the [?];
(b) transport of metabolites to the marrow and their secondary activation to [?] by peroxidase enzymes;
(c) induction of apoptosis, DNA damage and altered differentiation in (?); and
(d) depletion of the [?]

A

liver

toxic quinones and free radicals

early progenitor cells

stem cell pool

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9
Q

-associated with congenital anomalies or with genetic predesposition to chronic BM failure

A

c) Constitutional Aplastic Anemia

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10
Q

-developmental abnormalities including hyperpigmentation, short stature, hypogonadism, mental retardation, strabismus and malformation

A
  • Fanconi’s Anemia (Congenital Aplastic anemia)
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11
Q
  • subset of Fanconi’s Anemia.
A

*Familial Aplastic anemia

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12
Q

-Pancytopenia, hypocellular marrow but without developmental abnormalities

A

*Familial Aplastic anemia

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13
Q

Pure Red Cell Aplasia Subtypes:

A

*)Transitory Arrest of Erythropoiesis/ Transient aplastic crises
*) Transient Erythroblastopenia of Childhood
*) Acquired Pure red cell aplasia
*) Congenital Red Cell aplasia/Congenital Hypoplastic Anemia (Diamond-Black fan anemia)

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14
Q

-occur during course of a hemolytiv anemia preceded by an infection with Parvovirus B19

A

*)Transitory Arrest of Erythropoiesis/ Transient aplastic crises

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15
Q

-associated with history of viral infections w/n the last 3 months

A

*) Transient Erythroblastopenia of Childhood

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16
Q

-associated with thymoma

A

*) Acquired Pure red cell aplasia

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17
Q

-caused by a defect in the CFU-E and BFU-E

A

*) Congenital Red Cell aplasia/Congenital Hypoplastic Anemia (Diamond-Black fan anemia)

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18
Q

Hematologic classification: Congenital pure red cell aplasia

A

DIAMOND-BLACKFAN ANEMIA

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19
Q

Hematologic classification: Congenital aplastic anemia

A

FANCONI ANEMIA

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20
Q

Brown skin pigmentation: Uncommon

A

DIAMOND-BLACKFAN ANEMIA

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21
Q

Brown skin pigmentation: Common

A

FANCONI ANEMIA

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22
Q

Thumb abnormalities: Uncommon

A

DIAMOND-BLACKFAN ANEMIA

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23
Q

Thumb abnormalities: Common

A

FANCONI ANEMIA

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24
Q

Renal abnormalities: Uncommon

A

DIAMOND-BLACKFAN ANEMIA

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25
Q

Renal abnormalities: Common

A

FANCONI ANEMIA

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26
Q

Onset of hematologic abnormalities: <1 year of age

A

DIAMOND-BLACKFAN ANEMIA

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27
Q

Onset of hematologic abnormalities: 5-10 years of age

A

FANCONI ANEMIA

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28
Q

BM biopsy: Cellular

A

DIAMOND-BLACKFAN ANEMIA

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29
Q

BM biopsy: Hypoplastic to aplastic

A

FANCONI ANEMIA

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30
Q

BM aspirate: Marked decrease in erythroid precursor only

A

DIAMOND-BLACKFAN ANEMIA

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31
Q

BM aspirate: Pancytopenia

A

FANCONI ANEMIA

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32
Q

Peripheral blood: Decrease in RBC,WBC and plt

A

DIAMOND-BLACKFAN ANEMIA

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33
Q

Peripheral blood: Pancytopenia

A

FANCONI ANEMIA

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34
Q

Cytogenetics: No assoc abnormalities

A

DIAMOND-BLACKFAN ANEMIA

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35
Q

Cytogenetics: Multiple chromosomal abnormalities in many tissues

A

FANCONI ANEMIA

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36
Q

-Normocytic/Normochromic

A

MYELOPHTISIC ANEMIA

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37
Q

-Associated with marrow replacement by metastatic carcinoma, multiple myeloma or other conditions

A

MYELOPHTISIC ANEMIA

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38
Q

MYELOPHTISIC ANEMIA
-Characterized by the presence of :

A

normoblast and immature neutropils (leukoerythroblastic anemia)

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39
Q

: inappropriate release of immature erythroid and myeloid due to damage to the underlying marrow stroma by invasion of abnormal cells

A

**Myelopthisis

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40
Q

-N/N to M/H

A

ANEMIA OF CHRONIC DISORDER

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41
Q

-Associated with chronic diseases

A

ANEMIA OF CHRONIC DISORDER

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42
Q

-Decreased EPO production

A

*Anemia of Renal insufficiency

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43
Q

prominence of burr cells, helmet cell and fragments

A

*Anemia of Renal insufficiency

44
Q

Low iron in serum but normal TIBC

A

*Anemia of Renal insufficiency

45
Q

-Hypothyroidism

A

*Anemia of Endocrine diseases

46
Q

exhbits macrocytic, normochromic cells despite having normal B12 and folate

A

*Anemia of Endocrine diseases

47
Q

prominence of acanthocytes due to elevated cholesterol.

A

*Anemia of Endocrine diseases

48
Q

-Inherited refractory anemia characterized by eythroid multinuclearity, karyorrhexis and bizarre malformations

A

Congenital Dyserythropoietic Anemia (CDA)

49
Q

Congenital Dyserythropoietic Anemia (CDA) Types:

A

I. Megaloblastic changes w/ some binuclearity
II. HEMPAS (Herediatry Eyrhtroblastic Multinuclearity with a Positive Serum Test)
III. Giant erythroid precursor w/ pronounced multinuclearity

50
Q

-most common type

A

HEMPAS (Herediatry Eyrhtroblastic Multinuclearity with a Positive Serum Test)

51
Q

-shows binuclearity and multinuclearity

A

HEMPAS (Herediatry Eyrhtroblastic Multinuclearity with a Positive Serum Test)

52
Q

-RBC’s possess the “i” blood antigen (HEMPAS antigen)

A

HEMPAS (Herediatry Eyrhtroblastic Multinuclearity with a Positive Serum Test)

53
Q

▪ characterized by a severe reduction of the amount of hematopoietic tissues that results to deficient production of blood cells (hypocellular bone marrow)

A

APLASTIC/HYPOPLASTICANEMIA

54
Q

▪ rare but potentially fatal bone marrow failure syndrome

A

APLASTIC/HYPOPLASTICANEMIA

55
Q

▪ most serious clinical problems relate to neutropenia and thrombocytopenia

A

APLASTIC/HYPOPLASTICANEMIA

56
Q
  • Anemia with normal mophologies (no problem with iron and hemoglobin)
A

APLASTIC/HYPOPLASTICANEMIA

57
Q
  • bm fails to produce rbc
A

APLASTIC/HYPOPLASTICANEMIA

58
Q
  • Otherwise known as “ Hypoplastic anemia”
A

APLASTIC/HYPOPLASTICANEMIA

59
Q
  • Characterized by:
    ● reduction of hematopoietic tissues
    ● hypocellular marrow deficient production of red blood cells
A

APLASTIC/HYPOPLASTICANEMIA

60
Q
  • Common signs: Anemia, infection and bleeding
A

APLASTIC/HYPOPLASTICANEMIA

61
Q
  • No splenomegaly (no excess production to accomodate extra cells) and no lymphadenopathy
A

APLASTIC/HYPOPLASTICANEMIA

62
Q

CHARACTERISTIC FEATURES

A

▪ no response to EPO (working normal but bm not responding)
▪ reticulocytopenia
▪ bone marrow hypocellularity

63
Q
  • ↓: Hb, Hct, Retic ct
A
64
Q
  • ↑/N: EPO
A
65
Q

PATHOGENESIS

A
  1. Direct damage to the hematopoietic stem and progenitor cells
  2. Immune-mediated destruction of marrow cells
  3. Decreased effectiveness/production of EPO
66
Q

Causes:
- Chemicals
- Accidents (breakage of femur/tissue damage)

A
67
Q
  • Ab working against the bm damaging the stem cells (less comon)
A
68
Q
  • No problem in bm but in EPO (more common)
A
69
Q

FACTORS AFFECTING IRON ABSORPTION

A

A1. Idiopathic Aplastic Anemia

A2 .Acquired Aplastic Anemia

A3. Constitutional Aplastic Anemia

70
Q

with more insidious (sudden) onset/unknown origin

A

Idiopathic Aplastic Anemia

71
Q

has no known cause/origin

A

Idiopathic Aplastic Anemia

72
Q

Effects of exposure to:
• certain physical and chemical agents:

  • ionizing radiation
  • benzene
A

Acquired Aplastic Anemia

73
Q

▪ associated with other congenital anomalies (since birth) or with genetic predisposition to chronic bone marrow failure

A

Constitutional Aplastic Anemia

74
Q
  • occurs in Children
A

Fanconi’s Anemia (Congenital Aplastic Anemia)

75
Q

features of developmental abnormalities that include:
• hyperpigmentation
• short stature
• hypogonadism
• mental retardation
• strabismus
• malformation of the extremities

A

Fanconi’s Anemia (Congenital Aplastic Anemia)

76
Q
  • occurs in Any age; more severe
A

Familial Aplastic Anemia

77
Q

• subset of Fanconi’s anemia

A

Familial Aplastic Anemia

78
Q

• patients may have pancytopenia and a hypocellular marrow without major developmental abnormalities

A

Familial Aplastic Anemia

79
Q

may occur during the course of a hemolytic anemia often preceded by an infection with Parvovirus B19

A

Transitory Arrest of Erythropoiesis/Transient Aplastic Crises

80
Q

● Targets mature CFU-E (forming unit of erythrocyte)

A

Parvovirus B19

81
Q

● Infects humans (different strain in dogs)

A

Parvovirus B19

82
Q

associated with a history of viral infections within the last 3 months having humoral inhibition

A

Transient Erythroblastopenia of Childhood (TEC)

83
Q
  • Transient suppresion of humoral immune system concerning B lymphocytes
    ● Ex. Occurs after 3 mos of covid infection
    ● trasient due to recent viral infection
A

Transient Erythroblastopenia of Childhood (TEC)

84
Q

▪ associated with thymoma (tumors of the thymus gland)

A

Acquired Pure Red Cell Aplasia

85
Q

▪ Diamond-Blackfan anemia: common name

A

Congenital Red Cell Aplasia/Congenital Hypoplastic Anemia (Diamond-Blackfan anemia)

86
Q

▪ caused by a defect in the erythroid-committed progenitor cell (CFU-E and BFU-E) resulting to its accelerated apoptosis

A

Congenital Red Cell Aplasia/Congenital Hypoplastic Anemia (Diamond-Blackfan anemia)

87
Q

associated with marrow replacement by metastatic carcinoma, multiple myeloma, or other conditions

A
88
Q

anemia that develops in leukemia = normocytic normochromic

A

MYELOPHTHISIC ANEMIA

89
Q
  • Resembles milary tuberculosis or granuloma
A

MYELOPHTHISIC ANEMIA

90
Q

characterized by the presence of varying number of:
• normoblasts (↑NRBC) (normoblastic anemia)
• immature neutrophils or blast cells of rbc (leukoerythroblastic anemia)
• peripheral blood granulocytic (WBC) shift to the left (associated with the appearance of bands, metamyelocytes, and myelocytes; increased blasts/immature cells)

A

MYELOPHTHISIC ANEMIA

91
Q

Blood picture:
• usually normocytic-normochromic
• occasionally microcytic-hypochromic

A

ANEMIA OF CHRONIC DISORDERS

92
Q

ASSOCIATED CHRONIC DISEASES

A

*Anemia of Renal insufficiency
*Anemia of Liver diseases
*Anemia of Endocrine diseases

93
Q
  • N/N to M/H
A
  • Inc cytokine
  • Dec EPO
  • Altered iron metabolism (microcytic)
94
Q

▪ megaloblastic changes with some binuclearity (N-C asynchrony)

A

CDA TYPE I

95
Q

▪ mild to severe chronic anemia

A

CDA TYPE I

96
Q

▪ caused by mutations in the CDAN1 or C15orf41 genes

A

CDA TYPE I

97
Q
  • chromosome 15
A

CDA TYPE I

CDA TYPE III

98
Q

▪ Hereditary Erythroblastic Multinuclearity with a Positive Acid Serum Test (HEMPAS)

A

CDA TYPE II

99
Q

• most common subtype

A

CDA TYPE II

100
Q

• red cells show binuclearity and multinuclearity

A

CDA TYPE II

101
Q

▪ RBCs possess the i-blood antigen (HEMPAS antigen) — severe hemolysis

A

CDA TYPE II

102
Q

▪ results from mutations in the SEC23B gene

A

CDA TYPE II

103
Q
  • chromosome 20 (most common type of CDA)
A

CDA TYPE II

104
Q

▪ least common of the CDA subtypes

A

CDA TYPE III

105
Q

▪ giant erythroid precursor with more pronounced multinuclearity (blast cell divides, but w/o daughter cell; nulceus divides similar to megakayocyte appearance)

A

CDA TYPE III

106
Q

associated with mutations in the KIF23 gene, which codes for a protein involved in cytokinesis

A

CDA TYPE III

Hematology 2 Lec (29 decks)

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