Part 3 Flashcards
- What happens to Heme?
Heme is degraded into a toxic chemical called “Biliverdin”
- What happens to “Biliverdin”
It is further degraded to a toxic (less toxic) yellow colored chemical called “Bilirubin”.
- Bilirubin as it leaves the Spleen is “Unconjugated” or “Free”, is very very toxic to the developing brain the new born baby and if found in high levels will deposit in the Basal Nuclei/Ganglia and lead to permanent Mental Retardation and/or death. This condition is called
Kernicterus
- What is the routing of Unconjugated Bilirubin?
Unconjugated Bilirubin travels to the Liver and is made less toxic by conjugating it with carrier proteins. The Bilirubin that is processed by the Liver is termed “Conjugated Bilirubin” and is excreted in the Intestines via the Bile.
The Human feces have their characteristic dark color due to the presence of Bilirubin. In case the feces are clay colored it could be a sign of Liver failure or Biliary obstruction by a gall stone or a much more serious condition like cancer of the Pancreas/Gall bladder and etc.
- What condition results due to excessive deposition of Bilirubin in the subcutaneous tissues, sclera of the eyes and the urine
Jaundice
- In what conditions can Bilirubin be found to be in excess in the blood?
A
B
C
a. Pre-hepatic causes: excessive breakdown of red blood cells
b. Hepatic causes:
c. Post-hepatic causes:
- What parasites classically are blood sucking?
A
B
C
Hookworms:
Ancylostoma Duodenale
Necator Americanus
- What condition can exacerbate “Iron deficiency” in Pregnancy?
PICA
- Spoon shaped Nails: Koilonychia - Sign of
Iron deficiency
- Lesions at the angles of the mouth that exhibit delayed healing: Cheilitis (Angular Chelosis) - sign of
Iron/riboflavin deficiency
- What vitamin helps in the absorption of Iron from the Intestines?
Vitamin c
- Pernicious anemia: deficiency of Vitamin B12 is common where
Northern Europe - Japan and etc
- Megaloblastic anemia:
Megaloblasts are witnessed - Can be due to deficiency of Vit B12 and/or Folic acid
- Mediterranean anemia?
Thalassemias
Either the apha/beta or both globin chains are malformed. Presents as a picture, opposite to that of Iron deficiency. There is in fact excess of Iron due to perpetual hemolysis. Iron deposits in the vital organs and can precipitate heart/other organ failure. Repeated/periodic blood transfusions are the main stay of management along with Chelation (Deferoxamine)
- What are the classical features of Chronic anemia e.g Sickle cell anemia and/or Thalassemia?
Chipmunk facies.
X ray skull: Hair on end appearance
- IN Sickle Cell Anemia there is a point mutation. Hemoglobin undergoes morphological change in lowered oxygen conditions which results in
the change of shape of the red blood cells (Sickling). These red blood cells block the micro-circulation of the vital organs of the body and a state of Crisis is witnessed e.g. Autosplenectomy, Acute Chest syndrome and etc.
- What is Polycythemia?
Excessive number of Red blood cells in the blood
What are the 3 types of polycythemia?
Polycythemia Vera
Secondary Polycythemia:
Blood Doping:
Type of polycythemia:
Blood doping
Where an athlete will have their own blood transfused to themselves a few hours before the competition (The transfused blood was obtained and stored in a blood bank a few months before in anticipation of its use later on).
Type of polycythemia:
Polycythemia Vera
Cancer of the red blood cells
Type of polycythemia:
Secondary polycythemia
Polycythemia that is due to an identifiable cause:
- Living at high altitudes
- Advance lung disease
- Smoking
- Leukocytosis
WBC count over 11,000 per cubic centimeter
- Must be able to identify the white blood cells:
- Neutrophil - Lymphocyte - Eosinophil - Monocyte - Basophil
- Eosinophils rise in the blood in these 3 conditions:
- Severe Allergies - Parasitic infestations - Drug reactions
