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HEMATOLOGY 2🙏 > QUANTITATIVE RED CELL DISORDERS > Flashcards

QUANTITATIVE RED CELL DISORDERS Flashcards

1
Q

QUANTITATIVE RED CELL DISORDERS

A
  1. IRON DEFICIENCY ANEMIA
  2. ANEMIA OF CHRONIC INFLAMMATION
    3.SIDEROBLASTIC ANEMIA
    Lead Poisoning
    Porphyrias
    4.IRON OVERLOAD
    5.MEGALOBLASTIC ANEMIA
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2
Q

-develops due to inadequate intake, increased need, impaired absorption, and chronic blood loss

  • develops slowly, progressing through stages that physiologically blend into one another.
A

IRON DEFICIENCY ANEMIA

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3
Q

Storage compartment

A

ferritin

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4
Q

Transport compartment

A

transferrin

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5
Q

Functional compartment

A

hemoglobin, myoglobin, cytochrome

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6
Q

Hemoglobin N
Serum Iron N
TIBC INCREASED
Ferritin DECREASED

A

STAGE 1 IRON DEFICIENCY ANEMIA IDA

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7
Q

Hemoglobin N
Serum Iron DECREASED
TIBC INCREASED
Ferritin DECREASED

A

Stage 2 IDA (Transport iron depletion)

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8
Q

Hemoglobin DECREASED
Serum Iron DECREASED
TIBC INCREASED
Ferritin DECREASED

A

Stage 3 IDA
( Functional iron depletion)

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9
Q

IRON DEFICIENCY ANEMIA SYMPTOMS

A

-Fatigue, weakness, shortness of breath (especially with exertion)
-Pallor is evident in light-skinned individuals
-Pallor in the conjunctiva, mucous membranes or palmar creases of dark-skinned individuals
-Glossitis
-Angular cheilosis
-Koilonychia
-Pica

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10
Q

Laboratory diagnosis:
Screening: IDA should be suspected when the CBC findings show a ?

A

hypochromic, microcytic anemia with an elevated
RDW but no consistent shape changes to the RBC

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11
Q

Serum ferritin DECREASED
Serum iron DECREASED OR NORMAL
TIBC INCREASED
Transferrin saturation DECREASED

A

Iron deficiency anemia or IDA

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12
Q

-inflammation is the unifying factor
- sideropenia in the face of an ABUNDANT IRON stores is the central feature
- the impaired ferrokinetics is the more significant cause of the anemia

A

ANEMIA OF CHRONIC INFLAMMATION

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13
Q

Substances that contribute/explain the inconsistency of decreased serum iron despite the abundant iron stores:

A

1.Hepcidin - a hormone produced by hepatocytes to regulate body iron levels

2.Lactoferrin - an iron-binding protein in granules of neutrophils

3.Ferritin

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14
Q

Peripheral blood picture is that of mild anemia, with hemoglobin concentration usually 8-10 g/dL, and without reticulocytosis

A

ANEMIA OF CHRONIC INFLAMMATION

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15
Q

Normocytic, normochromic.

Prussian blue stain of the bone marrow confirms abundant stores of iron in macrophages.

A

ANEMIA OF CHRONIC INFLAMMATION

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16
Q

are a diverse group of diseases that include hereditary and acquired conditions

A

SIDEROBLASTIC ANEMIA

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17
Q
  • the metal affects the central nervous system and the hematologic system
  • interferes with porphyrin synthesis
A

Lead Poisoning

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18
Q
  • basophilic stippling is a classic finding
  • represents punctate basophilia
A

Lead Poisoning

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19
Q

-are diseases characterized by impaired production of the porphyrin component of heme

  • is the most often used to refer to the hereditary conditions that impair production of protoporphyrin
A

Porphyrias

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20
Q

most common inherited porphyria

A

Acute intermittent hepatic porphyria

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21
Q

Deficient enzyme:

Uroporphyrinogen I synthetase/ Porphobilinogen synthase

A

Acute intermittent hepatic porphyria

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22
Q

Increased delta-aminolevulinic acid and porphobillinogen in urine

A

Acute intermittent hepatic porphyria

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23
Q

Deficient enzyme

Coproporphyrinogen II oxidase

A

Hereditary coproporphyria

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24
Q

Increased coproporphyrin III in urine and feces

A

Hereditary coproporphyria

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25
Q

Deficient enzyme

Protoporphyrinogen oxidase/ Porphobilinogen oxidase

A

Variegate porphyria

26
Q

Increased porphobilinogen and delta-aminolevulinic acid in urine and protoporphyrinogen and coproporphyrin in feces

A

Variegate porphyria

27
Q

Deficient enzyme

Uroporphyrinogen decarboxylase

A

Cutaneous hepatic porphyria

28
Q

Increased uroporphyrin I in urine

A

Cutaneous hepatic porphyria

29
Q

Deficient enzyme

Uroporphyrinogen III cosynthase

A

Congenital erythropoietic porphyria

30
Q

Increased uroporphyrinogen I and coproporphyrinogen I in urine, feces, and bone marrow

A

Congenital erythropoietic porphyria

31
Q

Congenital erythropoietic porphyria involved?

A

Erythroid

32
Q

Deficient enzyme

Delta-aminolevulinic acid dehydrase and ferrochelatase

A

Acquired porphyria

33
Q

Porphyrias diseases

A

1.Acute intermittent hepatic porphyria
2.Hereditary coproporphyria
3.Variegate porphyria
4.Cutaneous hepatic porphyria
5.Congenital erythropoietic porphyria
6.Acquired porphyria

34
Q

1.Acute intermittent hepatic porphyria
2.Hereditary coproporphyria
3.Variegate porphyria
4.Cutaneous hepatic porphyria

Involved?

A

HEPATIC/LIVER

35
Q

excess accumulation of iron results from acquired or hereditary conditions in which the body’s rate of iron acquisition exceeds the rate of loss

A

IRON OVERLOAD

36
Q

excess iron are stored in the form of ferritin and hemosiderin (non-metabolically active form of ferritin) within cells.

A

IRON OVERLOAD

37
Q

IRON OVERLOAD
accumulation of iron in the macrophages, with less parenchymal injury

A

ACQUIRED Transfusion-related hemosiderosis

38
Q

IRON OVERLOAD
-mutations of HFE gene remain the most common

  • individuals usually harbor 20 to 30 g of iron by the time their disease usually becomes clinically evident
  • accumulation of iron in the parenchymal cells, with tissue injury
  • traditional characterization: Bronzed diabetes
A

Hereditary hemochromatosis

39
Q

Elevated transferrin saturation or serum ferritin Abnormal results on common tests of liver function

A

IRON OVERLOAD

40
Q
  • defective nuclear maturation due to impaired DNA synthesis due to Vitamin B12 or folate deficiency
  • the resulting DNA is nonfunctional, DNA replication process is incomplete, and cell division is halted
  • ineffective erythropoiesis
A

MEGALOBLASTIC ANEMIA

41
Q
  • defective nuclear maturation due to impaired DNA synthesis due to Vitamin B12 or folate deficiency
  • the resulting DNA is nonfunctional, DNA replication process is incomplete, and cell division is halted - ineffective erythropoiesis
A

MEGALOBLASTIC ANEMIA

42
Q

Causes of Folate deficiency:

A
  • Inadequate intake
  • Increased need
  • impaired absorption
  • impaired use of folate
  • excessive loss of folate
43
Q

Causes of Vitamin B12 deficiency

A
  • Inadequate intake
  • increased need
  • impaired absorption
    1. Failure to separate vitamin B12 from food proteins
    2. Failure to separate vitamin B12 from haptocorin
    3. Lack of intrinsic factor
    4. Malabsorption
    5. Competition for vitamin B12
44
Q
  • is an autoimmune disorder characterized by impaired absorption of vitamin B12 due to a lack of intrinsic factor
A

Pernicious Anemia

45
Q
  • production of antibodies to intrinsic factor and gastric parietal cells
  • autoantibodies are directed against the a- and b- subunit of the gastric H+/K+ -ATPase, a hydrogen transporting enzyme, responsible for the acidification of the stomach lumen
A

Pernicious Anemia

46
Q
  • caused by mutations in the genes for either cubilin or amnionless
A

Imerslund-Gräsbeck syndrome

47
Q

Systemic manifestations of folate and vitamin B12 deficiency:

A
  • general symptoms related to anemia
  • glossitis
  • gastritis, nausea, constipation
  • neurologic symptoms may be pronounced and may even occur in the absence of anemia (Vitamin B12 deficiency)
48
Q

Systemic manifestations of folate and vitamin B12 deficiency:

A
  • general symptoms related to anemia
  • glossitis
  • gastritis, nausea, constipation
  • neurologic symptoms may be pronounced and may even occur in the absence of anemia (Vitamin B12 deficiency)
49
Q

Laboratory diagnosis:
SCREENING TESTS MEGALOBLASTIC ANEMIA

A

CBC
PBS
BILIRUBIN
LACTATE DEHYDROGENASE

50
Q

decreased hemoglobin and hematocrit levels, pancytopenia, reticulocytopenia

A

CBC

51
Q

oval macrocytes, hypersegmented neutrophils with six or more lobes, nucleated RBCs, Howell-Jolly bodies, basophilic stippling, Cabot rings

A

PBS

52
Q

increased

A

Bilirubin
Lactate dehydrogenase

53
Q
  • are macrocytic anemias in which DNA is unimpaired
  • lack hypersegmented neutrophils and oval macrocytes in the peripheral blood and megaloblasts in the bone marrow
A

Macrocytic nonmegaloblastic anemias

54
Q

Remains the reference confirmatory test to identify megaloblastic appearance of the developing RBCs

A

Bone marrow examination

55
Q

Competitive binding chemiluminesence

A

Serum Vitamin B12

56
Q

GC-MS

A

Methylmalonic acid

57
Q

Used to diagnose pernicious anemia

A

Schillings test

58
Q

Pathophysiology includes:
- destruction of hematopoietic stem cells due to injury by drugs, chemicals, radiation, viruses, or autoimmune mechanisms

  • premature senescence and apoptosis
  • ineffective hematopoiesis due to stem cell mutations or vitamin B12 or folate deficiency
  • disruption of the bone marrow microenvironment that supports hematopoiesis - decreased production of hematopoietic growth factors or related hormones
  • loss of normal hematopoietic tissue
A

BONE MARROW FAILURE

59
Q

include pancytopenia, reticulocytopenia, bone marrow hypercellularity, and depletion of hematopoietic stem cells

A

APLASTIC ANEMIA

60
Q

Acquired Aplastic Anemia
Two major categories:

A
  1. Idiopathic acquired aplastic anemia - 70%
  2. Secondary acquired aplastic anemia - 10%-15%

HEMATOLOGY 2🙏 (12 decks)

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