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Pathology EX 2 > RBC > Flashcards

RBC Flashcards

1
Q

Anemia is defined as a ________ in red cell mass, with consequent decrease in ______ capacity of the blood.

A

Reduction

Oxygen transport

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2
Q

Symptoms of Anemia

A

Shortness of breath
Weakness
Fatigue
Pallor

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3
Q

What happens if 500-1000 ml of Red Cell volume lost?

A

usually no effect,

but some will have: sweating, weakness, nausea, slow HR, Hypotension

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4
Q

What happens if 1000-1500 ml of RC volume lost?

A

Lightheaded, orthostatic hypotenstion

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5
Q

1500-2000 ml lost?

A

Decreased BP, loss of consciousness, short breath, rapid pulse, clammy skin

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6
Q

2000-2500 ml lost?

A

Shock then Increase of reticulocyte count!

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7
Q

Chronic hemorrhage occurs when loss is ____ than RBC production, or ____ are depleted

A

more

Iron levels

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8
Q

RBC loss is called?

A

Hemorrhage (acute and chronic)

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9
Q

Decreased RBC survival is called?

A

Hemolysis

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10
Q

Decreased RBC production is due to….

A

Nutritional deficiencies, aplastic anemia, myelophthistic processes

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11
Q

Young healthy individuals can tolerate up to _____ of rapid blood loss with minimal symptoms?

A

1000 ml

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12
Q

Chronic hemorrhage can lead to… bleeding in…

A

GI tract

Menorrhagia (leads to iron deficiency)

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13
Q

RBC destruction is where in Intravascular hemolysis?

A

within circulation

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14
Q

Examples of Intravascular hemolysis?

A

Trauma (non-immune)

Transfusion (immune)

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15
Q

Symptoms of Intravascular hemolysis?

A

Decrease in Haptoglobin (binding protein)

Hemoglobin in urine

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16
Q

RBC destruction is where in Extravascular hemolysis?

A

in Reticuloendothelial system (spleen, liver)

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17
Q

Examples of Extravascular hemolysis?

A

Sickle cell anemia

Spherocytosis

Erthroblastosis fetalis

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18
Q

Symptoms of Extravascular hemolysis?

A

Free hemoglobin not released: only the breakdown products!

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19
Q

______ is when product of hemoglobin lost in the urine

A

Hemosiderinuria

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20
Q

Intrinsic defects of hemolysis are ____ and all _______

A

inherited

all Extravascular

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21
Q

______ is when Hb released from RBC into circulation

A

hemoglobinemia

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22
Q

_____ is when free Hb is excreted in the urine?

A

hemoglobinuria

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23
Q

_______ is dependent on the functional capacity of the liver and rate of hemolysis

A

The degree of jaundice

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24
Q

4 intrinsic defects of Hemolysis

A
  1. Spherocytosis (hereditary)
  2. Sickle cell anemia (autosomal codominant)
  3. Thalassemia (autosomal codominant)
  4. Glucose-6-phosphate dehydrogenase (G6PD) deficiency (X-linked)
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25
Q

Chronically elevated levels of _____ can promote formation of ______

A

bilirubin

gallstones

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26
Q

spherocytosis results in _______ so that they are sequestered and destroyed in the spleen due to deficiency of ______, a structural protein of the cytoskeleton. Removal of spleen results in normal red cell survival but not normal ______

A

less deformability of RBC

spectrin

morphology

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27
Q

Sickle cell anemia is a disease with _____ hemoglobin. Single base pair amino acid substitution (valine for glutamate) at ______ in the beta chain of globin to produce _______

A

abnormal
position 6
sickle hemoglobin (HbS)

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28
Q

Sickle cell anemia causes cells to be ____ and vulnerable to splenic sequestration which _______ survival

A

rigid

decreases

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29
Q

sickled cells also become trapped in the ______ leading to __________

A

microcirculation

ischemia/infarction

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30
Q

________ and _____ are two leading causes of ischemia-related death for affected patients

A

acute chest syndrome

stroke

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31
Q

About ____ of blacks in USA have sickle cell trait but usually asymptomatic due to low concentration of HbS but it is protective against _______

A

8%

Malaria

32
Q

Thalassemia (lack of globin chains) results in diminished or absent synthesis of ___ or ____ globin chains of hemoglobin

A

alpha

beta

33
Q

Thalassemia leads to decreased ____ production which results in _____ production

A

globin

hemoglobin

34
Q

Thalassemia occurs due to ______ and _____

A

point mutation, gene depletion

35
Q

Thalassemia is common in people of __________ and also protective against _______

A

mediterranean, african, southeast asian descent

malaria

36
Q

G6PD deficiency (X-linked) is primarily in blacks in which red cells are ________ to oxidant injury by ______ or ______

A

susceptible

drugs or toxins

37
Q

G6PD deficiency has denatured oxidized hemoglobin which attaches to the RBC and ________ and causing ________

A

less flexibility

hemolysis

38
Q

Extrinsic defects of hemolytic anemia

A
  1. Erythroblastosis fetalis (Extravascular)
  2. Hemolytic transfusion reaction (Intravascular)
  3. Autoimmune hemolysis (Extravascular)
  4. Cardiac valve prosthesis (Intravascular)
  5. Malaria
39
Q

hemolytic disease of the newborn (HDN) is also known as _______

A

Erythroblastosis fetalis

40
Q

HDN is caused by?

A

blood group incompatibility between mother and fetus

In utero only

41
Q

HDN occurs when the _______ express antigens inherited from the father that are not present in the mother

A

fetal RBC

42
Q

Fetal red cells enter the maternal circulation resulting in _______

A

sensitization

43
Q

_______ antibodies can cross the placenta

A

maternal IgG

44
Q

IN HDN, _____ and _____ are the most common

A

ABO

Rh antigens

45
Q

________ is given to group ________ mothers routinely

A

anti-D

group O negative

46
Q

____ and _____ infants of group O mothers are also at risk

A

A

B

47
Q

Hemolytic transfusion reaction is when _______ red cells into a sensitized patient results in __________

A

incompatible red cells

binding of antibody to antigen (transfused RBC) with activation of complement and immediate intravascular hemolysis.

48
Q

Complement _______ RBC

A

lyses antibody-coated

49
Q

Autoimmune hemolysis is when patient makes antibodies to _______. Antibody-coated cells can be ______ or ______ by the reticuloendothelial system.

A

own RBCs.

lysed (complement activation) removed

*positive direct coomb’s test?

50
Q

_______ is the hallmark of autoimmune hemolytic anemia

A

Spherocytes

51
Q

Cardia valve prosthesis is when red cells are disrupted by _______ as they pass through areas of turbulence and abnormal pressure related to abnormal valve function.

A

physical trauma

DIC is an example

52
Q

Disseminated intravascular coagulation is where RBCs are lysed as they pass through _______ in the _______.

A

clots/strands

microcirculation

53
Q

________ (RBC fragments) are the hall mark of hemolysis due to mechanical trauma

A

schistocytes

54
Q

Parasies (malaria) can infect red cells resulting in _______. it is an ______ hemolysis

A

lysis

intravascular hemolysis

55
Q

What type of anemia is most common basis of anemia worldwide?

A

Iron deficiency anemia

devleops slowly in most cases

56
Q

Iron is need for ________

A

hemoglobin

globin

variety of enzymes

57
Q

In Iron deficiency anemia, RBCs become ______ and contain _______ than usual

A

smaller (microcytic)

hemoglobin (hypochromic)

58
Q

Iron deficiency anemia usually occurs most commonly in…..

A 
infants (inadequate intake)
adolescents (increased requirement)
pregnancy 
elderly
alcoholics
59
Q

Iron deficiency anemia can lead to more __________

A

serious disorder (cancer)

60
Q

Vitamin B12 and folate deficiency anemias are also known as _____

A

megaloblastic anemia

61
Q

Both B12 and folate are involved in the synthesis of _____

A

thymidine

62
Q

Impaired DNA synthesis caused by B12 and folate show a delay in ________

A

mitotic division: same nuclear size

RNA synthesis and cytoplasmic maturation proceed normally

63
Q

Vitamin B12 is found in ______ with _____ body stores and Folate is found in ________ with ____ body stores

A

Animal foods, large body stores

Fresh veggies, small body stores

64
Q

________ anemia is caused by autoantibodies to parietal cells and intrinsic factor

A

Pernicious

65
Q

B12 deficiency is also associated with ________

A

atrophic gastritis

66
Q

Megaloblastic features are indistinguishable morphologically in folate and B12 deficiencies, diagnosis is by lab tests testing ______

A

serum B12 level, RBC folate levels, presence of AB directed against intrinsic factor

67
Q

Aplastic anemia and Myelophthisic anemia are due to ________

A

red cell production

68
Q

Aplastic anemia is when production of all cellular elements of blood is ______.

A

decreased

69
Q

Two major pathogenic theories of Aplastic anemia?

A
  1. an acquired defect in stem cell production or suppression of stem cells by T lymphocytes
70
Q

Bone marrow transplantation in aplastic anemia has been successful, under ______ years old

A

40

71
Q

Myelophthisic anemia is when normal hematopoietic cells in the marrow are crowded out by ___ or ____

A

tumor (myeloma, metastatic cancer)

or

fibrosis

72
Q

Polycythemia is when there is _________

A

an increase in red cell mass

73
Q

Relative polycythemia is related to…

A

Dehydration, vomiting, diarrhea

74
Q

Absolute polycythemia can be _____

A

a primary or secondary

75
Q

Primary absolute polycythemia is when a _______ proliferation of RBCs also known as ______

A

neoplastic

Polycythemia vera

76
Q

Secondary absolute polycythemia is when there is an _____ in _____ production

A

increase, erythropoietin

cyanotic heart disease, pumonary disease, living at high altitudes, erythropoitein producing tumors

77
Q

Primary and secondary polycythemia are distinguished by _________

A

erythropoietin levels

Pathology EX 2 (3 decks)

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