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Hematology 1 > RBC AND ANEMIA > Flashcards

RBC AND ANEMIA Flashcards

1
Q

process of blood formation

A

hematopoiesis

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2
Q

process of RBC formation

where does it take place?

A

erythropoiesis

bone marrow

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3
Q

process of WBC formation

A

leukopoiesis

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4
Q

process of PLT formation

A

thrombopoiesis

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5
Q

total population of RBC inside the body

A

erythron

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6
Q

total population of RBC in circulation only

A

RBC mass

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7
Q

dynamics of RBC creation and destruction

A

erythrokinetics

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8
Q

graveyard of RBC

A

spleen

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9
Q

production of defective erythroid precursors

A

ineffective erythropoiesis

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10
Q

how does RBC die in effective erythropoiesis?

A

defective RBC precursors often undergo apoptosis

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11
Q

examples of ineffective erythropoiesis (4)

vfts

A

vitamin B12 deficiency
folate deficiency
thalassemia
sideroblastic anemia

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12
Q

type of anemia for vitamin B12 deficiency and folate deficiency

A

macrocytic, normochromic anemia

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13
Q

type of anemia for thalassemia and sideroblastic anemia

A

microcytic, hypochromic anemia

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14
Q

decrease in the number of erythroid precursors in the BM

A

insufficient erythropoiesis

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15
Q

examples of insufficient erythropoiesis (3)

A

IDA
renal disease
acute leukemia

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16
Q

type of anemia for IDA

A

microcytic, hypochromic anemia

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17
Q

type of anemia for renal disease and acute leukemia

A

normocytic, normochromic anemia

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18
Q

immature hematopoietic cell that is committed to a cell line but cannot be identified morphology

A

progenitor cells

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19
Q

examples of progenitor cells

A

BFU-E (bust forming unit)

CFU-E (colony forming unit)

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20
Q

immature hematopoietic cell that is morphologically identifiable as belonging to a given cell line

A

precursor cells

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21
Q

examples of precursor cells

A

rubriblast, prorubricyte

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22
Q

earliest marker of erythroid differentiation; transferrin receptor

A

CD71

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23
Q

meaning of CD

A

clusters of differentiation

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24
Q

transport protein of iron in the plasma

A

transferrin

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25
Q

chief stimulatory cytokine for RBC; major hormone that stimulates the production of erythrocytes

A

erythropoietin (EPO)

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26
Q

primary organ and cell source of EPO

A

kidney

peritubular interstitial cells

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27
Q

primary target cells of EPO

A

BFU-E and CFU-E

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28
Q

3 major effects of EPO

A
  1. early release of retics from BM
  2. reduce the time needed for cells to mature in BM
  3. preventing apoptosis
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29
Q

artificial way to induce RBC production using EPO

A

blood doping

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30
Q

hormone produced by pituitary gland that directly stimulates erythropoiesis

A

growth hormone

prolactin

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31
Q

hormone produced by testes/ovaries that indirectly stimulates erythropoiesis

A

testosterone

estrogen

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32
Q

the hormone that suppresses production of EPO

A

estrogen

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33
Q

T or F.
it takes about 21 to 30 days for the BFU-E to mature to an erythrocyte, of which approximately 7 days are spent as recognizable precursors in the bone marrow

A

18-20 days

6 days

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34
Q

RBC precursors (all stages)

A 
rubriblast
prorubricyte
rubricyte
metarubricyte
reticulocyte
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35
Q

3 RBC naming

A

rubriblast, normoblast, erythroblast

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36
Q

1st RBC stage

A

rubriblast/ pronormoblast/ proerythroblast

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37
Q

2nd RBC stage

A

prorubricyte/ basophilic normoblast/erythroblast

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38
Q

3rd RBC stage

A

rubricyte/ polychromatophilic normoblast/erythroblast

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39
Q

4th RBC stage

A

metarubricyte/ orthochromatic normoblast/erythroblast

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40
Q

5th RBC stage

A

reticulocyte

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41
Q

6th RBC stage

A

mature erythrocyte

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42
Q

supravital stains for retics:

A

brilliant cresyl blue

new methylene blue

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43
Q

t or f. if you use wright stain, the reticulocyte will change its name

A

true
polychromatophilic erythrocyte
diffusely basophilic erythrocyte

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44
Q

rubriblast characteristics

A

nucleoli: 1-2
cytoplasm: basophilic
N:C ratio: 8:1

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45
Q

RBC basophilia (color) correlation

A

cytoplasmic basophilia = ribosomal RNA

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46
Q

RBC eosinophilia (color) correlation

A

cytoplasmic eosinophilia = hemoglobin

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47
Q

last RBC stage with nucleolus

A

prorubricyte

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48
Q

this is where hemoglobinization starts

A

prorubricyte

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49
Q

prorubricyte gives rise to:

A

4 rubricytes

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50
Q

prorubricyte characteristics

A

nucleoli: 0-1
coarser chromatin
absence of nucleoli
N:C ratio: 6:1

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51
Q

rubriblast gives rise to:

A

2 prorubricytes

52
Q

rubricyte gives rise to:

A

2 metarubricytes

53
Q

last RBC stage capable of mitosis

A

rubricyte

54
Q

first RBC stage in which cytoplasm becomes pink

A

rubricyte

55
Q

lymphocyte vs rubricyte

A

lympho

nucleus: crushed velvet
cytoplasm: sky blue

rubri

nucleus: checkerboard
cytoplasm: muddy/gray

56
Q

rubricyte N:C ratio

A

4:1

57
Q

RBC precursor that has the same color with mature RBC

A

metarubricyte

58
Q

last RBC stage with nucleus

A

metarubricyte

59
Q

other names of metarubricyte

A

nucleated RBC
pyknotic erythroblast
acidophilic normoblast

60
Q

enveloped extruded nucleus of RBC

A

pyrenocyte

61
Q

which WBC engulfs the extruded nucleus of metarubricyte

A

macrophage

62
Q

small fragment of the extruded nucleus left in the RBC

A

howell-jolly bodies

63
Q

who removes howell-jolly bodies?

A

splenic macrophages

64
Q

in which RBC stage hemoglobin is first synthesized?

A

prorubricyte

65
Q

last immature RBC stage

A

reticulocyte

66
Q

what do reticulocytes contain?

A

residual RNA

67
Q

t or f. spends 2 to 3 days in the bone marrow and 1 day in the peripheral blood before developing into a mature RBC

A

true

68
Q

last stage of hemoglobin synthesis

A

reticulocyte

69
Q

type of retic:

polychromatic macrocyte, seen in increased RBC production

A

shift cells

70
Q

type of retic:

macroreticulocyte, seen in severe conditions (hemolytic anemia)

A

stress reticulocytes

71
Q

metarubricyte N:C ratio:

A

1:2

72
Q

mature RBC characteristics

A

shape: biconcave
color: salmon pink
life span: 120 days

73
Q

number of RBC produced from each rubriblast:

A

16

74
Q

normal ratio of RBC to WBC

A

600:1

75
Q

normal ratio of RBC to PLT

A

15:1

76
Q

is not a disease; a consequence of having a disease

A

anemia

77
Q

3 factors to dx anemia

A

low number of RBCs
low hemoglobin
low hct

78
Q

first consideration for anemia

A

hemorrhage

79
Q

common site for clinically significant bleeding

A

GIT bleeding

80
Q

2nd consideration for anemia

A

hemolysis

81
Q

3 mechanism of hemolysis

A
  1. shortened RBC survival not explained by bleeding
  2. destruction of RBC before 120th day
  3. can occur intravascularly or extravascularly
82
Q

3rd consideration for anemia

A

decreased RBC production

83
Q

disease associated with insufficient erythropoiesis

A

kidney disease, nutritional deficiencies

84
Q

two methods of classifying anemia

A
  1. morphological

2. pathological

85
Q

which blood parameters do we base on for morphological classification?

A
  1. mean corpuscular volume

2. mean corpuscular hemoglobin concentration

86
Q

normal or decreased retics, normocytic, normochromic anemia examples (2)

A

aplastic anemia

renal disease

87
Q

increased retics, normocytic, normochromic examples (5)

ppseo

A 
PNH
PCH
sickle cell disease
enzyme deficiencies
other hemolytic anemias
88
Q

rare, potentially deadly bone marrow failure syndrome

A

aplastic anemia

89
Q

characteristics of aplastic anemia (4)

prbd

A
  1. pancytopenia
  2. reticulocytopenia
  3. bone marrow hypocellularity
  4. depletion of HSC
90
Q

2 classification of aplastic anemia:

A

acquired

inherited

91
Q

most common aplastic anemia

A

acquired aplastic anemia (AAA)

idiopathic or secondary

92
Q

secondary acquired aplastic anemia causes

A 
chemicals
insecticides
benzene
EBV
chloramphenicol*
93
Q

most common inherited aplastic anemia

A

fanconi anemia

94
Q

fanconi anemia characteristics (6)

cam ssa

A
  1. chromosome instability disorder
  2. aplastic anemia, cancer susceptibility
  3. macrocytic
  4. skeletal abnormalities
  5. skin pigmentation
  6. abnormalities of the eyes, kidneys, and genitals
95
Q

paroxysmal nocturnal hemoglobinuria other name:

A

marchiafava-micheli syndrome

96
Q

cause of PNH (2)

A
  1. decay-accelerating factor or CD55

2. membrane inhibitor of reactive lysis or CD59

97
Q

tests for PNH (3)

A
  1. ham’s acidified serum test
  2. sugar water test/ sucrose hemolysis test
  3. flow cytometry (confirmatory)
98
Q

disease associated with microcytic, hypochromic anemia (5)

A 
thalassemia
anemia of chronic infection
iron deficiency anemia
lead poisoning
sideroblastic anemia
99
Q

microcytic, hypochromic anemia characteristics (lab)

A

mcv and mchc are low

100
Q

most common anemia among hospitalized patients

A

anemia of chronic inflammation/disease

101
Q

central feature of anemia of chronic inflammation

A

sideropenia

  • decreased serum iron despite having high iron stores
  • macrophages hog iron because of inflammation
102
Q

acute phase reactants that contribute to anemia of chronic inflammation
(3)
flh

A

ferritin
lactoferrin
hepcidin

103
Q

master regulatory for systemic iron metabolism

A

hepcidin

104
Q

what does hepcidin inactivates?

A

ferroportin

105
Q

protein that transports iron from tissue to blood

A

ferroportin

106
Q

most common anemia

A

iron deficiency anemia

107
Q

possible causes of IDA (5)

A 
blood loss
nutritional deficiency
increased iron demand
GIT malignancy
hookworms
108
Q

IDA clinical features (5)

fkgpp

A 
fatigue, weakness, pallor
koilonychia
glossitis
pica
pagophagia
109
Q

most sensitive test for IDA

A

serum ferritin test

110
Q

develop when the production of protoporphyrin or the incorporation of iron into protoporphyrin is prevented

A

sideroblastic anemia

111
Q

nucleated RBC precursor with cytoplasmic iron granules

A

sideroblast

112
Q

anucleated RBC with iron granules

A

siderocyte

113
Q

hallmark of sideroblastic anemia

A

ring sideroblasts

114
Q

indirect measure of transferrin concentration in the plasma

A

total iron binding capacity

115
Q

amount of protoporphyrin rings not bound to urine

A

free erythrocyte protoporphyrin

116
Q

heme is made up of?

A

protoporphyrin ring + iron

117
Q

mechanism of lead poisoning

A

inhibits:
ferrochelatase (heme synthetase)
pyrimidine-5’-nucleotidase (RNA catabolizer in retics) > basophilic stippling

118
Q 
megaloblastic anemia (3)
vfa
A

vitamin B12 deficiency
folate deficiency
acute erythroleukemia

119
Q

non megaloblastic anemia (3)

labm

A

liver disease
alcoholism
BM failure

120
Q

hypersegmented neutrophils are only seen in?

A

megaloblastic anemia

121
Q

macrocyte shapes in megaloblastic and non megaloblastic anemia

A

megaloblastic = oval

non megaloblastic = round

122
Q

vitamin B12 deficiency may be caused by (4)

A
  1. inadequate intake
  2. pregnancy
  3. D. latum infection
  4. lack of intrinsic factor
123
Q

causes of lack of intrinsic factor (3)

A
  1. gastrectomy > removes parietal cells
  2. H. pylori infection > destroys parietal cells
  3. pernicious anemia > autoantibodies against parietal cells and intrinsic factors
124
Q

folate deficiency may be caused by (3)

A
  1. inadequate intake
  2. pregnancy
  3. renal dialysis
125
Q

differentiate folate vs B12 deficiency

A

folate holoTC assay: normal

B12 holoTC assay: decreased

Hematology 1 (6 decks)

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