RBC and Bleeding Disorders I

Question 1

anemia

Answer 1

reduction total circulating RBC mass below normal limits

Question 2

poikilocytic

Answer 2

abnormal shaped RBCs

Question 3

microcytic normochromic

Answer 3

iron deficiency

Question 4

macrocytic

Answer 4

megaloblastic

folate B12 deficiency

Question 5

MCV

Answer 5

mean cell volume
-average volume of a red cell

normal 80-100

to determine size of RBCs

Question 6

MCH

Answer 6

mean cell hemoglobin
-average content of Hg per red cell

normal 27-33

Question 7

MCHC

Answer 7

mean cell hemoglobin concentration

average concentration of Hg in given volume packed RBCs

normal 33-37

Question 8

RDW

Answer 8

red cell distribution width

coefficienct of variation of red cell volume

ration of smallest to largest cell

normal 11.5-14.5

Question 9

hypoxia of anemia

Answer 9

can lead to fatty changes of liver, myocardium, and kidney

chronic change

Question 10

normal Hg

Answer 10

13-15

Question 11

normal Hct

Answer 11

35-45%

Question 12

normal red cell count

Answer 12

3-5 mil

Question 13

normal reticulocyte count

Answer 13

0.5-1.5%

Question 14

normal MCV

Answer 14

80-100

Question 15

normal MCH

Answer 15

27-33

Question 16

normal MCHC

Answer 16

33-37

Question 17

normal RDW

Answer 17

11.5-14.5

Question 18

hereditary spherocytosis

Answer 18

has altered MCHC**

Question 19

weakness, fatigue, easy fatigability

Answer 19

anemia

Question 20

acute blood loww

Answer 20

trauma

Question 21

chronic blood loss

Answer 21

GI tract lesions

heavy menstruation

Question 22

changes with acute blood loss

Answer 22

hemodilution - shift of water from interstitial compartment

decreased hematocrit

also, increased EPO from kidney

Question 23

increased reticulocytes

Answer 23

5 days after acute blood loss

Question 24

increased EPO

Answer 24

with hemolytic anemias

Question 25

hemolytic anemias

Answer 25

shortened RBC life span elevated EPO accumulation of Hg degradation products that are released with hemolysis

Question 26

extravascular hemolysis

Answer 26

destruction within macrophages get splenomegaly anemia, splenomegaly, and jaundice**

Question 27

intravascular hemolysis

Answer 27

NO SPLENOMEGALY anemia, hemoglobinemia, hemoglobinuria, hemosidinuria, jaundice

Question 28

haptoglobin

Answer 28

decreases with hemolytic anemia alpha-2 globulin that binds free Hg and prevents its urine excretion so more Hg release - more haptoglobin bound to Hg

Question 29

extravascular destruction

Answer 29

RBCs less deformable -anemia, splenomegaly, jaundice benefit from splenectomy

Question 30

intravascular destruction

Answer 30

mechanical injury - cardiac valves complement fixation parasites malaria

Question 31

bilirubin in hemolytic anemia

Answer 31

have unconjugated bilirubin

Question 32

increased direct bilirubin

Answer 32

conjugated bilirubin with obstruction

Question 33

with anemia and low tissue O2

Answer 33

EPO release - more normoblasts results in reticulocytosis

Question 34

severe anemia

Answer 34

see EMH

Question 35

mutations in hereditary spherocytosis

Answer 35

``` alpha-spectrin beta spectrin ankyrin band 4.2 band 3 ```

Question 36

hereditary spherocytosis

Answer 36

inherited disorder in RBC membrane - shapes less deformable -sequestered in spleen in northern europe

Question 37

symptomatic HS

Answer 37

if have 2x genetic defects -compound heterozygosity jaundice and birth and requires exchange transfusion

Question 38

asymptomatic HS

Answer 38

autosomal dominant | -75% of cases

Question 39

increased MCHC

Answer 39

seen in hereditary spherocytosis due to dehydration caused by loss of K and H20 from RBCs

Question 40

Tx for HS

Answer 40

splenectomy | -spherocytes persist, but anemia corrected

Question 41

anisocytosis

Answer 41

different sizes

Question 42

anisocytosis and howel jolly bodies

Answer 42

on PS of hereditary spherocytosis

Question 43

risk of exchange transfusions

Answer 43

high levels of iron - toxic

Question 44

Dx of HS

Answer 44

based on family hx, heme findings, lab evidence

Question 45

osmotic lysis

Answer 45

of RBCs | -seen in hereditary spherocytosis

Question 46

aplastic crisis in HS

Answer 46

triggered by acute parvovirus infection -bc infects RBC progenitors -cessation of erythropoiesis for a short time results in sudden worsening of anemia Tx - transfusion

Question 47

hemolytic crisis in HS

Answer 47

increased splenic destruction of RBCs -ex. infectious mono tx - splenectomy - treats anemia but increased risk of sepsis - by blood borne bacteria