RBC and Bleeding Disorders I Flashcards

1
Q

anemia

A

reduction total circulating RBC mass below normal limits

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2
Q

poikilocytic

A

abnormal shaped RBCs

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3
Q

microcytic normochromic

A

iron deficiency

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4
Q

macrocytic

A

megaloblastic

folate B12 deficiency

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5
Q

MCV

A

mean cell volume
-average volume of a red cell

normal 80-100

to determine size of RBCs

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6
Q

MCH

A

mean cell hemoglobin
-average content of Hg per red cell

normal 27-33

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7
Q

MCHC

A

mean cell hemoglobin concentration

average concentration of Hg in given volume packed RBCs

normal 33-37

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8
Q

RDW

A

red cell distribution width

coefficienct of variation of red cell volume

ration of smallest to largest cell

normal 11.5-14.5

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9
Q

hypoxia of anemia

A

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

chronic change

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10
Q

normal Hg

A

13-15

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11
Q

normal Hct

A

35-45%

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12
Q

normal red cell count

A

3-5 mil

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13
Q

normal reticulocyte count

A

0.5-1.5%

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14
Q

normal MCV

A

80-100

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15
Q

normal MCH

A

27-33

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16
Q

normal MCHC

A

33-37

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17
Q

normal RDW

A

11.5-14.5

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18
Q

hereditary spherocytosis

A

has altered MCHC**

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19
Q

weakness, fatigue, easy fatigability

A

anemia

20
Q

acute blood loww

A

trauma

21
Q

chronic blood loss

A

GI tract lesions

heavy menstruation

22
Q

changes with acute blood loss

A

hemodilution - shift of water from interstitial compartment

decreased hematocrit

also, increased EPO from kidney

23
Q

increased reticulocytes

A

5 days after acute blood loss

24
Q

increased EPO

A

with hemolytic anemias

25
Q

hemolytic anemias

A

shortened RBC life span

elevated EPO

accumulation of Hg degradation products that are released with hemolysis

26
Q

extravascular hemolysis

A

destruction within macrophages

get splenomegaly

anemia, splenomegaly, and jaundice**

27
Q

intravascular hemolysis

A

NO SPLENOMEGALY

anemia, hemoglobinemia, hemoglobinuria, hemosidinuria, jaundice

28
Q

haptoglobin

A

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

29
Q

extravascular destruction

A

RBCs less deformable
-anemia, splenomegaly, jaundice

benefit from splenectomy

30
Q

intravascular destruction

A

mechanical injury - cardiac valves

complement fixation

parasites malaria

31
Q

bilirubin in hemolytic anemia

A

have unconjugated bilirubin

32
Q

increased direct bilirubin

A

conjugated bilirubin

with obstruction

33
Q

with anemia and low tissue O2

A

EPO release - more normoblasts

results in reticulocytosis

34
Q

severe anemia

A

see EMH

35
Q

mutations in hereditary spherocytosis

A
alpha-spectrin
beta spectrin
ankyrin
band 4.2
band 3
36
Q

hereditary spherocytosis

A

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

in northern europe

37
Q

symptomatic HS

A

if have 2x genetic defects
-compound heterozygosity

jaundice and birth and requires exchange transfusion

38
Q

asymptomatic HS

A

autosomal dominant

-75% of cases

39
Q

increased MCHC

A

seen in hereditary spherocytosis

due to dehydration caused by loss of K and H20 from RBCs

40
Q

Tx for HS

A

splenectomy

-spherocytes persist, but anemia corrected

41
Q

anisocytosis

A

different sizes

42
Q

anisocytosis and howel jolly bodies

A

on PS of hereditary spherocytosis

43
Q

risk of exchange transfusions

A

high levels of iron - toxic

44
Q

Dx of HS

A

based on family hx, heme findings, lab evidence

45
Q

osmotic lysis

A

of RBCs

-seen in hereditary spherocytosis

46
Q

aplastic crisis in HS

A

triggered by acute parvovirus infection
-bc infects RBC progenitors

-cessation of erythropoiesis for a short time results in sudden worsening of anemia

Tx - transfusion

47
Q

hemolytic crisis in HS

A

increased splenic destruction of RBCs
-ex. infectious mono

tx - splenectomy - treats anemia but increased risk of sepsis - by blood borne bacteria