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HEME/LYMPH Exam 2 > RBC and Bleeding Disorders V > Flashcards

RBC and Bleeding Disorders V Flashcards

1
Q

achlorhydria

A

no HCl in GI tract

no release of B12 from food

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2
Q

gastrectomy

A

IF not available for B12 uptake

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3
Q

ileal resection

A

no IF/B12 complex absorption

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4
Q

tapeworms

A

compete with host for B12 and can induce a deficiency state

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5
Q

pregnancy, hyperthyroid, cancer, chronic infection

A

increased demand for B12

-relative deficiency

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6
Q

neuro sx of B12 deficiency

A

not improved with folate administration

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7
Q

chronic gastritis

A

fundic gland atrophy - metaplasia to goblet cells - no IF produced - pernicious anemia

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8
Q

atophic glossitis

A

glazed beefy tongue

-with pernicious anemia

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9
Q

risks with B12 deficiency

A

gastric carcinoma

athersclerosis (with homocysteine)

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10
Q

chronic alcoholic

A

folate deficiency

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11
Q

methotrexate

A

folic acid agonist

-leads to deficiency

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12
Q

folate vs. B12 deficiency

A

folate - increased homocysteine

methylmalonate normal

no neuro symptoms

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13
Q

cause of megaloblastosis

A

suppressed synthesis of DNA

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14
Q

most common nutritional disorder in world

A

iron deficienct anemia

toddlers, menstruation, women of child bearing age

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15
Q

ferrous

A

Fe2+

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16
Q

ferric

A

Fe3+

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17
Q

absorption of Fe

A

proximal duodenum

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18
Q

ferroportin

A

basolateral for Fe transport

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19
Q

transferrin

A

Fe transport

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20
Q

ferritin

A

storage of Fe

also hemosiderin

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21
Q

hepcidin

A

released with increased serum iron

inhibits Fe transport
-downregulate ferroportin

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22
Q

most common cause of iron deficiency in western world

A

chronic blood loss

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23
Q

anemia of chronic disease

A

chronic inflammation results in increase hepcidin

-high hepcidin - leads to decreased Fe absorption

24
Q

ferritin level in IDA

A

<12 ug/L

iron overload - 5000

25
Q

low hepcidin

A

primary and secondary hemochromatosis

26
Q

MDS

A

suppress hepcidin levels when iron stores are high

27
Q

diagnosis of iron deficiency

A

lab studies

  • decreased Hg and Hct
  • poikilocytosis
  • low ferritin
  • increased TIBC
  • decreased hepcidin
28
Q

plummer vinson syndrome

A

triad in IDA

1 esophageal webs
2 micro-hypo anemia
3 atrophic glossitis

29
Q

pica

A

eat things that arent food

-in IDA

30
Q

severe long standing IDA

A

alopecia, atrophy tongue, intestine malabsorption, koilonychia

31
Q

IL-6

A

stimulate hepcidin release in anemia of chronic disease

hepcidin - thought to suppress EPO release**

32
Q

most common type of anemia in hospitalized patients

A

anemia of chronic disease

33
Q

diagnosis of anemia of chronic disease

A

high ferritin
low TIBC
n/n anemia

34
Q

normocytic normochromic anemia

A

anemia of chronic disease

35
Q

aplastic anemia

A

pancytopenia

marrow suppressed and wiped clean of progenitors

36
Q

pathology of aplastic anemia

A

extrinsic - immune mediated
intrinsic - abnormal stem cells

activated T cells inhibit HSCs
-involves TNF, IFN-gamma

leads to pancytopenia

37
Q

fanconi syndrome

A

aplastic anemia
-rare, auto recessive

marrow dysfunction early in life

defect telomerase with short telomeres, or idiopathic

38
Q

cancer chemo

A

can lead to aplastic anemia

39
Q

diagnosis of aplastic anemia

A

bone marrow biopsy necessary

suppressed and wiped clean of progenitors

40
Q

bone marrow bx of aplastic anemia

A

marked hypocellular with adipocytes

41
Q

dry tap

A

in aplastic anemia

42
Q

absent splenomegaly

A

aplastic anemia

43
Q

prognosis of aplastic anemia

A

BM transplant

-5 year survival > 75%

44
Q

pure red cell aplasia

A

only red cell precursors affected

45
Q

causes of pure red cell aplasia

A
  • thymoma
  • large granular lymphocytic leukemia
  • drugs
  • autoimmune disorders
  • parvovirus B19
46
Q

pure red cell aplasia with thymoma

A

resection leads to improvement in 50% patients

47
Q

myelophthisis anemia

A

space-occupying lesion in marrow replace harmful marrow elements

commonly metastatic cancer - breast, lung, prostate

48
Q

chronic renal failure

A

anemia proportional to uremia

-decreased EPO synthesis

49
Q

leukoerythroblastosis and teardrop-shaped RBCs

A

in myelophthisis anemia

50
Q

teardrop-shaped RBCs

A

deformed escaping fibrotic marrow

51
Q

relative polycythemia

A

hemoconcentration with decreased plasma volume

-dehydration, diarrhea

52
Q

gaisback syndrome

A

stress polycythemia

HTN, obese, anxious

53
Q

absolute polycythemia

A

increased total RBC mass

primary and secondary

54
Q

primary absolute polycythemia

A

intrinsic abnormality of hematopoietic precursors

55
Q

secondary absolute polycythemia

A

increased EPO

HEME/LYMPH Exam 2 (16 decks)

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