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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
low hepcidin
primary and secondary hemochromatosis
26
MDS
suppress hepcidin levels when iron stores are high
27
diagnosis of iron deficiency
lab studies - decreased Hg and Hct - poikilocytosis - low ferritin - increased TIBC - decreased hepcidin
28
plummer vinson syndrome
triad in IDA 1 esophageal webs 2 micro-hypo anemia 3 atrophic glossitis
29
pica
eat things that arent food -in IDA
30
severe long standing IDA
alopecia, atrophy tongue, intestine malabsorption, koilonychia
31
IL-6
stimulate hepcidin release in anemia of chronic disease hepcidin - thought to suppress EPO release**
32
most common type of anemia in hospitalized patients
anemia of chronic disease
33
diagnosis of anemia of chronic disease
high ferritin low TIBC n/n anemia
34
normocytic normochromic anemia
anemia of chronic disease
35
aplastic anemia
pancytopenia marrow suppressed and wiped clean of progenitors
36
pathology of aplastic anemia
extrinsic - immune mediated intrinsic - abnormal stem cells activated T cells inhibit HSCs -involves TNF, IFN-gamma leads to pancytopenia
37
fanconi syndrome
aplastic anemia -rare, auto recessive marrow dysfunction early in life defect telomerase with short telomeres, or idiopathic
38
cancer chemo
can lead to aplastic anemia
39
diagnosis of aplastic anemia
bone marrow biopsy necessary suppressed and wiped clean of progenitors
40
bone marrow bx of aplastic anemia
marked hypocellular with adipocytes
41
dry tap
in aplastic anemia
42
absent splenomegaly
aplastic anemia
43
prognosis of aplastic anemia
BM transplant | -5 year survival > 75%
44
pure red cell aplasia
only red cell precursors affected
45
causes of pure red cell aplasia
- thymoma - large granular lymphocytic leukemia - drugs - autoimmune disorders - parvovirus B19
46
pure red cell aplasia with thymoma
resection leads to improvement in 50% patients
47
myelophthisis anemia
space-occupying lesion in marrow replace harmful marrow elements commonly metastatic cancer - breast, lung, prostate
48
chronic renal failure
anemia proportional to uremia | -decreased EPO synthesis
49
leukoerythroblastosis and teardrop-shaped RBCs
in myelophthisis anemia
50
teardrop-shaped RBCs
deformed escaping fibrotic marrow
51
relative polycythemia
hemoconcentration with decreased plasma volume | -dehydration, diarrhea
52
gaisback syndrome
stress polycythemia HTN, obese, anxious
53
absolute polycythemia
increased total RBC mass primary and secondary
54
primary absolute polycythemia
intrinsic abnormality of hematopoietic precursors
55
secondary absolute polycythemia
increased EPO

HEME/LYMPH Exam 2 (16 decks)

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