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RBC > RBC part 2 > Flashcards

RBC part 2 Flashcards

1
Q

what are the two most common causes of megaloblastic anemias

A

B12 and folate deficiencies

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2
Q

CBC in megaloblastic anemia shows what

A

pancytopenia- decreased RBC counts, WBC counts and platelet counts

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3
Q

the bone marrow in megaloblastic anemia shows what

A

giant bands

nuclear-cytoplasmic asynchrony

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4
Q

the peripheral blood in megaloblastic anemia shows what

A

macrocytic anemia
macro-ovalocytes
anisopoikilocytosis
hypersegmented neutrophils

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5
Q

neurological defects are associated with what cause of megaloblastic anemia

A

B12 deficiency

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6
Q

signs and symptoms of B12 and folate deficiencies

A

anemia
atrophic glossitis
gastric gland atrophy
neurologic (B12 only)

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7
Q

neurologic effects of B12 are due to what

A

demyelination of white matter of brain and dorsolateral columns of spinal chord
methylmalonic acid does this

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8
Q

in anemias of chronic disease where are iron levels increased

A

bone marrow- mostly macrophages

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9
Q

pernicious anemia is due to what

A

absent intrinsic factor (IF) which binds vitamin B12

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10
Q

pernicious anemia is likely what kind of disease

A

autoimmune

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11
Q

the autoantibodies in pernicious anemia are divided up how

A 
Type I- (blocking)- block binding of B12 to IF
Type II (binding)- bind B12-IF complex
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12
Q

pernicious anemia is associated with what

A

autoimmune disease:
hashimotos thyroiditis
adrenalitis
Grave’s disease

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13
Q

the shilling test is used to measure what

A

absorption of B12

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14
Q

folate deficiency is usually due to what

A

dietary insufficiency

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15
Q

folate can be stored for how long and where

A

3-6 months in liver

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16
Q

stage 1 of shilling test is done how

A

give radio labeled oral B12 and inject unlabeled B12 in bone
collect urine after 24 hours
Normal if a lot of of radio labeled B12 excreted
if abnormal proceed to stage II

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17
Q

stage 2 of shilling test is done how

A

oral radiolabled B12 + IF
Inject IM unlabeled B12
if results are normal there is a IF deficiency (pernicious anemia)
if abnormal results small bowel malabsorption (celiac)

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18
Q

If shilling test results yields abnormal stage I but normal stage II what does this mean

A

the stomach cannot make intrinsic factor/IF as in pernicious anemia

19
Q

If shilling test results yields abnormal stage I and stage II what does this mean

A

malabsorption of vitamin B12 and IF in the small intestine as in biliary disease, celiac disease, hypothyroidism, liver disease

20
Q

macrocytic anemia causes other than folate and B12

A

chemo
alcoholism
hypothyroidism
liver disease

21
Q

Diamond-Blackfan syndrome is the primary form of what

A

Pure Red Cell aplasia

22
Q

what is seen the peripheral blood of aplastic anemia

A

no reticulocytosis
pancytopenia
normocytic, normochromic anemia

23
Q

a dry tap is seen in what anemia

A

aplastic anemia

24
Q

what is seen clinically in aplastic anemia

A

anemia
neutropenia (infections)
thrombocytopenia (bleeding)

25
Q

how is aplastic anemia acquired

A

chemical, toxins, drugs, radiotherapy/irradiation, viral infections, SLE

26
Q

what is the most common acquired cause of aplastic anemia

A

autoimmune suppression by a T-cell mediated cell mechanism

27
Q

half of acquired aplastic anemias are due to what

A

idiopathic

28
Q

heridary aplastic anemia is also known as what

A

Fanconi’s anemia

29
Q

hereditary aplastic anemia is due to defects in what

A

DNA repair mechanism

30
Q

what congenital anomalies are seen with Fanconi’s anemia

A

hypoplastic radii
thumbs
organs

31
Q

Pure Red Cell Aplasia is what

A 
only erythroid (RBC) cell line affected 
myeloid and platelet lines normal
32
Q

Pure Red Cell Aplasia what is seen in bone marrow

A

few to absent erythroid (RBC) precursors (erythroblasts)

33
Q

Pure Red Cell Aplasia is what type of disease and what mediates it

A

autoimmune disease mediated by T-lymphs or IgG antibody vs red cell precursors

34
Q

what viruses can cause aplastic anemia

A

Hepatitis, EBV, HIV, parvovirus

35
Q

pure red cell aplasia is associated with what

A

SLE
CLL
thymomas
chloramphicol

36
Q

what is diamond-blackfan syndrome

A

severe anemia in first year of life, with congenital anomalies

37
Q

secondary form of pure red cell aplasia is due to what most of the time

A

infections especially parvovirus B19

38
Q

sideroblastic anemia is characterized by what histologically

A

ringed sideroblasts (cells with iron granules around the nucleus)

39
Q

sideroblastic anemia is due to what

A

failure to incorporate heme into protoporphyrin to form hemoglobin
(adequate iron stores but defective utilization of red blood cells

40
Q

in sideroblastic anemia what are serum iron, transferrin saturation, and ferritin levels

A

all high

41
Q

hereditary sideroblastic anemia is transmitted via what pattern

A

X-linked recessive

42
Q

hereditary sideroblastic anemia is due to what

A

ALA synthase defect (rate limiting step in heme synthesis)

43
Q

how can sideroblastic anemia be acquired

A

myelodysplasia
drugs (alcohol, isoniazid)
LEAD
nutritional deficiency

44
Q

how do you treat sideroblastic anemias

A

pyridoxine (vit b6)

RBC (5 decks)

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