RBC's

Question 1

three broad categories of anemias

Answer 1

1. blood loss
2. decreased RBC survival
3. decreased RBC production

Question 2

example of blood loss anemia

Answer 2

hemorrhage

trama

Question 3

example of decreased RBC survival

Answer 3

hereditary spherocytosis
mechanical trauma
transfusion reactions

Question 4

example of decreased RBC production

Answer 4

B12 deficiency
iron deficiency
folate deficiency
aplastic anemia

Question 5

RBC can be intravascular hemolysis or extravascualr

Answer 5

intravascular- in the circulation

extravascular- reticuloendothelial system including spleen

Question 6

reticuloendothelial system

Answer 6

The cells are primarily monocytes and macrophages, and they accumulate in lymph nodes and the spleen.

Question 7

example of intravascular hemolysis

Answer 7

mechanical trauma

Question 8

key feature of intravascular hemolysis

Answer 8

decrease haptoglobin, low levels

Question 9

example of extravascular hemolysis

Answer 9

hereditary sperhocytosis, sickle cell anemia, erythroblastosis fetalis

Question 10

what happens in extravascular hemolysis

Answer 10

damaged or abnormal RBC are removed in spleen, hemoglobin is broken down. hemo breakdown products increase (hyperbilirubinemia).

Question 11

high levels of bilirubin can cause what

Answer 11

gallstones

Question 12

intrinsic defects

Answer 12

inherited

Question 13

4 examples of intrinsic defects

Answer 13

membrade defects- hereditary spherocytosis
abnormal hemoglobin- sickle cell anemia
lack of globin chain- thalassemia
metabolic- G6PD deficiency

Question 14

Hereditary spherocytosis

Answer 14

quan or qual defect in spectrin, a structural protein of cytoskeleton leads to prodution of spherocytes

Question 15

spherocytes

Answer 15

smaller more dense RBC’s

Question 16

why are spherocytes bad?

Answer 16

1. cant flex as much to get into smaller capillaries
2. more prone to rupture
3. destroyed by spleen

Question 17

inheritance pattern of hereditary spherocytosis

Answer 17

auto Dominant

Question 18

what operation do people usually get with this disease

Answer 18

removing spleen, destruction of spherocytes is decreased

Question 19

example of disease that produces abnormal hemoglobin

Answer 19

sickle cell anemia- auto codominant

Question 20

sickle shape RBC bad because…

Answer 20

they get destoryed by spleen (extravascular)

clog up smaller capillaries

Question 21

carriers of sickle cell disease have an increase resistance to what

Answer 21

malaria

Question 22

what is thalassemia

Answer 22

inherited disorder. diminished or absent synthesis of either the alpha or beta globin chains of hemoglobin. decreased production of hemo and hemo gets destroyed more by spleen (extravascular)

Question 23

decreased globin chain synthesis means decreased…

Answer 23

hemoglobin production

Question 24

principal clinical manifestation of thalassemia

Answer 24

anemia

Question 25

this is more common in persons of mediterranean, african, southeast asian descent

Answer 25

thalassemia

Question 26

intrinsic metabolic defect

Answer 26

G6PD deficiency

Question 27

what is G6PD deficiency

Answer 27

X linked inheritance. cells are susceptible to oxidant injury by drugs or toxins

Question 28

examples of extrinsic defects and whether they are intra or extravascular hemolysis

Answer 28

erythroblastosis fetalis- extravasuclar hemolytic transfusions- intravascular mechanical trauma- RBCs going through abnormal vavles

Question 29

important antigens in erythroblastosis fetalis

Answer 29

ABO and Rh antigens

Question 30

characterized by incrased amount of schistocytes

Answer 30

mechanical trauma- cardiac valve prosthesis

Question 31

most common cause of anemia worldwide

Answer 31

iron deficiency

Question 32

what kind of anemia is result of low iron

Answer 32

microcytic anemia- smaller RBC's containing less hemoglobin

Question 33

low iron causes...

Answer 33

1. inadequate intake (infants) | 2. increased requirement- puberty, pregnancy, elderly

Question 34

diagnosis of microcytic anemia by

Answer 34

lab test

Question 35

megaloblastic anemia

Answer 35

vit B12 and folate deficiency- leads to impaired DNA synthesis, resulting in large red cell precursor (megaloblast)

Question 36

what do you need for B12 absorption

Answer 36

intrinsic factor

Question 37

what is pernicious anemia

Answer 37

when pt's have autoantibodies against intrinsic factor so they cant absorb vit B12

Question 38

aplastic anemia

Answer 38

decreased production of all cellular elements in blood, no predisposing cause. drugs and viral infection can cause it STEM CELL ABNORMALITY

Question 39

what is myelophthisic anemia

Answer 39

when normal hematopoietic cells in marrow are crowded out by tumor or fibrosis

Question 40

cyanotic heart disease, living at high altitude, pulmonary disease, abnormal hemoglibin all cause what kind of polycythemia

Answer 40

secondary

Question 41

what is secondary polycythemia

Answer 41

disease or environmental factors stimulate erythropoietin, increases growth of RBC

Question 42

what is primary polycythemia

Answer 42

RBC proliferate on their own, non regulated, called polycythemia vera

Question 43

polycythemia vera can cause what

Answer 43

neurologic and visual abnormalities

Question 44

treatment of polycythemia vera

Answer 44

phlebotomy

Question 45

what distinguishes primary from secondary

Answer 45

erythropoietin levels, secondary have increased levels