RBC's Robbins, Hematopath Rubin's

Question 1

Robbins 40: Patient with a microcytic anemia, namely iron deficiency, what is the most sensitive and cost-effective test you can order?

Answer 1

Ferritin concentration is a measure of storage iron because it’s derived from total body storage pool in the liver, spleen, and marrow; with severe liver disease, can have an elevated serum ferritin level because of its release from liver stores

Question 2

Robbins 46: Myelophthisic anemias can be caused by what?

Answer 2

A metastatic tumor (in this case prostatic adenocarcinoma) or also by infections)

Question 3

Rubin’s 11: What does the figure show? Why did this happen?

Answer 3

Elliptical erythrocytes; HE involves the cytoskeleton of the erythrocyte, specifically spectrin, spectrin-ankyrin binding, protein 4.1, glycophorin C

Question 4

Rubin’s 15: Why do we see these nuclei?

Answer 4

Hemolytic disease of the newborn: histoincompatibility between the mother and developing fetus (maternal IgG alloantibodies cross placenta, causing complement-mediated hemolysis of fetal erythrocytes, resulting in release of erythroid precursors.

Question 5

Rubin’s 22: Why does the figure look like this?

Answer 5

Chronic liver disease (increased free cholesterol deposited within cell membrane) can lead to acanthocytes (RBCs with spiny projections)

Question 6

Rubin’s 60: When does a hemolytic transfusion reaction occur?

Answer 6

Grossly incompatible blood administered to patients with preformed alloantibodies, usually a clerical error; massive hemolysis of transfused blood may be associated with severe complications, including hypotension, renal failure, and even death

Question 7

Rubin’s 61: presence of myeloblasts in peripheral blood is

Answer 7

acute myelogenous leukemia; accumulation of immature myeloid cells lacking potential for further differentiation and maturation, which leads to suppression of normal hematopoiesis

Question 8

Rubin’s 64: acute suppurative lymphadenitis occurs

Answer 8

in lymph nodes that drain a site of acute bacterial infection; they are tender due to distention of the capsule

Question 9

Rubin’s 66: _____ is a neoplasm of thymic epi cells; what can this lead to?

Answer 9

Thymoma; myasthenia gravis

Question 10

Rubin’s 67: ____ results from immunosuppression and is often associated with ____ infection. What is the disease driven by?

Answer 10

Posttransplant lymphoproliferative disorder (PTLD); EBV;

EBV-driven, monoclonal, lymphocyte proliferation with variable morphology