RED BLOOD CELL DISORDERS Flashcards
it is defined as decrease in RBC, Hgb, and hematocrit resulting in decreased oxygen delivery to the tissues
Anemia
anemia is derived from the Greek word anaimia, meaning
“without blood”
T/F
ANEMIA SHOULD NOT BE THOUGHT OF AS A DISEASE, BUT RATHER AS A MANIFESTATION OF AN UNDERLYING DISEASE OR DEFICIENCY
TRUE
what are the three (3) major pathophysiological categories that causes anemia
- blood loss
- impaired red blood cell production
- accelerated red blood cell destruction
it is refer to the production of erythroid precursor cells that are DEFECTIVE
Ineffective erythropoiesis
what are the example of Infective erythropoiesis
-megaloblastic anemia
-thalassemia
-sideroblastic anemia
-myelodysplastic anemia
refers to a decrease in the number of erythroid precursor in the bone marrow
Insufficient erythropoiesis
What are the example of Insufficient erythropoiesis
-Iron deficiency anemia
-Anemia of renal disease
-Acute leukemia
-aplastic anemia
-sarcoidosis
Initial lab test for diagnosis of Anemia
Complete blood count
Peripheral Blood smear
Reticulocyte count
Rbc indices
Disorder of DNA synthesis
Megaloblastic anemia
Disorder of Hemoglobin Synthesis
-Thalassemia
-Anemia of chronic inflammation
-Iron deficiency
-Sideroblastic anemia
Disorder associated with decrease production of erythropoiesis
Anemia of renal disease
Examples of Microcytic hypochromic anemia
“TAILS Che”
-thalassemia
-anemia of chronic inflammation
-iron deficiency anemia
-lead poisoning
-sideroblastic anemia
-Chronic blood loss
-Hemoglobin E disease
Examples of Macrocytic Normochromic anemia
MEGALOBLASTIC ANEMIA
-Congenital dyserythropoietic anemia
-reverse transcriptase inhibitors
-acute erythroid leukemia
-myelodysplastic anemia
-pernicious anemia
-vit b12 deficiency
folate def
NON MEGALOBLASTIC ANEMIA
-Chronic liver disease
-alcoholism
-aplastic anemia
-reticulocytosis
-bone marrow failure
-normal newborns
it can help determine the cause of an anemia when used in conjunction with the MCV
RDW
it is the most common form of anemia world widely
-it is an example of nutritional anemia
Iron deficiency anemia
hemoglobin level in mild anemia
9 to 11 g/dL
hemoglobin level in severe anemia
<7 g/dL
hemoglobin level in moderate anemia
7 to 10 g/dL
hemoglobin level in newborns with anemia
<14 g/dL
stage of IDA wherein it develops into a full blown IDA/ frank’s
Stage 3 functional depletion
Parasites associated with IDA
Hookworm
trichuris trichiuria
schistosoma mansoni
schistosoma haematobium
it is the second most common type of anemia
it is the most common anemia in hospitalized patient (nosocomial anemia)
associated with systemic disease
Anemia of chronic inflammation
anemia caused by blocks in protoporphyrin pathway resulting in defective hemoglobin synthesis and iron overload
Sideroblastic anemia
where does iron accumulate in sideroblastic anemia
perinuclear mitochondria of metarubricyte
excess iron accumulates in the mitochondrial region of the immature RBC in the BM and encircles the nucleus; cell are called
ringed sideroblasts
sideroblasts and siderocyte are best demonstrated using what stain
Perl’s prussian blue stain (rous test)
serum iron: DECREASE
serum TIBC: INCREASE
% saturation: DECREASE
% sideroblasts: DECREASE
iron stores: DECREASE
serum ferritin: DECREASE
IDA
serum iron: DECREASE
serum TIBC: DECREASE
% saturation: DECREASE
% sideroblasts: DECREASE
iron stores: INCREASE
serum ferritin: INCREASE
ANEMIA OF CHRONIC INFLAMMATION
serum iron: INCREASE
serum TIBC: DECREASE
% saturation: INCREASE
% sideroblasts: INCREASE
iron stores: INCREASE
serum ferritin: INCREASE
SIDEROBLASTIC ANEMIA
it is an indicator of available transport iron
requires 12 hours fasting
Serum Iron
Indirect indicator of iron STORE
12 hour fasting
Total iron binding capacity (TIBC)
Good indicator of iron storage status
useful in diagnosis of iron deficiency
-first laboratory test to become abnormal when iron stores become to decline
Serum Ferritin
used for differentiating Thalassemia, IDA and Anemia of chronic infection
Free Erythrocyte Protoporphyrin
used to differentiate IDA and ACI
(sTfR) Soluble transferrin receptor
IDA = Increase sTfR
AC= Normal sTfR
STATEMENT I
In megaloblastic anemia, DNA synthesis is defective and RNA synthesis is normal
STATEMENT II
The nucleus matures slower than the cytoplasm (Asynchronism)
Both are TRUE
Characteristic of Megaloblastic anemia
Oval shaped
MCV is usually 100-150 fl and commonly greater than 120fl
Clinical symptoms includes CNS problems
Vitamin B12 defi
a anti folic drugs not recommended for pregnant women
Methotrexate
confirmatory for megablastosis
Bone marrow aspirate
needle used for Bone marrow aspirate
Aspirate needle
University of Illinois needle
test requires a 24 hour urine collection and the use of radioactive cobalt in vitamin b12 to trace absorption
Schilling test
it is increase in both Vitamin B12 and Folic acid deficiency
Homocysteine level
It is increased in Vitamin B12 only and normal in folic acid deficiency
Methylmalonic acid level
Characteristic of Non megaloblastic anemia
-round in shaped
-MCV 101-115 fl
-related to membrane changes caused by disruption of the cholesterol-to-phospholipid ratio
What form and the anatomical site present in functional compartments in iron
-Hemoglobin iron in the blood
-myoglobin iron in the muscle
-peroxidase, catalase, cytochrome, riboflavin enzymes in all cells
What form and the anatomical site present in storage compartments in iron
Ferritin and Hemosiderin
What form and the anatomical site present in transport compartments in iron
Transferrin in plasma
In ACI, what are the increased acute phase reactant present
Hepcidin , lactoferrin, fertin
Type of Sideroblastic anemia which is irreversible; causes of the block is unknown
Primary
Type of Sideroblastic anemia which is reversible; causes includes alcohol, anti -tb drugs, chloramphenicol
Secondary
lead poisoning will lead to
Acquired porphyria and acquire sideroblastic anemia
reference range for serum iron
50-160 ug/dl
reference range for TIBC
250-400 ug/dl
reference range for serum ferritin
15-200 ug/L (men)
12-150 ug/L (women)
characterized by impaired absorption of Vitamin B12 due to deficiency of intrinsic factor and the presence of autoantibodies to parietal cell
Pernicious anemia
it is elevated in Aplastic anemia
EPO, TPO, CSF-GEMM
Characteristic features of aplastic anemia
-pancytopenia
-reticulocytopenia
-bone marrow hypocellularity
-depletion of hematopoietic stem cell
Characterized by dwarfism , low birth weight
-lab findings: elevated Hb F and alpha feto-protein
Fanconi’s anemia/ genetic aplastic anemia/ familial aplastic anemia
Characterized by true red cell aplasia
-bone marrow is normal except to a marked decreased in erythroid precursor
Diamond black fan anemia
replacement of bone marrow hematopoietic stem cells by malignant cells or fibrotic tissue
-associated with cancers with bone metastasis
Myelophthisic anemia (marrow replacement)
-increase WBC and RBC in the circulation
Laboratory finding for hemolytic anemia
decrease hemoglobin and serum haptoglobin
increase retic
it characterized by Rbc destruction exceeds the increase rate of Rbc production
Hemolytic anemia
it is a group of potentially life-threatening disorders characterized by RBC fragmentation and thrombocytopenia
Microangiopathic anemia
examples of microangiopathic anemia
DIC, HUS, TTP, HELLP syndrome
characteristic features found in the peripheral blood films of microangiopathic anemia
Schistoctye/ schizocyte
