red blood cells and anaemia

Question 1

what hormone regulates erythropoiesis

Answer 1

erythropoietin (Epo)

Question 2

where is the hormone erythropoietin found

Answer 2

90% in the kidney

Question 3

where does red blood cell production start

Answer 3

in red bone marrow from stem cells, creating bursting forming units then colony forming units

Question 4

what do red cells differentiate into when they eject their nuclei

Answer 4

reticulocytes

Question 5

once differentiated what do reticulocytes digest

Answer 5

their organelles (Golgi)

Question 6

what does a high reticulocyte count indicate

Answer 6

a high rate of new red blood cells are present (can occur after blood loss)

Question 7

what is the transport molecule for iron in haemoglobin

Answer 7

transferrin

Question 8

what is the advantages and disadvantages of red blood cells having an uncomplicated cell membrane

Answer 8

A - simple passage of oxygen
D - fragile so damage easily

Question 9

what is the advantages and disadvantages of red blood cells having a lack of a nucleus and most cellular enzymes and organelles

Answer 9

A - flexibility to penetrate fine capillaries
D - cant make protective enzymes

Question 10

what is the advantages and disadvantages of red blood cells having membranes that carry antigens

Answer 10

A - certain phenotypes confer resistance to malaria
D - incompatibility can trigger serious transfusion reactions

Question 11

what is ferritin

Answer 11

an intracellular protein that stores iron.

Question 12

what are some of the main symptoms of anaemia

Answer 12

dizziness, low BP, shortness of breath

Question 13

main repercussions of anaemia

Answer 13

tiredness, (in children) decreased IQ, (in pregnancy) failure to breast feed
cardiovascular risk (myocardial infarction)

Question 14

what are some of the main reasons for differences in symptom presentation

Answer 14

• Speed of onset (rapidly progressive produces more symptoms than slow )
• severity (mild doesn’t produce as many symptoms)
  Age - (elderly more effected)

Question 15

what factors make the oxygen disassociation curve to move to the right

Answer 15

physiological states where tissues require more oxygen such as during excersise

Question 16

what does the oxygen disassociation curve moving to the right mean for the unloading of oxygen at target tissues

Answer 16

• makes it more difficult to bind to oxygen but makes it easier to unload to the tissues that require it

Question 17

is foetal haemoglobin to the left or to the right of adult haemoglobin

Answer 17

to the left as it needs a to easily take up oxygen from adult haemoglobin

Question 18

what is Haematocrit (HCT) a measurement of

Answer 18

the proportion of whole blood that is taken up by red blood cells

Question 19

how is HCT calculated

Answer 19

(MCV x RBCC)/1000

Question 20

what is Mean Cell Haemoglobin (MCH) a count of

Answer 20

the average Hb per red cell but does not consider its size.

Question 21

how is MCH calculated

Answer 21

Hb/RBCC

Question 22

what is Mean Cell Haemoglobin Concentration (MCHC) a measurement of

Answer 22

the average Hb per cell
taking into account MCV.

Question 23

how is MCHC calculated

Answer 23

[Hb/(MCV x RBCC)] x 100

Question 24

what can red blood cell distribution width indicate

Answer 24

can indicate a dual population of red
cells e.g. post transfusion, post treatment.

Question 25

what is 1/2 classification of anaemia (and what are the main types within it )

Answer 25

size based
microcytic - small red blood cells
macrocytic - large red blood cells
normocytic - normal red blood cells

Question 26

what is 2/2 classification of anaemia (and what are the main types within it )

Answer 26

variation based on colour
normochromic - normally stained red blood cells
hypochromic - less stained red blood cells
hyperchromic - more densely stained red blood cells

Question 27

what does the biochemical test CRP (C reactive protein) indicate

Answer 27

gives indication to the level of inflammation so helps interpret ferritin levels

Question 28

what are the 3 main biochemical tests for anaemia

Answer 28

-serum ferritin
- C reactive protein
- soluble transferrin receptors

Question 29

why can drinking caffeine when eating cause anaemia

Answer 29

less iron is absorbed into the body

Question 30

what are some treatments of hypochromic anaemia

Answer 30

correct diet, iron tablets

Question 31

what is ferinject given for

Answer 31

rapid correction of iron levels before surgery

Question 32

what happens if there is a lack of folate in the body

Answer 32

causes a lack of divisions in cells causing larger cells but fewer of them

Question 33

what is the treatment for folate deficiency

Answer 33

correction of the diet

Question 34

what is the treatment for pernicious anaemia

Answer 34

• either diet related correction
• or injections of hydroxocobalamin every 3 months

Question 35

what are Haemoglobinopathies

Answer 35

are genetic (inherited) disorders of haemoglobin,
the oxygen-carrying protein of the red blood cells.

Question 36

what are the 2 types of thalassaemia

Answer 36

alpha and beta

Question 37

what are the treatment methods for beta thalassaemia

Answer 37

blood transfusions
iron chelation
prevention - antenatal haemoglobinopathy
screening & counselling

Question 38

what is the three stage response to a haemorrhage

Answer 38

1 - hypovolemia and cardiovascular compensation
2 - transcapillary fluid redistribution and isovolemic anaemia
3 - renal fluid/ electrolyte conservation and haemopoiesis