Review- Heme Flashcards
What is the normal size and shape of erythrocytes?
Red, Biconcave discs.
Red color is from hemoglobin, which contains iron
What are reticulocytes?
Polychromatophilic macrocytes in the blood smear that represent RBC precursors
Which hemoglobin is most common (97%) and what chains is it composed of?
HgA
two alpha + two beta chains
Which hemoglobin makes up 1.5-3% and is composed of 2 alpha and 2 delta chains. What disease is this type of hemoglobin increased in?
HgA2
Increased in beta-thalassemia
Which type of hemoglobin? Increased in what disease?
50-90% at birth, <1% in adults
2 alpha + 2 gamma chains
HgF
Increased in beta-thalassemia
What are the normal percentages of human hemoglobin in an adult? (Hemoglobin A, A2 and F)
HgA= 97% (MC)
HgA2= 1.5-3%
HgF= 50-90%
what is the name of the big pieces of bone between marrow elements in normal bone?
bony trabeculae or cancellous bone
How many days do RBCs live?
120 days
What are the normal components of bone marrow?
- Fat
- Trabecular bone
- Hematopoietic elements
What is anisocytosis vs. Poikilocytosis?
Anisocytosis= Size of RBC
Poikilocytosis= Shape of RBC
Which anemia?
- MC type of megaloblastic anemia
- Malabsorption of B12 due to lack of gastric intrinsic factor
- Can be caused by gastrectomy
Pernicious anemia
Which anemia?
- Raw beefy tongue
- CNS- loss of vibratory sense and proprioception
- Loss of DTRs
- _Can’t walk w/o looking at their legs**_
Pernicious anemia
(Vit B12 deficiency due to lack of gastric IF)
*note- megaloblastic anemia due to folate deficiency will NOT have CNS sxs
What is the schilling test and what is it used for?
- Cobalamine absorption measured indirectly by giving radioactive cobalamine and measuring its excretion in the urine
- Tests for pernicious anemia (vit B12 deficiency due to lack of gastric IF)- ptsmaren’t able to absorb PO cobalamine
Which Megaloblastic anemia is MC in:
- late adult life (> 30y/o)
- Scandanavians, English or Irish
Pernicious Anemia
(Vitamin B12 def due to lack of gastric IF)
Basophilic Stippling is seen in which anemia?
Megaloblastic anemia
(Caused by vit B12 or folate deficiency)
How do you tx pernicious anemia?
Cobalamine IM, IV or SQ
(Cant give PO b/c of the lack of intrinsic factor)
Which megaloblastic anemia?
- Common in alcoholics, pregnancy and malnourished
- Raw beefy tongue
- weakness, fatigue, weight loss, loss of appetite, abdominal pain
- NO CNS SXS
Folate deficiency
sxs are similar to pernicious anemia EXCEPT for CNS sxs
Description of a patient with which anemia
- Blue eyes
- grey hair
- pallor (low Hgb level)
- lemon yellow tinge
- Raw beefy tongue
Pernicious anemia
How do you tx a megaloblastic anemia caused by folate deficiency?
PO folic acid
Is pernicous anemia and folate microcytic, normocytic or macrocytic anemia
Macrocytic, normochromic
What are aplastic anemias usually due to?
- a rare but serious form of anemia due to bone marrow hypoplasia or aplasia
- Either due to idiopathic (MC) or
- Cytotoxic drugs, viral infections, radiation therapy or benzene
The following are causes of which type of anemias?
- Cytotoxic Drugs (NSAIDS, Alkylating Chemotherapeutic Agents, Insecticides, Arsenicals, and Anticonvulsants)
- Viral Infections (CMV, EBV, HIV, Parvovirus B19, and Hep C)
- Radiation Therapy
- Chemicals such as Benzene
Aplastic anemias
(a rare but seious form of anemia due to bone marrow hypoplasia or aplasia)
