SQs RBC Disorders Flashcards
The causes of anemia include
a. blood loss
b. impaired red cell production
c. accelerated red cell destruction
d. AOTC
d. AOTC
The clinical signs and symptoms of anemia can result from
a. diminished delivery of oxygen to the tissues
b. lowered hemoglobin concentration
c. increased blood volume
d. both A and B
d. both A and B
Which of the following is a significant laboratory finding in anemia?
a. decreased hemoglobin
b. increased packed cell volume
c. increased erythrocyte count
d. normal erythrocyte indices
a. decreased hemoglobin
If you are grading changes in erythrocytic size or shape using a scale of 0 to 4+ and many erythrocytes deviate from normal per microscopic field, the typical score would be
a. 1+
b. 2+
c. 3+
d. 4+
c. 3+
Anemias can be categorized into
a. hemolytic types
b. blood loss types
c. impaired production types
d. all of the above
d. all of the above
Identify whether the given characteristic is
a. Acute blood loss
b. Chronic blood loss
Disorders of the GI system or heavy menstruation
b. chronic blood loss
Identify whether the given characteristic is
a. Acute blood loss
b. Chronic blood loss
Increased thrombocytes
a. acute blood loss
Identify whether the given characteristic is
a. Acute blood loss
b. Chronic blood loss
Traumatic conditions
a. acute blood loss
Identify whether the given characteristic is
a. Acute blood loss
b. Chronic blood loss
Does not disrupt blood volume
b. chronic blood loss
Identify whether the given characteristic is
a. Acute blood loss
b. Chronic blood loss
Results in an iron deficiency and a hypochromic/microcytic erythrocyte morphology on a peripheral blood smear
b. chronic blood loss
The erythrocyte morphology associated with anemia in an otherwise healthy individual caused by acute blood loss is usually
a. microcytic
b. megaloblastic
c. normochromic
d. hypochromic
c. normochromic
Anemia caused by chronic blood loss is characterized by
a. hypochromic, microcytic erythrocytes
b. decreased packed cell volume
c. increased platelets
d. both A and B
d. both A and B - hypochromic, microcytic erythrocyte and decreased packed cell volume
Acquired aplastic anemia may be caused by
a. benzene or benzene derivatives
b. ionizing radiation and vitamin B12
c. purine or pyrimidine analogues
All of the choices :)
The sudden appearance of plastic anemia or pure red cell aplasia is often caused by
a. hemolytic process
b. an immune process
c. acute leukemia
d. chronic leukemia
b. an immune process
Aplastic anemia can occur years before a diagnosis of ___________ is made.
a. paroxysmal noctural hemoglobinuria
b. myelodysplasia
c. acute myelogenous leukemia
All of the choices
If a patient with aplastic anemia is referred to as exhibiting pancytopenia, which cell lines are affected?
Erythrocytes
Leukocytes
Thrombocytes
A subset of Fanconi anemia
Familial aplastic anemia
A rare congenital form of red cell aplasia
Diamond-Blackfan syndrome
Is characterized by selective failure of red blood cell production
Pure red cell anemia
The best-descried congenital form of aplastic anemia
Fanconi anemia
Hematopoietic cells targets in aplastic anemia are affected by
Activated cytotoxic lymphocytes
Activation of the Fas receptor
Direct cell-cell interactions between lymphocytes and target cells
Fanconi anemia is associated with abnormal genes located on chromosomes
9,20
The etiology of Iron Deficiency Anemia (IDA) is
a. nutritional deficiency
b. faulty iron absorption
c. excessive loss of iron
all of the choices
Iron deficiency is still common in
a. toddlers
b. adolescent girls
c. women of childbearing age
all of the choices
Decreased iron intake
meat-poor diet
Faulty iron absorption
Sprue
Pathological iron loss
Colon cancer
Physiological iron loss
Menstruation
Increased iron utilization
Adolescent growth spurt
The average adult has _____g of total iron.
3.5 to 5.0
Most functional iron in humans is found in
hemoglobin molecules of erythrocytes (RBCs)
Approximately _____% of iron from food is in the form of ______ iron.
90, nonheme respectively
Most ingested iron is readily absorbed into the body in the
duodenum and upper jejunum
Transferrin represents a
Beta globulin and Glycoprotein that moves iron
In Iron Deficiency Anemia, the erythrocytic indices are typically
MCV decreased, MCH decreased, MCHC decreased (nag decrease ang all)
The peripheral blood smear demonstrates _______ red blood cells in the IDA.
microcytic, hypochromic
In Iron Deficiency Anemia, the serum iron is severely _________ and the TIBC is _________.
decreased, increased respectively
Anemias of inflammation/chronic diseases can be caused by
inflammation, infection, malignancy
AOI can result from
a. inappropriately decreased erythropoietin
b. suppression of erythropoiesis by cytokines from activated macrophages and lymphocytes
c. impaired iron metabolism
All of the choices
The typical peripheral blood film of a patient with AOI typically reveals ______ erythrocytes.
Normocytic, normochromic
Leukoerythroblastosis can appear as ________ on a peripheral blood smear.
Immature leukocytes & erythrocytes
What is the most appropriate treatment for AOI?
Treatment of the inflammatory condition
Sideroblastic anemia can be caused by
a. congenital (chromosomal) defect
b. drugs
c. association with malignant disorders
d. acute mylogenous leukemia
e. chloramphenicol
All of the choices
A common feature of sideroblastic anemia is
Ringed sideroblasts
The greatest portion of operational body iron is normally contained in what compound?
Hemoglobin
Storage iron in the human body is
a. found in hepatocytes
b. found in macrophages
c. sequestered as ferrotin
d. all of the above
e. none of the above
d. all of the above
The most sensitive assay for the diagnosis of hereditary hemochromatosis (HH) is
transferrin saturation
Megaloblastic anemias can be caused by
a. tapeworm infestation
b. gastric resection
c. nutritional deficiency
all of the choices
Megaloblastic anemia related to folic acid deficiency is associated with
a. abnormal absorption
b. increased utilization
c. nutritional deficiency
all of the above
The underlying type A gastritis that causes pernicious anemia is immunologically related to
a. autoantibody to IF
b. low serum gastrin
c. autoantibody to parietal cells
Both A and C
Cobalamin transport is mediated by
IF
TC II
R proteins
In megaloblastic anemia, the typical erythrocytic indices are
MCV increased
MCH increased
MCHC normal
The peripheral erythrocyte morphology in folate deficiency is similiar to pernicious anemia, and the RBCs are ___________.
large
In a case of class pernicious anemia, the patient has
leukopenia
hypersegmented neutrophils
anemia
The reticulocyte count in a patient with untreated pernicious anemia is characteristically
<1.0%
What is the expected value in pernicious anemia of the given chemistry assay:
- Serum haptoglobin-binding capacity
- Serum B12
Decreased
What is the expected value in pernicious anemia of the given chemistry assay:
Folate
Normal
What is the expected value in pernicious anemia of the given chemistry assay:
- Serum Iron
- Percent transferrin
- Unconjugated bilirubin
Increased
What is the expected value in pernicious anemia of the given chemistry assay:
Serum LDH
Significantly increased
Hemolytic disruption of the erythrocyte involves
an alteration in the erythrocyte membrane
Destruction of RBCs within the circulatory blood
Intravascular hemolysis
Destruction of RBCs outside the circulatory blood
Extravascular hemolysis
Which of the following tests is not useful in determining increased erythrocyte destruction?
a. reticulocyte count
b. total leukocyte count
c. serum haptoglobin
d. unconjugated bilirubin
b. total leukocyte count
Defect of the hemoglobin molecule
Thalassemia
Erythrocytic enzyme defect
G6PD Deficiency or Pyruvate Kinase (PK) Deficiency
Structural membrane defect
Hereditary spherocytosis
The most common prevalent hereditary hemolytic anemia among people of Northern European descent.
Hereditary spherocytosis
An overabundance of oval-shaped red cells
Hereditary elliptocytosis
A subgroup of common hereditary elliptocytosis
Hereditary pyropoikilocytosis (HPP)
Can be seen in the genetic hemoglobin defect, thalassemia
Hereditary stomatocytosis
A permeability disorder
Hereditary xerocytosis
Heinz bodies are associated with the congenital hemolytic anemia
G6PD Deficiency
A hemolytic crisis may be precipitated in 10% of American black males suffering from G6PD deficiency by
primaquine
What is the most common glycolytic enzyme deficiency associated with the aerobic pathway of erythrocyte metabolism?
Glucose-6-phosphate dehydrogenase (G6PD)
What is the most common glycolytic enzyme deficiency associated with the anaerobic pathway of erythrocyte metabolism?
Pyruvate Kinase
What laboratory assay would specifically indicate a deficiency of G6PD enzyme?
Heinz bodies on peripheral blood smears
What enzyme deficiency causes methemoglobinemia?
NADH-methemoglobin reductase
Acquired hemolytic anemia can be caused by
a. chemical
b. drugs
c. infetious organisms
d. antibody reactions
All of the choices
The infectious microorganism directly associated with hemolytic uremic syndrome is
E. coli O157-H7
Rh antibodies are the most frequent cause
Warm-type autoimmune hemolytic anemia (AIHA)
IgM, usually anti-I
Cold-type AIHA
Anemia that usually occurs in newborn infants
Isoimmune hemolytic anemia
The erythrocyte alteration characteristically associated with hemolytic anemia is
spherocytosis
What laboratory procedures would reflect a typical hemolytic anemia?
a. Increased osmotic fragility
b. Increased total serum bilirubin
c. Increased reticulocyte count, unless hematopoiesis is suppressed
d. AOTC
d. AOTC
Which of the following is not associated with hemolytic anemia?
a. Decreased HgB and Hct
b. Increased reticulocyte count
c. Increased serum haptoglobins
d. Decreased erythrocyte survival
c. Increased serum haptoglobins
Paroxysmal nocturnal hemoglobinuria exhibits sensitivity of one population of red blood cells to
complement
Paroxysmal nocturnal hemoglobinuriaepisodes are usually associated with
sleep
The defect in PNH probably is a (an) ___________ associated defect of the red cell membrane.
Structural protein
The common denominator in the hemoglobinopathies is that all are
inherited or genetic defects related to hemoglobin
Hemoglobinopathies can be classified as
a. abnormal hemoglobin globulin structure
b. a defect of hemoglobin globulin synthesis
c. a combination of defects of both structure and synthesis
d. all of the above
AOTA
True or False.
Normal adult hemoglobin contains the following components: Hb A (95% to 98%), Hb A2 (2% to 3%), Hb A1 (3% to 6%), and Hb F (<1%)
True
In the hemoglobinopathis, a trait is described as
heterozygous and asymptomatic
In sickle cell anemia the cause is
change of single nucleotide (GAT to GTT) and
substitution of valine for glutamix acid at the sixth position on the beta chain of the hemoglobin molecule
In sickle cell disease the abnormality is related to
an abnormal structure of hemoglobin
One of the two most common monogenetic diseases of man is
sickle cell anemia
If a patient with sickle cell anemia is in an acute crisis state, peripheral blood smears may exhibit
drepanocytes
What estimated percentage of black Americans are heterozygous for Hb S?
8%
The most common complaint associated with sickle cell anemia
acute pain
Absence or decrease in synthesis of one or more globin subunits
Thalassemia
Homozygous B-thalassemia patients have
Severe transfusion-dependent anemia
In a-type thalassemia, with three inactive a genes, which of the following is characteristic?
a. Hb A2
b. Hb A
c. Hb H
d. Hb F and A2
Hb H
What is the primary risk to thalassemia major patients who receive frequent and multiple blood transfusions?
Iron overload
The peripheral blood smear in silent state patients with a-thalassemia typically appears as
normochromic, normocytic
The characteristic hemoglobin concentration in a patient’s silent state with heterozygous B-thalassemia is
Hb A level normal
Decreased solubility; the ability to form intracellular crystals
Deoxyhemoglobin C
The incidence of Hb E hemoglobinopathy is highest in
Southeast Asia
Most unstable hemoglobins
- inherited autosomal dominant disorders
- result from amino acid substitutions or deletions
- hemoglobin variants
Common clinical symptoms of anemia include:
a. Splenomegaly
b. shortness of breath and fatigue
c. chills and fever
d. jaundice and enlarged lymph nodes
b. shortness of breath and fatigue
This is reduced as an adaptation to long-standing anemia
Oxygen affinity of hemoglobin
An autoimmune reaction destroys the hematopoietic stem cells in the bone marrow of a young adult patient, and the amount of active bone marrow, including RBC precursors, is diminished. The RBC precursos that are present are normal in appearance, but there are too few to meet the demand for circulating red blood cells, and anemia develops. The reticulocyte count is low. The mechanism of the anemia would be described as:
Insufficient erythropoiesis
What are the initial lab tests that are performed for the diagnosis of anemia?
CBC, reticulocyte count, and peripheral blood film examination
Its increase suggests a shortened life span of RBCs and hemolytic anemia
Reticulocyte count
Which of the following is detectable only by examination of a peripheral blood film?
a. microcytosis
b. anisocytosis
c. hypochromia
d. poikilocytosis
d. pokilotcytosis
Schistocytes, ovalocytes, and acanthocytes are examples of abnormal changes in RBC:
a. volume
b. shape
c. inclusions
d. hemoglobin concentration
shape
An anemic adult patient with an absolute reticulocyte count of 20x10^9/L and an MCV of 65 fL.
a. aplastic anemia
b. sickle cell anemia
c. iron deficiency
d. folate deficiency
c. iron deficiency
An anemic adult patient with an MCV of 125 fL and an RDW of 20% (reference interval 11.5% to 14.5%)
Vitamin B12 deficiency
