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Clinical Hematology > Test 3 review sheet > Flashcards

Test 3 review sheet Flashcards

1
Q

What causes most Megaloblastic anemias?

A

Defects in DNA synthesis

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2
Q

What is needed for normal nuclear development?

A

Folate and Vitamin b12

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3
Q

What is iron deficiency associated with?

A

Microcytic red cells (aka RBCs smaller than usual)

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4
Q

Red cell production in megaloblastic anemia

A

is asnychronus, nucleus lags behind cytoplasm

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5
Q

When DNA synthesis is affected

A

Cell division doesn’t occur normally and cells become larger

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6
Q

Methotrexate

A

a drug that tends to compete with folate absorption

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7
Q

What cells are affected by Folate and B12 Deficiency

A

Any system of cells that need replacement

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8
Q

Areas of present symtoms for Folate and B12 deficiency

A

gastrointestinal tract, the skin, and the hematopoietic system

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9
Q

Low folate associated with

A

Macrocytic anemia

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10
Q

Who needs more folate: Men or Women

A

Women, especially when pregnant to help baby make blood too

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11
Q

Sources of B12

A

Meat (the best source) and meat byproducts (mild and eggs)

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12
Q

Cause of Pernicious Anemia

A

Deficiency of intrinsic factor due to an autoimmune disorder

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13
Q

atrophic gastritis

A

chronic inflammation and thinning of your stomach lining accompanied by a change in your stomach lining cells to mimic intestinal cells

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14
Q

What does atrophic gastritis affect

A

Secretion of H+, affecting acidity thus affecting digestion

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15
Q

What does Pernicious Anemia and folate deficiency have in common?

A

Elevated MVC, Hyper segmented neutrophils, megaloblastic bone marrow findings

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16
Q

What occurs during megaloblastic anemia

A

MCV is increased, RPI is decreased, thus having macrocytic anemia

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17
Q

What does ineffective erythropoiesis lead to

A

increased Lactate dehydrogenase increase and increased bilirubin

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18
Q

Pancytopenia

A

deficiency of all 3 blood cells

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19
Q

Why is pancytopenia found in megaloblastic anemia

A

Since the cells require DNA synthesis to make cells and replace dead cells

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20
Q

What does pancytopenia lead to?

A

Decrease in all blood cell counts, but an MCH increase due to RBCs being Macrocytic and normochromic

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21
Q

Ineffective erythropoiesis leads to?

A

Intracellular death since RBCs never make it to circulation, oval shaped RBCs, and pancytopenia

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22
Q

What is typically found first in megaloblastic anemia?

A

Hyper segmented neutrophils, are considered a specific thing in megaloblastic anemia

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23
Q

How many lobes depict Hyper segmented neutrophils

A

6 lobes

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24
Q

erythroid hyperplasia

A

immature red blood cells (erythroid cells) in the bone marrow are abnormal in size, shape, organization, and/or number

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25
Q

Myeloid cells and Erythroid Precursor ratio

A

10:1

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26
Q

What does the M:E ratio decrease to? and what does it mean?

A

1:1; bone marrow is hypercellular and defects in DNA synthesis occurs

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27
Q

What is a test of Pernicious anemia?

A

Venipuncture test for vitamin B12

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28
Q

What is pernicious anenia associated with

A

Deficiency of vitamin B12, due to lack of intrinsic factor that’s needed for absorbtion

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29
Q

What is a method for b12 deficiency?

A

Injection through the muscle to by pass absorption, since intrinsic factor deficiency can’t absorb it all

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30
Q

Schilling test

A

A test to see if B12 deficiency is due to lack of absorption because of low intrinsic factor or other reasons

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31
Q

What test would be done if a person has megaloblastic anemia

A

Folate and Vitamin b12 assays to see which one is deficient

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32
Q

Haptocorrin

A

a salivary protein that binds vitamin B12 found in food

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33
Q

Trypsin

A

Releases b12 from haptocorrin in the small intestines

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34
Q

Intrinsic factor

A

Brings the b12 to circulation

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35
Q

Transcobalamin

A

Most important carrier protein for b12

36
Q

Result of Bone Marrow Failure (BMF)

A

decrease in all the blood cells’ elements in the bone marrow, leading to pancytopenia

37
Q

Aplastic anemia

A

Rare and fatal syndrome of bone marrow failure, condition that occurs when your body stops producing enough new blood cells

38
Q

Neutrophil count: Aplastic anemia

A

less than 0.5  103/dL

39
Q

Bone marrow: Aplastic anemia

A

hypocellular with fat, all that’s left are lymphocytes, mast and plasma cells

40
Q

What test is not needed for testing BMF

A

platelet count

41
Q

Age range for aplastic anemia

A

Any age but mainly in: 10 to 25 years old, as well as in those older than 60 years

42
Q

Red cells in aplastic anemia

A

normocytic normochromic, but some macrocytosis

43
Q

Treatment for those younger than 40: aplastic anemia

A

hematopoietic stem cell transplant from an HLA-matched donor

44
Q

Treatment for those older than 40: Aplastic anemia

A

antithymocyte globulin (ATG) in combination with cyclosporine

45
Q

ATG: aplastic anemia

A

decreases the number of activated T cells

46
Q

cyclosporine: aplastic anemia

A

inhibits t cell functions thus suppressing the autoimmune suppression of stem cells

47
Q

Fanconi anemia

A

autosomal recessive disorder, which means that the gene must be inherited from both parents to express the phenotype

48
Q

What are acquired aplastic anemia

A

Myelodysplasia and secondary aplastic anemia

49
Q

Acquired aplastic anemia

A

a rare, serious blood disorder, due to failure of the bone marrow failure to produce blood cells

50
Q

What is a inherited aplastic anemia

A

Diamond-Blackfan anemia

51
Q

Inherited aplastic anemia

A

rare aplastic anemia. so rare that the cause is unknown

52
Q

What is common of both inherited and acquired aplastic anemia?

A

normal platelet and neutrophil counts

53
Q

Diamond-Blackfan anemia

A

characterized by an isolated PRCA and normal cellularity of myeloid cells

54
Q

Congenital dyserythropoietic anemia (CDA II)

A

known as hereditary erythroblastic multinuclearity with positive acidified serum (HEMPAS), most common CDA

55
Q

Tests for CDA II

A

Ham test is positive; Sucrose hemolysis test is negative

56
Q

Myelophthisic anemia

A

when invading or infiltrating cells replace normal bone marrow cells

57
Q

chronic renal failure

A

Leads to low EPO which is the primary cause of anemia

58
Q

CD34

A

are decreased with aplastic anemia, identifies HSCs

59
Q

idiopathic aplastic anemia

A

aplastic anemia where cause is unknown

60
Q

Diepoxybutane

A

DNA cross linking agent, is broken when exposed to Fanconi anemia cells

61
Q

Resonse to anemia

A

increase rate of of blood cell production and release

62
Q

compensated hemolytic disorder

A

When the marrow response is robust enough to keep up with the rate of red cell destruction, anemia does not develop

63
Q

immunoglobulin (Ig) antibody

A

common antibody

64
Q

What removes red cells at the end of their life

A

macrophages from the spleen

65
Q

How long do RBCs live

A

120 days

66
Q

protoporphyrin ring is converted to what?

A

bilirubin which is excreted from body

67
Q

What happens to globin chains?

A

Broken to amino acids and are reused for future synthesis

68
Q

What is released from splenic macrophages?

A

Bilirubin after degrading protoporphyrin ring

69
Q

Extravascular hemolysis

A

liver and spleen macrophages break down RBCs

70
Q

Intravascular hemolysis

A

the destruction of red blood cells in the circulation with the release of cell contents into the plasma

71
Q

hemoglobinemia

A

hemoglobin in the circulation

72
Q

When is hemoglobin found in pee

A

Renal threshold is exceeded and hemoglobin passes through kidneys

73
Q

urobilinogen

A

oxidize conjugated bilirubin into various water-soluble compounds

74
Q

When is free hemoglobin found in plasma

A

When the amount of free hemoglobin exceeds the capacity of plasma salvage systems (like haptoglobin)

75
Q

What happens to hemoglobin found in plasma

A

filtered through kidneys with some iron

76
Q

Concentration of plasma hemoglobin

A

greater than 50 mg/dL

77
Q

When does haptoglobin decrease

A

free hemoglobin is bound in an attempt to salvage the iron.

78
Q

chronic extravascular hemolytic process leads to

A

enlarged spleen (splenomegaly)

79
Q

Haptoglobin

A

binds the free hemoglobin and thus decreases in plasma

80
Q

What is seen with acute hemolysis

A

elevated reticulocyte count

81
Q

What test is best for acute hemolysis

A

reticulocyte count, which requires nothing more than a blood sample

82
Q

hemolytic anemia

A

disorder in which red blood cells are destroyed faster than they can be made

83
Q

What is the result of hemolytic anemia

A

Erythropoiesis is increased with no change in the production of granulocytes, M:E ratio will therefore be decreased

84
Q

Hypochromia

A

red blood cells have less color than normal when examined under a microscope

85
Q

When is hypochromia present

A

present when hemoglobin synthesis is abnormal such as in iron deficiency anemia

86
Q

What do Spherocytes indicate

A

extravascular hemolysis

87
Q

Schistocytes

A

fragmented red cells that result when the red cell membrane is damaged by trauma as can be seen in some intravascular hemolytic anemias

Clinical Hematology (6 decks)

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