In each blank, try to type in the
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If your not sure what answer should be entered, press the space bar and the next missing letter will be displayed. When you are all done, you should look back over all your answers and review the ones in red. These ones in red are the ones which you needed help on. Question: Reticulocyte Answer: 0.5 - 1.5% Question: retic count calculation Answer: (Patient Hct)/Normal Hct (45%) X Retic count Question: Answer: Red cell Distribution Width; of size (anisocytosis) Question: RDW Answer: 11.5-13.5% - than this indicates anisocytosis Question: Serum Iron Answer: 50-150micrograms/dL Question: Total Iron Binding Capacity Answer: 250-450 mcg/dl Question: TransferrinAnswer: iron transport protein; transfers in the 2+ (ferrous) Question: % Saturation Answer: 20-50% Question: % calculationAnswer: Iron/TIBC X 100 = % Question: Top procedures to measure ironAnswer: 1) serum iron 2) TIBC 3) % Question: TIBC equals what?Answer: increased Question: Reasons for decreased IronAnswer: IDA; Acute or chronic inflammatory disorders; of other anemias (iron gets used up making more cells); hemorrhage or menstruation Question: Reasons for normal serum iron (in an anemic )Answer: Thalassemia (Iron levels are critical for determining if this is the of anemia) Question: Reasons for increased ironAnswer: hemachromatosis; hepatitis; hemolytic anemias; sideroblastic anemia; thalassemia major Question: Reasons for changes in serum iron Answer: 1) age 2) variation Question: Reasons for TIBCAnswer: 1) IDA 2) Question: Disease with decreased or normal TIBCAnswer: Anemia of chronic disease; hemolytic ; chronic liver disease; hemochromatosis; nephrosis Question: FerritinAnswer: Apoferritin (the ) + iron Question: increased in . . . Answer: any condition that to increased protein: hepatic necrosis; acute-phase reaction; sideroblastic anemia; hemochromatosis Question: Ferritin in . . .Answer: only in iron leading to IDA Question: ZPPAnswer: zinc protoporphyrin; used as a screening test for lead poisoning; elevated in iron deficient conditions (most porphyrin with zincion and makes ZPP) Question: Free ProphyrinAnswer: pretty much the same thing as ZPP, except instead of measuring porphyrin attached to zinc, you extract the free porphyrins from Question: Ferrous Answer: 2+ Question: Ferric Answer: 3+ Question: Iron is mostly as . . .Answer: (2+) Question: Iron is to appoferritin or transferrin as . . .Answer: (3+) Question: IDA can result from . . .Answer: Just drinking Question: male IDA can result from . . .Answer: GI Question: IDA can result from . . .Answer: Menstruation Question: with gastric resection can have IDA from . . . Answer: absorption Question: stage of IDA (first of three)Answer: Iron depletion - ferritin is Question: Second stage of IDA (of )Answer: Iron-deficient ertythropoiesis - TIBC Question: Third Stage of IDA (of )Answer: Full on IDA - , hypochromic RBCs; increased ZPP and FEP Question: IDA MCV and Answer: <80 and <30 (microcytic, )
Question: IDA serum Fe, TIBC, % Answer: decreased; increased; (less than 15%) Question: IDA ferritin, ZPP, TfR (transferrin )Answer: decreased, increased, increased (because no iron is being carried, so there are more transferrin receptors) Question: Anemia of Chronic Disease differences from Answer: can be normocytic/normochromic (or micro/hypo); normal to increased hemosiderin in bone (it's there, just isn't released); normal to decreased TIBC; % saturation is >15% (this is key); normal to increased serum ferritin Question: Anemia of Chronic Disease same as Answer: decreased serum Question: Two causes of macrocytic anemiaAnswer: Vit B12 ; folic acid deficiency Question: MCV of macrocytic Answer: MCV >99 Question: Vit. B12 aka . . . Answer: Question: Needed to absorb Vit. Answer: factor Question: Vit B12 absorbed ?Answer: Ileum Question: Common causes of Vit B12 Pernicious Answer: Dietary lack of B12 (not common in U.S.); against intrinsic factor Question: Features of a anemia blood smearAnswer: marcrocytic/normochromic RBCs (ovalocytes); neutrophils; Question: Macrocytic bone Answer: hypercellular - M:E of 1:1; (if anemia, shows megaloblastic lagging in nuclei of cells) Question: Macrocytic LD, haptoglobin, and Iron levelsAnswer: increased (they look yellow); decreased; increased (can't iron) Question: Schilling's Answer: radioactive B12 and measure what percentage is recovered in the urine in 24hrs; if <5 or 7% than repeat with intrinsic factor Question: features of B12 macrocytic anemiaAnswer: 1) neurological 2) smooth tongue 3) yellow appearance Question: acid is absorbed in the . . . Answer: Question: Folic acid can be stored for ____; B12 can be stored for ___Answer: weeks; Question: anemia aka Answer: iron loading Question: vs IDA Answer: both are /hypo; sidero usually has a dimorphic blood picture and papenheimer bodies; sidero has ringed sideroblasts in bone marrow (stained with prussian blue); Question: Bone in sideroblastic anemia has . . . Answer: increased hemosiderin; sideroblasts; Question: Sideroblastic serum iron, TIBC, % sat, ferritin Answer: increased serum Fe; normal to TIBC; increased %; increased serum ferritin (very important) Question: aka Answer: diabetes Question: stippling can indicate Answer: lead poisoning; dyserythropoetic anemia; thalassemia alpha and beta (among others) Question: Ham's test aka . . .Answer: Acidified test Question: Ham's test for what and how does it do it?Answer: Tests for complement mediated hemolysis; Patient serum is mixed with patient RBCs, but without an ABs. If complement is the cause of the hemolysis, it will in acidified serum, but not in heated serum (which destroys complement) Question: Ham's test if for which ?Answer: nocturanl hemoglobinuria (PNH); also can be postive for HEMPAS Question: PNH can be tested for with tests?Answer: Ham's Test; water test Question: What type of causes sickle cell?Answer: Question: What is the acid switch that causes sickle cell?Answer: Beta chain, 6th position, Glu --> Question: What is the fragility test for? Answer: Shows the of spherocytes; hereditary spherocytosis, and hemolytic anemias are more fragile (also increased in old blood) Question: How is the RBC fragility test set up? Answer: set up a serial dilution of distilled water and NaCl buffer; first tubes have all 1% NaCl, last tubes have no NaCl; spherocytes will lyse at a higher concentration (in tube 4) while normally they lyse at about tube 5 or 6 Question: What are some associated signs of hemolytic ? Answer: jaunide; dark/red urine; anemia; splenomegaly; hemoglobinuria (this is an one) Question: What are some of intravascular hemolytic anemias? Answer: PNH; MAHA; DIC; Drug in G6PD; transfusion reaction; Hereditary spherocytosis; H. eliptocytosis; H. pyropoikilocytosis; H. stomatocytosis Question: Horizontal of RBCs Answer: HE (spectrin form tetramers and protein 4.1 defect) and HPP (alpha spectrin + dimers) Question: defects of RBCs Answer: HS (spectrin ) Question: Why are spherocytes more destroyed? Answer: They aren't as flexible- get caught in spleen where there is too much Na; they run out of to pump out excess Na and they are destroyed by macrophages Question: values of HS hgb, MCV, MCHC)Answer: hgb is decreased; MCV is sligthly ; MCHC is increased Question: Problems with hreditary elliptocytosis Answer: Mostly there are none (90% ) Question: HPP Answer: Hereditary Pyropoikilocytosis; inherited; horizontal defect; PB shows budding, torn, shapes of RBCs Question: problems associated with HPP Answer: hyperbilirubinemia; Question: Treatment of hemolytic anemiasAnswer: Often splenectomy is best course; may need exchange Question: Rh Null is associated with . . . Answer: stomatocytosis is associated with . . . Question: What is a ?Answer: A qualitative disorder in one of the of hemoglobin Question: What is a ?Answer: A quanitative of a hemoglobin chain (too much of one) Question: What is the RBC , the indices and the typical RBC morphology of thalassemia? Answer: increased RBC (erythroid hyperplasia); /hypo; target cells, basophilic stippling Question: What is the of siderocytes/sideroblasts? Answer: Sideroblastic anemia; there is a disturbed or missing enzyme in the heme synthesis pathway; this to iron accumulation within mitochondria, which eventually rupture and deposit the iron into the cell Question: What causes PA, tropical sprue, and loop syndrome? Answer: Question: What does the bone in megaloblastic anemia look like? Answer: hypercellular with an in erythroid precursors and a decreased M:E ratio; cells show nuclear lagging (megaloblastic changes) "nuclear-cytoplasmic asyncrhony" - metamyelocytes and bands with loose chromatin; increased intercellular destruction Question: % saturation of iron in IDA vs. anemia of diseaseAnswer: IDA is <15%, Disease is >%15 Question: What does a longterm hookworm infection do to the ?Answer: anemia - looks like IDA (micro/hypo, elliptocytes); also increased eosinophils Question: What is myelophthisic ?Answer: destruction of blood precursor cells and caused by invasion from an non-hematopoetic cell like (like a tumor or cancer); dacryocytes and bizzare platelets are common (like MMM, which is also fibrotic) Question: What does the smear of a burn victim look like?Answer: , fracturing of RBCs (looks like Herditary Pyropoikilocytosis) Question: What does the bone of IDA look like?Answer: M:E ratio, increased cellularity Question: What does the bone of pernicious anemia look like?Answer: decreased M:E ratio; increased cellularity; macrocytic changes (lagging ) Question: What does the bone of hereditary elliptocytosis look like?Answer: some increased cellularity (enough to the benign condition of HE) Question: What causes increased Heinz bodies?Answer: 6 Phosphate deficiencty (G6PD) Question: What are bodies made of?Answer: hemoglobin Question: What is stippling composed of?Answer: RNA and Question: What does blue stain?Answer: Iron Question: What is in sickle cell caused by?Answer: extravascular hemolysis (cells out by spleen) Question: What are some complications by sickle cell anemia?Answer: sickled stick in narrow capillaries and can cause a vaso-oclusive crisis Question: What a vaso-oclusive crisis?Answer: cells Question: What happens to the blood in renal failure?Answer: a toxic environment (from BUN) and that leads to the formation of ecchinocytes Question: What to the blood in alcoholism?Answer: can cause stomatocytes and/or Question: What happens to the in chronic liver disease?Answer: typically causes anemia; can cause codocytes and/or ecchinocytes Question: What are four states that can lead to cells?Answer: thalassemia; disease; hemoglobin C disorders; splenectomy Question: What and chemicals can cause aplastic anemia?Answer: drug - chloramphenicol (and and penicillin);chemcial - benzene (and arsenic and insecticides) Question: Congenital red cell aplasia is . . .Answer: Blackfan Question: Congenital aplastic is called . . .Answer: Fanconi's Question: What does bone in aplastic anemia look like?Answer: <25% , >70% fat Question: What can cause hemolysis of blood cells?Answer: penicillin, , aldomet, Question: What is the mechanism of penicillinAnswer: drug to the membrane (which then activates IgG and complement) Question: What is the hemolytic mechanism of ?Answer: unknown, but it causes Abs to RBCs Question: What is G6PD?Answer: glucose 6 phosphate dehydrogenase deficiencty; the most erythorcyte enzyme disorder Question: Why is G6PD deficiency to cells?Answer: helps reduce oxidized ; when it can't the cells burst due to oxidative stress Question: What are some drugs that increase the activity in G6PD deficiency?Answer: antimalrials (primaquine, ) Question: Hemolytic uremia syndrome can cause what ?Answer: or chronic renal failure Question: How is HUS ?Answer: bacterial infection releases toxins into blood stream; toxins cause release of PLTs attach to glomeruli and tear up passing RBCs Question: age group is most affected by HUS?Answer: Question: Which age is most affected by TTP?Answer: |
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