anemia
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| What does RPI stand for? | Reticulocyte Production Index
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| What are the 3 morphological classifications of anemia? | Microcytic/Hypochromic
Macrocytic/Normochromic
Normocytic/Normochromic
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| What are the 2 basic pathophysiological causes of anemia? | Increased destruction
Decreased production
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| What does RDW stand for? | Red Cell Distribution Width
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| The RDW indicates 1) The degree of anisocytosis 2) The degree of poikilocytosis 3) Both | Both, however, anisocytosis is the main component. In the event there are many different types of poiks, the RDW will increase due to their variation in size.
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| A slide stained with New Methylene Blue will help to distinguish reticulocytes from other cells. How? | The remnant RNA (or reticulum) that is left in the retic will stain bright blue. (Mature RBC's do not contain RNA)
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| Hemoglobin A is composed of _______. | 2 Alpha and 2 Beta chains
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| Hemoglobin F is composed of _______. | 2 Alpha and 2 Gamma chains
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| Hemoglobin A2 is composed of _______. | 2 Alpha and 2 Delta chains
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| How many globin chains are in a hemoglobin molecule? | 4
Normal hemoglobin molecules are made of 2 alpha globin chains and either 2 beta, delta or gamma globin chains.
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| How many heme molecules are in a hemoglobin molecule? | 4
One heme molecule for each globin chain.
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| What are globin chains made of? | Amino acids liked together forming a polypeptide chain.
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| The anemias that develop from improperly made globin chains are collectively called_____. | Hemoglobinopathies
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| How many iron molecules can one hemoglobin molecule carry? | 4
One on each heme molecule.
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| Hemoglobinopathies are considered 1) Quantitative globin defects 2) Qualitative globin defects | 2) Qualitative globin defects
There are plenty of globin chains being made, but they are being made incorrectly.
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| Thalassemias are considered 1) Quantitative globin defects 2) Qualitative globin defects | 1) Quantitative globin defects
The globin chains are being made correctly, but the rate of synthesis is decreased.
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| What are the 2 types of thalassemias? What is the difference? | Alpha thalassemia and Beta thalassemia. Alpha thal has a decreased rate of synthesis of alpha globin chains, but normal rate of beta chains.
Beta thal has a decreased rate of synthesis of beta chains, but normal rate of alpha chains.
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| How many alpha genes are missing from alpha thalassemia minor? What does this mean for the rate of synthesis? | There is only one gene missing.
The rate of synthesis for alpha chains will only be slightly decreased.
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| How many alpha genes are missing from alpha thalassemia trait? What does this mean for the rate of synthesis? | There are two alpha genes missing.
The rate of synthesis for alpha chains will be moderately decreased. The body will try to compensate by making some hgb molecules with 4 beta chains. (Hgb H)
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| How many alpha genes are missing from alpha thalassemia major? What does this mean for the rate of synthesis? | There are three alpha genes missing.
The rate of synthesis for alpha chains will be severely decreased resulting in Hgb H disease. (Most hemoglobin molecules will be made with 4 beta chains)
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| What effect does lead poisoning have on the hgb molecule? | It will cause defects in heme synthesis resulting in the inability of iron to enter the heme molecule.
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| What is the lab picture of lead poisoning? If it is not caught soon enough what kind of permanent damage can occur? | There will be a mild anemia with micro/hypo RBCs. Basophilic stippling will be noted. FEP will be increased.
Patient can develop permanent CNS damage.
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| An increase in Free Erythrocyte Protoporphyrin and Zinc Protoporphyrin indicates what? | Iron molecules are unable to attach to protoporphyrin, thus there is an excess in the blood. This is seen in IDA, ACD, lead poisoning and Sideroblastic Anemia.
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| What are the 4 most common reasons for Iron Deficient Anemia? | Nutritional deficiency (poor diet)
Faulty or incomplete absorption (bowel resection, genetic factors)
An increase in demand (pregnancy, growth spurt)
Excessive loss (heavy menstruation, internal bleeding)
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| What is the most common cause of IDA in men? What can this indicate? | Gastrointestinal bleeding.
Indicative of colon cancer.
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| What is the most common cause of IDA in women? | Heavy menstrual bleeding.
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| What are the 3 stages of IDA? | 1) Iron levels being to deplete. Serum iron and TIBC (indirect measure of transferrin) will be normal. Ferritin will begin decreasing.
2)
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| What lab values will differentiate IDA and Sideroblastic Anemia? | Serum Iron and Ferritin
IDA-low iron and ferritin
Sideroblastic-normal to increased iron and normal ferritin
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| Which anemia can cause pica? | IDA
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| What is the morph picture of IDA? | Microcytic/Hypochromic
May see targets and some anisocytosis.
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| Is sideroblastic anemia caused by a lack of iron or the inability of iron to enter the heme molecule? | The inability of iron to enter the heme molecule.
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| If IDA is successfully treated what will the initial morph picture be? | A dimorphic population of cells.
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| What are the treatment options for people with IDA? | Iron therapy, or in severe cases transfusion.
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| What is the morph picture of Sideroblastic Anemia? | Microcytic/Hypochromic with targets, ringed sideroblasts, basophilic stippling and possibly a dimorphic population.
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| What causes ACD? | Anemia of Chronic Disease results from inflammation, infection or malignancy.
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| What will the morph be of Beta Thalassemia Trait? (Heterozygous) | A mild micro/hypo anemia with slight amt of targets and basophilic stippling.
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| A homozygous beta thalassemia is also known as what? | Beta Thalassemia Major or Cooley's Anemia
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| What happens to RBCs in beta thalassemia major? | Alpha chains precipitate and damage the rbc membrane.
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| What type of thalassemia is transfusion dependent? | Beta Thalassemia Major (Cooley's Anemia)
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| What is the rate of migration for the following? Hgb C Hgb S Hgb F Hgb A | Hgb C = crawl
Hgb S = slow
Hgb F = fast
Hgb A = accelerate
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| What disease occurs from hemoglobin S? | Sickle Cell Anemia
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moriah.jacy
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