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Clin Path 1 - Quiz 2
| Question | Answer |
|---|---|
| Reference Range(RR) for Hemoglobin | 16 g/dl for males; 14 g/dl for females |
| RR for RBC | 4.3-5.9 for males; 3.5-5.5 for females |
| RR for Hct | 40%-54% for males; 37%-47% for females |
| RR for MCV | 80-100 fl |
| RR for MCH | 27-33 pg |
| RR for MCHC | 32-36 g/dl |
| RR for RDW | 11-15% |
| RR for platelets | 15,000-400,000 |
| RR for WBC | 4,500-11,000 |
| RR for reticulocytes | 0.5-1.5% |
| RR for Neutrophils | 50-70% |
| RR for Lymphocytes | 20-40% |
| RR for Eosinophils | 1-5% |
| RR for Monocytes | 2-10% |
| RR for Basophils | 0-1% |
| ESR Rate | 3-13 mm/hr children; 1-15 mm/hr Adult Males; 1-2 mm/hr Adult Females |
| Decrease in the oxygen-carrying capacity of the blood | anemia |
| The clinical expression of anemia results from what? | tissue hypoxia |
| Tissue hypoxia produces increased levels of what? | erythropoietin (EPO) in the plasma |
| EPO does what when it is increased? What is this response called? | Stimulates the marrow stem cells to produce more RBC's; normoblastic hyperplasia |
| General symptoms of anemia | weakness, vertigo, headache, tinnitus, spots before the eyes, drowsiness, irritability, amenorrhea, loss of libido, GI complaints, jaundice, pallor and splenomegaly |
| 3 basic mechanisms of anemia | blood loss, decreased production of RBC's, increased destruction of RBC's |
| RBC lives how long | 120 days |
| We make how many RBC's a minutes? | 8 million |
| Clinically anemia is defined as hemoglobin less than what? | <11 gm/dl for females and <13 gm/dl for males |
| What treatment for any type of anemia is not justifiable? | treatment with multiple agents also known as shotgun therapy |
| Lab tests for anemia | CBC, PBS, Reticulocyte count, RBC indices, RDW and bond marrow aspiration and biopsy |
| The most important single test in the diagnosis of anemia? | PBS (Blood Smear) |
| What is a reticulocyte? | immature cell which have been released from the bone marrow and appear polychromatophilic |
| What is the most important RBC index in thet differential diagnosis of anemia? | MCV |
| What is the first test that goes abnormal in anemias? | RDW and it only increases |
| Etiological classifications of anemias | Anemia due to blood loss, anemia due to deficient erythropoiesis (dec. production) and anemia due to excessive RBC destruction |
| 2 anemias due to blood loss? | acute posthemorrhagic anemia and chronic posthemorrhagic anemia |
| 3 subcategories of anemias due decreased RBC production | hypochromic-microcytic anemia, normochromic-normocytic anemia and megaloblastic/macrocytic anemia |
| Hypochromic-microcytic anemias? | Iron-deficiency anemia, sideroblastic anemia, ACD, beta thalassemia |
| Normochromic-normocytic anemias? | anemia of renal disease, anemia of endocrine failure, aplastic anemia, myelophthistic anemia |
| Megaloblastic/macrocytic anemias? | vit B12 anemia and folic acid deficiency anemia |
| 2 subcategories of anemias due to excessive RBC destruction? | anemia due to intrinsic red cell defects and anemia due to extrinsic red cell defects |
| Anemias due to intrinsic red cell defects? | hereditary spherocytosis, G6PD deficiency, sickle cell anemia, thalassemia |
| Anemia due to red cell membrane alterations? | hereditary spherocytosis |
| Anemia due to disorders of red cell metabolism? | G6PD deficiency |
| Anemias due to defective hemoglobin synthesis? | sickle cell(structural and thalassemia(rate of synthesis) |
| Anemia due to extrinsic red cell defects? | traumatic hemolytic anemia(microangiopathic HA), hemolysis due to infectious agents, anemia due to immunologic abnormalities |
| Anemia due to immunologic abnormalities? | isoimmune and autoimmune (warm antibody and cold antibody) |
| Etiology of acute posthemorrhagic anemia | due to traumatic or spontaneous rupture of a mojor blood vessel, erosion of an artery by lesions or failure of normal hemostatic processes |
| Lab findings of acute posthemorrhagic anemia | during and immediately after hemorrhage, the RBC counts, Hb and Hct are normal; several days later the blood smears reveals polychromatophilia, slight macrocytosis, occasional normoblasts and immature WBC's |
| Best lab test to help diagnose hypochromic-microcytic anemias | serum ferritin which is an iron storage glycoprotein |
| Iron deficient anemia does what to serum ferritin levels? | decreases it (this is the only anemia that decreases ones serum ferritin) |
| Most common cause of anemia? | iron deficiency |
| Most common cause of IDA? | menorrhagia |
| Most common age group and sex in IDA? | toddlers and menstruating women; females |
| Etiology of IDA? | iron intake not sufficient to replace normal iron losses, iron not available for erythropoiesis despite adequatae body iron, increased loss of body iron not adequately replaced by normal intake |
| Causes of IDA? | inadequate dietary intake, pregnancy, pica, malabsorption diseases, achlorhydria, excessive blood loss, chronic intravascular hemolysis, excessive blood donation |
| Stage 1 of IDA | depleted storage iron, Hb and plasma iron normal; want to diagnose here |
| Stage 5 of IDA | symptoms and signs of iron deficiency |
| Clinical findings of IDA? | pica, pagophagia, koilonychia and cheilosis |
| What is pica? | craving for dirt or clay and its also a symptom and cause of IDA |
| What is pagophagia? | craving ice |
| What is koilonychia? | spoon shaped nails |
| What is cheilosis? | cracked side of lips |
| Lab findings of IDA? | decreased serum ferritin, RBC, Hb, Hct, MCV, MCH, MCHC, hypochromic, microcytic RBC's and elevated RDW |
| Best noninvasive test for IDA in adults and does it always work to diagnose IDA? | low serum ferritin and no because it may miss some deficient patients due to ferritin being an acute phase reactant |
| What may alter thet lab results of IDA? | iron supplements or multivitamin-mineral preparations that contain iron |
| Iron utilization anemia | sideroblastic anemia |
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