Final Units 3-5 Heme Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
What is the cause of Iron Deficiency Anemia (IDA)? | It is a deficiency of iron due to malnutrition, malabsorption, or blood loss |
What is the cause of Anemia of Chronic Diseases (ACD)? | Iron is blocked from reaching the RBC precursors due to impaired release from stores |
The stain used to view unused iron | Prussian blue |
What is the cause of Sideroblastic Anemia (SA)? | Iron leaves the stores but cannot be inserted to protoporphyrin ring. It accumulates in the mitochondria and forms ringed sideroblasts. |
What are the three progressions (stages) of IDA? | Stage 1: Iron store depletion Stage 2: Iron deficient erythropoiesis Stage 3: Iron deficiency anemia |
What is the red cell morphology for stage 1 IDA? | Normocytic normochromic |
What is the red cell morphology for stage 3 IDA? | Microcytic hypochromic |
What are the iron studies for IDA? (ferritin, serum iron, TIBC, and % saturation) | Ferritin: decreased Serum iron: decreased TIBC: increased Transferrin saturation: decreased |
What are the iron studies for ACD? (ferritin, serum iron, TIBC, and % saturation) | Ferritin: normal-increased Serum iron: decreased TIBC: normal-decreased Transferrin saturation: normal-decreased |
What are the iron studies for SA? (ferritin, serum iron, TIBC, and % saturation) | Ferritin: normal-increased Serum iron: normal-increased TIBC: normal-decreased Transferrin saturation: increased |
Primary megaloblastic anemia | Nutritional deficiency of B12 or folate that leads to impaired DNA synthesis. Causes impaired nuclear maturation and cell division. |
Secondary megaloblastic anemia | Due to malabsorption condition such as pernicious anemia where there is a defect in HCl secretion and Intrinsic Factor (IF) |
Cell types affected by megaloblastic anemia | All cell types (pancytopenia) |
Nuclear cytoplasm asynchrony | Nuclear maturation defect characterized by high N:C ratio; immature nucleus with mature cytoplasm. Usually results in ineffective erythropoiesis. |
Non-megaloblastic anemia | Unrelated to nutritional deficiency. Characterized by high liver enzymes from liver disease or alchoholism. |
Peripheral blood findings in megaloblastic anemia | Pancytopenia Macrocytic normochromic cells Macro-ovalocytes Anisocytosis Hypersegmented neutrophils HJ bodies Ineffective erythropoiesis |
BM findings in megaloblastic anemia | Marked N:C asynchrony |
Chemistry findings in megaloblastic anemia | Decreased serum folate and/or B12 Increased MMA Increased homocysteine |
Laboratory findings in non-megaloblastic anemia | Round macrocytes No hypersegmented neutrophils Normal WBC, and PLT Normal B12 and folate Normal MMA and homocysteine |
Intravascular hemolytic anemia | Occurs within blood vessels Increased schistocyes Increased serum bilirubin Decreased haptoglobin Hemoglobinuria |
Extravascular hemolytic anemia | Occurs mainly in spleen Increased spherocytes Increased serum bilirubin Hepatosplenomegaly |
What is the job of haptoglobin in intravascular hemolysis? | To transport and elminate serum bilirubin |
How is bilirubin eliminated in extravascular hemolysis? | By the spleen |
DAT seperates hemolytic anemias into what two groups? | Immune-mediated (allo or auto immune) or non-immune (inherited) |
Compensated hemolytic anemia | No anemia unless RBC destruction exceeds production |
What are the three types of intrinsic RBC defects? | Membrane protein defects Enzyme defects Hgb (globin chain) defects |
What are the intrinsic membrane protein defect HA's? | Hereditary spherocytosis (HS) Hereditary elliptocytosis (HE) Hereditary stomatocytosis PNH (CD55 and CD59) |
What are the intrinsic enzyme defect HA's? | Glucose-6-phosphate dehydrogenase(G6PD Pyruvate kinase (PK) deficiency |
What is hereditary spherocytosis (HS)? | Defect in vertical proteins. Shows elevated number of spherocytes and MCHC <36%. |
What is the diagnostic test for HS? | Osmotic fragility test for spherocytes and negative DAT |
What is hereditary elliptocytosis and it's severe form? | Horizontal protein defect. When fragmentation begins to occur it is called hereditary pyropoikilocytosis (HPP). |
What is hereditary stomatocytosis? | Defect in membrane protein stomatin which helps regulate ions across the red cell channel |
What two types of hereditary stomatocytosis are there? | Overhydrated: Excessive gain of Na+ and water rushes in causing uncompensated HA Dehydrated: Excessive loss of Na+ and water rushes out causing compensated HA |
What is PNH? | Defect in GPI anchor for complement regulator proteins CD55 and CD59. C' reg. proteins missing = C' activated, cells destroyed |
Tests for diagnosing PNH | Sucrose hemolysis (sugar water), Ham's (acid serum) and flow analysis |
What is G6PD deficiency? | Causes impaired generation of glutathione in reduced state (GSH) that helps to prevent oxidative damage to Hgb. Causes denatured, oxidized Hgb forming Heinz bodies. |
What type of stain is used to view Heinz bodies? | Supravital stain |
What will the blood film of G6PD deficient patient look like? | Bite cells and blister cells |
What is a source of error in testing for G6PD deficiency? | Reticulocytosis because retics have high G6PD activity causing false increase in levels |
DAT tests for what antibodies associated with HA? | Autoimmune antibodies (Warm or cold) |
IAT tests for what antibodies associated with HA? | Alloimmune antibodies (transfusion reaction or hemolytic disease of the newborn - HDN) |
Warm and cold AIHA are associated with which HA? | Autoimmune hemolytic anemia |
Amino acid substitution for Hgb S | B6(Glu) -> (Val) |
Amino acid substitution for Hgb C | B6(Glu) -> (Lys) |
Amino acid substitution for Hgb E | B26(Glu) -> (Lys) |
Is Hgb SA sickle cell anemia or trait? | Trait; asymptomatic |
Is Hgb SS sickle cell trait or anemia? | Anemia (also known as sickle cell disease) |
Is Hgb S soluble in the deoxygentated state or the oxygenated state? | Oxygenated |
Under what conditions does Hgb S turn into insoluble aggregates? | Under deoxygenated, deoxyhemoglobin state; Hgb S polymerizes |
What clinical condition is the hallmark manifestation of sickle cell disease? | Vaso-occlusive crisis; causes very intense pain termed "body biting" |
Deterioration of tissues from recurring vaso-occlusive episodes can cause what two things? | Autosplenectomy and overwhelming infections |
Screening test for sickle cell and it's reagent | Solubility test - Sodium Dithionite (reducing agent that takes O2 from cells and causes sickling = turbidity) |
Major difference in Thalassemia and Hemoglobinopathies? | Thalassemia is decreased or absent synthesis of structurally NORMAL globin chains. Hgbopathies are synthesis of structurally ABNORMAL globin chains. |
Thalassemias are characterized by what RBC morphology and iron status | Microcytic hypochromic and NORMAL iron status |
Types of alpha Thalassemia | Intermedia (Hgb H) [4 beta chains] Major (Hgb Barts/Hydrops Fetalis) [4 gamma chains] |
Which alpha Thalassemia is incompatible with life? | Hydrops Fetalis |
Type of beta Thalassemia | Major (Cooley's or Mediterranean anemia) [Little or no Beta chain synthesis; Majority are Hgb F] |
Classification of anemia deals with stem cell defects | Aplastic anemia (Fanconi anemia) causing hypocellular BM and pancytopenia |
Classification of anemia that deals with progenitor cell defects | Pure red cell aplasia (PRCA) where there is failure to produce erythroid progenitor cells but WBC's and PLT's are normal [Diamond Blackfan syndrome] |
Classification of anemia dealing with bone marrow replacement | Myelophthisic anemia |
Stages of neutrophil development | Myeloblast Promyelocyte Myelocyte Metamyelocyte Band Neutrophil |
First stage of neutrophil development incapable of division | Metamyelocyte |
Which pool are dividing cells located? | Mitotic pool |
Which pool are non-dividing cells located? | Post-mitotic pool |
Where do cells travel in the event of infection? | Directly from marginal pool to tissues |
Formula for absolute count of WBC's | Absolute count = Relative count (in decimal)*WBC count |
Is LAP higher in Leukemoid reaction or CML | Leukemoid reaction |
Is Philidelphia chromosome associated with CLL or CML? | CML - Chronic Myeloid Leukemia |
Causes malignancies and abnormal proliferation of cells after mutation | Proto-oncogene -> Oncogene |
Causes inability to suppress malignant clones of cells | Loss of a tumor suppressor gene |
Are Auer rods found in lymphoid or myeloid leukemias? | Myeloid leukemia |
Organization classifies leukemia by someone having >30% blasts and relies on morphology | French-American-British (FAB) |
Organization classifies leukemia by someone having >20% blasts and relies on immunophenotyping | The World Health Organization (WHO) |
AML classified by t(8;21) | M2: Acute Myeloblastic Leukemia with maturation |
AML classified by t(15;17) and multiple Auer rods | M3: Acute Promyelocytic (PG) Leukemia |
AML classified by Inv (16) | M4: Acute Myelomonocytic leukemia |
AML classified by t(9;11) | M5: Acute Monocytic leukemia |
M6 also goes by what other name? | Acute Erythroblastic leukemia |
AML classified by t(1;22) | Acute Megakaryoblastic leukemia |
ALL classification with homogenous population of blasts and seen in children 2-10 years old | L1 |
ALL with heterogeneous population of blasts seen in adolescents and adults | L2 |
Burkitt's type leukemia with homogenous populations of LARGE blasts; seen in adults and children | L3 |
Importance of immunophenotyping in ALL | To determine B or T cell origin; B cell has better prognosis and T cells more aggressive |
Most important prognostic indicators of ALL | Age WBC count Cell type/Lineage |
MPO, SBB, Specific esterase (SE) and NSE are all positive for which leukemia? | Acute Myeloid Leukemia (AML/ANLL) [SE pos for granuloblast; NSE pos for monoblast] |
MPO, SBB, Specific esterase (SE) and NSE are all negative for which leukemia? | Acute Lymphoid Leukemia (ALL) |
What is cytochemical in NSE? | a-naphthyl Butyrate/Acetate |
TdT and PAS usually negative for what? | Acute Myeloid Leukemia (AML/ANLL) |
TdT and PAS usually positive for what? | Acute Lymphoid Leukemia (ALL) |
Chronic myelogenous/granulocytic leukemia is characterized by what? | Marked leukocytosis (>50,000/ul) and includes all three granulocytes maturation stages [immature granulocytes] (VS leukemoid with only neutrophils) |
Philidephia (Ph') chromosome deals with which leukemia and is what translocation? | CGL and t(9;22) |
What are other names for Ph' chromosome? | BCR-ABL fusion gene P210 protein Philidelphia chromosome Chronic granulocytic leukemia |
Blast crisis | Where CGL progresses to produce 90% blasts and resembles AML. Must know of previous CML condition and patients usually die. |
What mutation do Polycythemia Vera (PV) patients have? | JAK2 mutation |
What is primary PV? | Polycythemia Vera; overproduction of all cells (no correlation with EPO) |
Relative PV | Decreased plasma volume from vomitting, diarrhea, dehydration |
Secondary PV | Appropriate and inappropriate increase in EPO; O2 elevated and EPO abnormal; associated with: Renal disease Tissue hypoxia Pulmonary disease High O2 affinity Hgb |
What is Chronic Lympohocytic Leukemia (CLL)? | Overproduction of non-functional lymphs; immune system doesn't respond properly to infection |
Hallmark blood film characteristic of absolute lymphocytosis patient | Smudge cells |
Owl eyes are characteristic of what lymphoma? | Hodgkin Lymphoma (HL) |
Difference between leukemia and lymphoma | Lymphoma is solid tumor involving lymphatic tissue Leukemia is liquid tumor where malignant cells circulate |
Burkitt lymphoma with C-MYC gene rearrangement [t(8;14)] | Non-hodgkin Lymphoma (NHL) - Similar to L3 |
Aggressive form of CLL | Prolymphocytic leukemia (PLL) |
TRAP positive leukemia | Hairy Cell Leukemia (HCL) |
What is TRAP? | Tartrate resistent acid phosphatase stain for HCL |
Presence of Rouleaux Bence Jones Proteinuria M spike | Multiple Myeloma (plasma cell myeloma) |
Created by:
1078269716
Popular Laboratory Science sets