Patho Hematology

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Catalyzes reversible reaction between CO2 and H2O to form HCO3

Erythrocytes

RBC production in early gestation

yolk sac then liver

RBC production last month gestation to 5 years.

bone marrow

RBC production after 5 years

vertebrae, sternum, ribs, ilia

Anemia, hypoxemia, circulatory failure, high altitude all stimulate.

RBC production

Elevated Reticulocyte Level

Normal in Anemia

Anemia without elevated Reticulocyte

Bone Marrow Disease

Detecting Erythroblasts in Lab Test

Indicates Malignancy

Low tissue oxygen triggers

Kidneys to make Erythropoietin

In low oxygen, Erythropoietin makes Hematopoietic Stem Cells that makes.

Proerythroblasts

Pluripotent Stem Cell makes Erythrocyte CFU that leads to.

Erythroblast makes Reticulocyte makes Erythrocyte

Succinyl-Co-A from Krebs binds with Glycine to form.

Pyrrole Molecule

Protoporphyrin IX is comprised of.

4 Pyrrole Molecules

Heme Molecule

Protoporphyrin IX and Iron Molecule

Hemaglobin Metabolism

Succinyl-Co-A binds Glycine forms Pyrroles to make Protoporphyrin IX combines Iron to make Heme combines Globins to make Hemaglobin

Alpha, Beta, Gamma, Delta, Fetal

Types of Globins

2 Alpha 2 Beta Chains

Adult Hgb

Oxygen Carrying Capacity of Hemoglobin

8 O2 Molecules

Each Hbg Fe can carry.

2 O2 Molecules

Fetal Hbg is comprised of.

2 Alpha and 2 Fetal chains

Has the greatest affinity for oxygen.

Fetal Hemoglobin

Which of the following is not a normal component of plasma?

Collagen

What is the average life span of an erythrocyte?

120 days

Which of the following minerals is required for erythropoiesis?

Iron

Erythropoietin is released by the:

Kidneys

The purpose of erythropoietin is:

Control erythrocyte production

Where does the sequestration and destruction of aged erythrocytes normally take place?

Spleen

As an individual ages:

Lympocyte function decreases

When a blood cell is damaged:

All the above

RBC lysis yields which of the following products?

Bilirubin

What is the correct sequence in coagulation:

extrinsic and intrinsic, Factor X, Thrombin, Fibrinogen, Fibrin, Clot

What is the correct sequence in fibrinolysis?

Plasmin, Plasminogen, FDP

Granulocytes contain:

Enzymes capable of killing microorganisms

Why do lymph nodes enlarge and become tender during an infection?

Macrophages are proliferating

Eosinophils

All the above

The greatest proportion of total body iron is located in the:

Erythrocytes

Polycythemia is typically seen in:

Babies born to Diabetic Mothers and Twin-to-Twin Transfusion Syndrome

Polycythemia puts babies at risk for:

Blood Clots and Strokes

Hemolytic Disease of the Newborn:

Occurs when mothers blood crosses placenta that produces antibodies that attack babies RBCs

Anemia is:

Abnormal in elderly adults

Increases for every 1000 meters above sea level

Hemoglobin level

Smoking Increases:

Hemoglobin levels

Aging causes RBCs to become:

Fragile and prone to lysis

After lysis/hemolysis of RBCs, Hbg is:

Phagocytized by macrophages in the Liver Kupper cells, Spleen, Bone Marrow

Macrophages release Fe from Hgb and transported as:

Transferrin

Storage of Transferrin not in use:

Ferritin

Porphyrin is converted to:

Bilirubin transported to liver and released in bile

Anemia

Reduced RBC count, Hbg, Hct

Kidney disease leading to decreased Erythropoietin production causes:

Anemia

Low Fe, B12, Folate intake causes:

Anemia

Co-morbid inflammatory diseases cause:

Anemia

Shortened RBC lifespan in Aging causes:

Anemia

Sickle Cell Disease and Thalassemia cause:

Anemia

Decreased: pCO2, H+, 2,3-DPG, Temp, HbF

Left Shift

Increased: pCO2, H+, 2,3-DPG, Temp

Right Shift

Low WBC and PLT levels alone indicate:

Bone Marrow failure

Average size of RBC

MCV

Amount of Hbg in RBC compared to size (color of RBC)

MCHC

MCV < 80

Microcytic

MCHC < 27

Hypochromic

MCV 80-100

Normocytic

MCHC >= 27

Normochromic

MCV > 100

Marcocytic

Iron Deficiency Anemia, Anemia of Chronic Ilness, Thalassemia, Sideroblastic Anemia

Microcytic and Hypochromic

Anemia of Chronic Illness, Sickle Cell Amemia, Aplastic Anemia, Hemolytic Anemia, CKD, HIV, Acute Blood Loss:

Normocytic and Normochromic

B12 and Folate Deficiency, Myelodysplastic Syndrome, Adverse Drug Reaction, Alcohol Abuse, Hypothyroidism:

Macrocytic

New RBC will have:

Larger RDW than old RBCs

Iron, Folate, B12 Deficiencies. Hemolytic Anemia.

Increased RDW

GI Bleeding associated with

Iron Deficiency Anemia

Vegetarians are at risk for:

Iron Deficiency Anemia

Chron’s Disease and Gastric Bypass causes Iron Deficiency Anemia due to:

Malabsorption

Periods of rapid growth (toddler and adolescents) can cause:

Iron Deficiency Anemia

Pregancy increases metabolism which can lead to:

Iron deficiency anemia

What MCV should you expect in Iron Deficiency Anemia

Hypocytic

What can interfere with Ferritin levels when diagnosing Iron Deficiency Anemia?

Acute Inflammation

Indicates amount of stored Iron

Ferritin

Ability of the body to transport Iron

Transferrin

Proteins available to bind Iron

TIBC

Increased in Iron Deficiency Anemia

TIBC

Decreased in inflammation and malignancy

TIBC

Autosomal Recessive- Alpha and Beta Types - Mutation of HBB gene

Thalassemia

Decrease O2 affinity, Hgb more unstable and prone to early breakdown

Effects of HgbA in Thalassemia

Treating Thalassemia with transfusions risks:

Iron overload

Thalassemia is what type of anemia?

Microcytic and Hypochromic

Proinflammatory cytokines inhibit erythropoietin, destroy immature erythroblasts, and stimulate release hepcidin

Anemia of Chronic Illness

Stores too much Iron in the liver. Decreases oral absorption of Iron in GI tract, and blocks release of Iron from Reticuloendothelial system. Found in Anemia of Chronic Illness.

Hepcidin

Can be both Hypocytic or Normocytic

Anemia of Chronic Illness

Labs: increased - bilirubin, phosphorus, uric acid, hemoglobinuria; decreased - haptoglobin

Hemolytic Anemia

Normocytic

Hemolytic Anemia

Pancytopenia - decreased “all cell lines” (RBC, WBC, PLT)

Aplastic Anemia

Normocytic

Aplastic Anemia

RBCs with Hgb S has low O2 capacity and found in:

Sickle Cell Anemia

Sickle Cell is what type of anemia?

Normocytic

Shorter RBC lifespan r/t less effective DNA synthesis, lack intrinsic factor, autoimmune can atrophy gastric cells

Pernicious Anemia (B12 deficiency)

Symptoms: paraesthesia, decreased balance, sore tongue, increased homocysteine

Pernicious Anemia

Pernicious Anemia is what type of anemia?

Macrocytic

Impaired RNA/DNA synthesis, found commonly in alcoholics, elderly, effects of aspirin, fetal neural tube defects.

Folate Deficiency Anemia

What type of anemia is Folate Deficiency Anemia?

Macrocytic

Granulocytes and Monocytes

Formed in the bone marrow

100

Lymphocytes and Plasma Cells

Formed in lymph tissue

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