Hematology Ch 9 + 10: IDA & ACD/AOI – Flashcards
Unlock all answers in this set
Unlock answersquestion
Aplastic Anemia
answer
reduced proliferation of red blood cells, can be acquired (drug related) or inherited. Exposure to oil wells burning of benzene. Hep B & C infections.
question
Panctytopenia
answer
Bone Marrow Applasia. Reduction off all cell lines: RBC, WBC, platelets
question
Red Cell Applasia
answer
hypoplastic proliferation of the RBC cell line
question
In aplastic anemia, what are the lab findings?
answer
normocytic/normochromic, thrombocytopenia, increased iron,
question
Treatment for aplastic anemia?
answer
immunosuppresive drugs, bone marrow transplant, and splenectomy
question
Describe Fanconi's anemia
answer
Congenital/ Inherited, skeletal abnormalities, pancytopenia
question
What are telomeres and how do they relate to aplastic anemia?
answer
short sequence of DNA located at the end of the chromosome that get shorter until the cell can no longer divide (apoptosis). Aplastic anemia and AML are associated with inherited mutations that inhibit in telomere repair = bone marrow failure
question
What is shelterin?
answer
DNA protein that covers the telomere
question
What are the molecular techniques used to identify telomeres in Aplastic Anemia?
answer
flow- FISH cytometry (most common), southern blot. Used to detect residual disease in bone marrow after treatment
question
what are the lab findings in Bone Marrow Failure?
answer
macrocytosis (may be masked if patient has thalassemia or IDA), micromegkaryocytes, pelger-huet anomaly, nuclear/ cytoplasmic asynchrony
question
What are the lab findings in Diamond Black Fan Anemia?
answer
anemia appearing prior to the first birthday, decreased neutrophil count, macrocytosis,
question
Red Cell Aplasia?
answer
hypoproliferative RBC's, serum erythropoietin increase. Can be caused by infection and hemolytic anemia
question
Black- fan Anemia?
answer
proapoptoic hematopoesis, bone marrow failure, birth defects, thrombocytosis, ribosomal disorder caused by deletion and translocation
question
Causes of IDA?
answer
decreases iron intake, increase utilization( pregnancy, growth), excessive iron loss( menstruation), decreased absorbtion
question
In a patient that has IDA, what might cause decreased absorbtion?
answer
H. pylori, autoimmune gasteritis, cancer, GI bleeding
question
What is the avg. total iron in a normal adult? What is the normal iron loss per day?
answer
3.5-5.0g ; 1mg/day
question
What may cause daily iron loss
answer
exfoliation of epithelial cells, skin cells, urinary excretion
question
What is operation iron?
answer
Iron used for O2 binding and found in the heme portion of Hb and myoglobin
question
What is transferrin?
answer
Glycoprotein produced by the liver, transports iron for the production of hemoglobin
question
what is ferritin?
answer
Stores iron. Acute-phase reactant (class of proteins whose plasma concentrations increase in response to inflammation)
question
How much of the iron in the body is made of iron salts?
answer
90% (iron salts is the non-reduced Non-heme iron) Fe3+
question
What are the inhibitors and the enhancers of iron absorption?
answer
Enhancers: Ascorbic acid. Inhibitors: tanins intea
question
Where is iron absorbed and stores
answer
Duodenum/ hepatocytes
question
What are the 3 stages in IDA?
answer
pre-latent (decrease in storage of iron), latent( decrease in iron for erythropoiesis), Anemia (clinical)
question
In IDA, describe the levels of serum iron, Total iron binding capacity, and serum ferritin?
answer
levels of serum iron decrease, Total iron binding capacity increases, and serum ferritin decreases
question
What are the normal levels of levels of serum iron, Total iron binding capacity, reticulocyte, and serum ferritin?
answer
Iron 60-170g/dL, Total iron binding capacity 240-450 ug/dL, serum ferritin 12-300 ug/dL, reticulocyte >2.5%
question
what is the relationship between total iron and transferrin?
answer
As total iron decreases, transferrin increases
question
Describe the Soluble transferin receptor test?
answer
test for transferin receptors in body. detects increases erythropoesis. as the level of iron decreases, production of sTfR increases in cells. Provides differentiation of IDA from anemia of chronic inflammation
question
What causes Anemia of Chronic Disease?
answer
second most prevalent after IDA, hypoproliferative, decreased erythropoietin caused by hepcidin which blocks release of iron
question
What is the pathogenesis of Anemia of Chronic Disease?
answer
increased hepcidin induces iron sequestration and blockage of iron for erythropoiesis . Hemoglobin & Hematocrit will be low BUT transferrin & serum ferritin will be normal
question
In ACD, describe the levels of serum iron, Total iron binding capacity, serum transferrin, and serum ferritin?
answer
levels of serum iron decrease, Total iron binding capacity decreases, serum transferrin decreases, and serum ferritin increases
question
Constitutional Aplastic Anemia
answer
congenital or genetic predisposition to bone marrow failure
question
iatrogenic
answer
a disease produced secondary to the treatment of the patient; often it is the result of side effects of the drug therapy chosen by the physician
question
Exposure to this led to Aplastic Anemia
answer
Benzene from the burning oils in kuwait
question
This antibiotic led to Aplastic Anemia
answer
Chloamphenicol
question
These viruses have caused Aplastic Anemia?
answer
Hepatitis B &C, measels, Epstein Bar virus, cytomegalovirus
question
What are the three phases of Aplastic Anemia?
answer
onset of disease, recovery, and late disease
question
Describe the serum iron in aplastia anemia?
answer
Increased becasue the lack of iron turnover
question
Describe the function of the enzyme telomerase?
answer
cause telomeres to shorten with age
question
which leukemia is assosiated with aplastic anemia and the cause?
answer
AML and mutation in telomere
question
What are the most common hematological abnormality in Bone Marrow Failures?
answer
macrocytosis, pelger huet anomallies
question
This type of anemia occurs most frequently 25-30% of childhood Aplastic Anemia cases
answer
Fanconi's Anemia
question
chelation therapy
answer
chemical process in which a synthetic solution—EDTA (ethylenediaminetetraacetic acid)—is injected into the bloodstream to remove heavy metals and/or minerals from the body. Chelation means "to grab" or "to bind.
question
When total body iron is low, the levels of this___ increases, but the relative and absolute aounts of serum decline?
answer
Transferrin
question
A patient with IDA would exhibit increased or decreased souluble trnsferrin receptors?
answer
increased
question
In ACD/AOI one would expect the serum iron and the iron binding capacity to be?
answer
serum iron low, iron binding capacity to be high
question
In ACD/AOI one would expect the ferritin to be?
answer
high
