RBC Disorders
MCV: Mean cell volume - ANS The average volume per red cell, expressed in
femtoliters, Hematocrit/number of erythrocytes
MCH: Mean cell hemoglobin - ANS The average mass of hemoglobin per red cell,
expressed in picograms, Hemoglobin/number of erythrocytes
MCHC: Mean cell hemoglobin concentration - ANS The average concentration of
hemoglobin in a given volume of packed red cells, expressed in grams per
deciliter, Hemoglobin concentration/Hematocrit
RDW: Red cell distribution width - ANS the coefficient of variation of red cell
volume
Three causes of anemias - ANS Blood loss (hemorrhage), Increased red cell
destruction (hemolysis), decreased red cell production
Small red blood cells are called and caused by - ANS Microcytic (caused by iron
deficiency, thalassemia)
Large red blood cells are called and caused by - ANS Macrocytic (caused by
folate or B12 deficiency)
Hereditary spherocytosis manifests as: - ANS spherocytic shaped cells with
anemia, splenomegaly, and jaundice. There is both a dominant and recessive
form (dominant mutation usually due to ankyrin) recessive is usually worse
Folate deficiency and B12 deficiency both interfere with what cellular process? -
ANS DNA synthesis
What is the most common type of anemia in hospitalized patients? - ANS Anemia
of chronic disease (induced by chronic inflammation)
, What diseases are associated with anemia of chronic disease? - ANS Microbial
infections (ex. Osteomyelitis, endocarditis), Chronic immune disorders (ex.
Rheumatoid arthritis), Neoplasms (ex. Hodgkin lymphoma)
How does folate deficiency differ from B12 deficiency? - ANS Neurologic
abnormalities do not occur with folate deficiency
Unless otherwise suggested a deficiency of B12 in the western world is caused
by: - ANS pernicious anemia (i.e. inadequate absorption of b12, b12 need
intrinsic factor for absorption)
Aplastic anemia is: - ANS a disorder in which multipotent myeloid stem cells are
suppressed leading to marrow failure and pancytopenia. Can be caused by
radiation, toxins, drugs, viruses, inherited reactions and idiosyncratic reactions
Myelophthisic anemia is: - ANS a form of anemia caused by extensive
replacement of the marrow by tumors (usually from breast, lung or prostate) or
other lesions, this leads to the release of early erythroid and granulocytic
precursors (leukoerythroblastosis) and the appearance of tear-drop red cells in
the peripheral blood
Megaloblastic anemia: - ANS Caused by folate or b12 deficiency, results in
enlarged abnormal hematopoietic precursors (megaloblasts) in the bone marrow
and often pancytopenia, and hypersegmented neutrophils
Hematopoiesis starts where? Where does it end in adulthood? - ANS It starts in
the yolk sac in the 4th month it migrates to the bone marrow, by adulthood on the
vertebrae, ribs, sternum, skull, pelvis, and proximal regions of humerus and
femur retain red marrow
If hematopoiesis is needed what happens? - ANS Old areas like distal bones and
liver can compensate upregulating hematopoiesis
The two elements of blood: - ANS Plasma (liquid component) and formed
elements (RBC, WBC, platelets)
During red blood cell development what happens morphologically? - ANS The
nucleus becomes smaller (eventually eliminated), the cytoplasm becomes bigger,
final stage RBC is reticulocyte (still has some RNA in the cell, bluer color)
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