Chapter 14 - RBC CIS

Question 1

Low MCV and high RDW is ___ anemia until proven otherwise

Answer 1

iron deficiency anemia (chronic blood loss anemia)

Question 2

Chronic Blood Loss Anemia is most likely due to

Answer 2

colonic carcinoma

Question 3

Normal RCW (red cell distribution width)

Answer 3

11.5-14.5

Question 4

Normal Hgb

Answer 4

about 15

Question 5

Normal Hct

Answer 5

about 45

Question 6

normal platelet count

Answer 6

150,000 - 450,000

Question 7

Ferritin is 10ug/L. Ferritin deficiency causes what? Why?

Answer 7

Chronic blood loss over time causes ferritin deficiency. Ferritin is for iron storage

Question 8

Define Pica

Answer 8

People with (iron deficiency) anemia who eat anything – especially dirt or ice.

Question 9

Normal MCV. What’s above/below?

Answer 9

80-100
Above=megaloblastic
Below = microcytic

Question 10

Any disorder of ineffective erythropoiesis that starts as normocytic, can COT to what?

Answer 10

Microcytic

Question 11

Normal MCHC

Answer 11

31-37%

Question 12

Oral iron supplementation given to a person with chronic blood loss anemia prior to surgery for colon carcinoma. Reticulocytosis on PS noted in about one week. Why?

Answer 12

Person had IDA - pt is receiving oral iron and the marrow responds with reticulocytes (RDW will probably increase even more).

Question 13

Will ACD repsond to Fe?

Answer 13

Probably not.

Question 14

What type of anemia is asosciated with membrane defect?

Answer 14

extravascular hemolytic anemia.

Question 15

RF+ and erosive, inflammatory arthritis of hands and elbow. WBC elevated, left shift, thrombocytosis. Hgb is 12 (so Hct is ~36) RBC has normocytic, normochromic anemia. What is this?

Answer 15

Anemia of Chronic Disease

Question 16

Episodic manifestations of hemolysis. Acutely ill with severe anmeia. Precipitated bu infeciton or drugs

Answer 16

G6PD deficiency

Question 17

High serum ferritin seen in

Answer 17

ACD

Question 18

Significant thrombocytopenia, PS shows leukoerythroblastosis. Marrow transplant 10 year ago during radiation for papillary carcinoma of the thyroid. Presents with normocytic, normochromic anemia.

Answer 18

MDS or MPD

Question 19

Parkinson-like neuro symptoms. Moderate leukopenia with MCV of 110 (high) and PS multiple hypersegmented PMNs (means megaloblastic). Labs indicate elevated homocysteine and methymalonate. Most likely?

Answer 19

Pernicious Anemia

Question 20

Hypersegmented PMNs means

Answer 20

megaloblastic

Question 21

Labs for homocysteine and methymalonate. in folate deficiency.

Answer 21

Elevated homocyteine, but not methymalonate.

Question 22

24 year old woman with lethargy and low libido. Basophilic stippling is identified in some erythrocytes. Serum ferritin increased significantly. HbA2 is 7% (elevated) and small quantity of HbF detected upon electrophoresis. Most likely?

Answer 22

Beta-thalassemia minor (younger in life)

Question 23

HbF in beta-thalassemia major v. minor

Answer 23

increased in major, not much in minor.

Question 24

excess of beta globin chains form Beta 4 tetramers known, seen in newborns.
excess gamma chains form gamma 4 tetramers - this is?

Answer 24

HbH = severe microcytic anemia

Hydrops fetalis, Hemoglobin barts = death

Question 25

Immunohemolytic anemia: | IgM antibody

Answer 25

Cold agglutinin(i.e. mono or mycoplasma infection)

Question 26

Warm antibody associated with...

Answer 26

SLE, diret coombs IGG

Question 27

Most common hematologic manifestation of HIV

Answer 27

thrombocytopenia

Question 28

1. A 37 year old white female. 12gm/dl Hgb, MCV of 75fl and RDW of 16. Plts 30,000. Sparse petechiae, weak, pale pallor, pale conjuctivae, ferritin low. Most likely which of the following?

Answer 28

Primary Chronic ITP

Question 29

Modestly increased marrow megakaryocytes. PS has abnormally large platelets.

Answer 29

TTP

Question 30

Target cells and spherocytes

Answer 30

Thalassemias

Question 31

Haptoglobin decrease indicates

Answer 31

Hemolytic anemia (both intravascualr or extravascular)

Question 32

6 year old male hx of easy bruising with casual physical contact. PT normal, PTT elevated. What is most likely?

Answer 32

Hemophilia A and B

Question 33

IDA v. ACD levels: - Free iron - Transferrin saturation - TIBC - Serum ferritin - Hepcidin

Answer 33

- Free iron - low, low - Transferrin saturation - low, high - TIBC - high, low - Serum ferritin - low, high - Hepcidin - low, high

Question 34

Low plt count, PTT/PT prolonged, fibrin split products identified, microangiopathic fragmented red cell forms.

Answer 34

DIC

Question 35

low MCV, low Hct/Hg. IDA. PBS=

Answer 35

hypochromasia

Question 36

nucleated RBC suggest?

Answer 36

hemolysis or a disease infiltrating and replacing bone marrow (hymolysis=hyperBr)

Question 37

anisocytosis and poikilocytosis

Answer 37

alpha thalasemia

Question 38

high HCt v low Hct

Answer 38

``` high = polycythemia low = anemia ```