Hematology Lecture 01/16
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- What is a Coomb's test?
- a test used to evaluate for hemolytic anemia
- What is poikilocytosis?
- variation in shape of red blood cells
- Name different types of microcytic anemia
- - iron-deficiency anemia - thalassemia - anemia of chronic disease (such as chronic infection, inflammation, cancer, and liver disease) - sideroblastic anemia
- What are causes of iron deficiency anemia?
- - MCC is occult blood loss - deficient diet - decreased absorption - increased requirements - blood loss - hemoglubinuria - iron sequestration
- What is ferritin?
- - the storage form of iron
- What are some causes of normocytic anemia?
- - aplastic anemia - anemia of chronic disease - chronic renal failure - spherocytosis
- What labs should you get with a microcytic anemia?
- - iron level - ferritin level - total iron binding capacity (TIBC)
- What is haptoglobin?
- a transport protein that binds and clears hemoglobin released into plasma
- What are causes of macrocytic anemia?
- - Vitamin B12 deficiency - Folate deficiency - liver disease/alcoholism - drugs (Sulfonamides, anti-retroviral drugs, anti-neoplastic drug)
- What are different types of RBC cell morphologies seen on a peripheral smear?
- - Burr Cells - Spur Cells - Spherocyte - Stomatocyte - Schistocyte (helment-shaped fragments) - Elliptocyte - Tear Drop - Sickle Cell - Target Cell (nucleated RBC, looks like a target)
- What is a Rouleaux formation?
- - when RBCs stack on top of each other when seen on a peripheral smear - equivalent to an elevated ESR (erythrocyte sedimentation rate)
- What are the anticoagulant factors?
- Protein S, Protein C, Antithrombin III, & plasminogen
- Which coagulation factors are not made in the liver?
- - Factor VIII is derived from platelets and vascular endothelial cells - Factor XIII
- What is the function of factor VIII cofactor (von Willebrand factor) in clot formation?
- provides the substrate for platelet aggregation
- Hemophila A is caused by a deficiency in this factor
- Factor VIII
- Hemophila B is caused by a deficiency in which factor?
- Factor IX
- What forms the prothrombin activator that converts prothrombin to thrombin?
- Calcium , factor X, factor V, and platelet phospholipids
- Clinical evidence of thrombocytopenia usually occurs with this platelet count.
- 35000 - 50000
- Where do people with hemophilia have a tendency to bleed?
- joints and soft tissue (muscles)
- What is fibrinolysis and what enzymes are involved?
- - fibrinolysis is the process by which a blood clot dissolves - plasminogen ⬺ plasmin - plasmin digests the fibrin strands of the clot and certain clotting factors (fibrinogen, factor V, factor VIII, prothrombin, factor XII)
- How is pernicious anemia different from B12 deficiency?
- - pernicious anemia is an autoimmune disorder characterized by damage to gastric parietal cells (which make intrinsic factor) - B12 deficiency is due to decreased absorption of the vitamin
- Where is the vitamin B12-intrinsic factor complex absorbed?
- terminal ileum
- What are signs and symptoms are a patient with vitamin B12 deficiency?
- - neurologic symptoms such as paresthesias, difficulty with balance, dementia