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Test 3 Quiz 1

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zokomaju's version from 2017-04-18 23:18

Hypochromic Anemias

Question Answer
Iron is absorbed where?duodenum and proximal jejunum
Iron transport across the apical membrane is facilitated by what?divalent metal transporter (DMT)
Transport of iron through the cytoplasm require it to be in what form?Fe2+
What iron form bind to transferrin?Fe3+
What is released from the liver to stop ferroportin transfer and decrease EPO release from Kidney?Hepcidin
Hepcidin cause what receptor to be endocytosed and degrade?ferriportin
Iron carrier proteintransferrin
Allows transferrin-bound iron to enter the celltransferrin receptor
Iron storage proteinferritin
Cytoplasmic mRNA-binding proteins that control the expression of genes involved in iron metabolismIRP1 & IRP2
Precipitated and partially digested (lysosomal) aggregates of ferritin-slow releasehemosiderin
protein (apoferritin) surrounding a core of ferric hydroxyphosphate-readily available for metabolismferritin
Storage poolferritin, hemosiderin
Transit pooltransferrin
Lab metabolic pool measure asblood hemoglobin
Storage pool is measured asserum ferritin (in EQ with macrophage)
Serum iron plus the additional iron that transferrin can bindTotal iron binding capacity
Excess protoporphyrin accumulated when there is insufficient what to form heme?Iron
What causes elevated free erythrocyte protoporphyrin? 4Iron deficiency, ACD, Lead Poisoning, Sideroblastic Anemia
Iron deficiency in adult caused by what?Blood loss from menstruation, GI blood loss
Iron deficiency in children caused by what?insufficient dietary intake
What are the symptoms of iron deficiency?cheilosis, tongue atrophy, koilonychias, Pica
Plummer Vinson Syndrome is caused by what?Iron Deficiency
What are the pathology of Plummer Vinson SyndromeEsophageal webs, microcytic hypochromic anemia, atrophic glossitis
Lab values for Iron deficiency RDW, Retic, Serum Iron, Ferritin, TIBC, sTFR, Hepcidin, BMiron storesInc RDW, Dec Retic, Dec Serum Iron, Dec Ferritin, INC TIBC, INC sTFR, Dec Hepcidin, absent BM iron stores
PB smear will show what kind of RBC in iron deficiency 3?Hypochromic microcytic anemia, pencil cell, and fragmented RBC
Iron overload leads to what two conditions?Hemosiderosis and Hemochromatosis
Accumulation of iron in macrophagesHemosiderosis
Accumulation of iron within parenchymal cellsHemochromatosis
How do you diagnosis iron deficiency?ferritin level, BM biopsy, liver biopsy
Anemia of chronic disease can be caused by what 3 categories?infection, immune disorder, neoplasm
ACD is caused by what 2 factor?dec release of iron from MAC and low EPO response
Lab values for ACD are, ferritin, serum iron, TIBC, BM iron storesinc ferritin, dec serum iron, dec TIBC, inc BM iron stores
Sideroblastic anemia congenital , pattern of inheritanceALA syn, (tx with B6) and ferrochelatase defect, X-linked
Sideroblastic anemia acquiredClonal disorder in which abnormal iron transport from RBC mitochondria to cytoplasm occurs – lead poisoning, Alcohol
Lab findings for sideroblastic anemiaringed sideroblasts, PB maco and micro hypochromic red cells
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Macrocytic Anemia

Question Answer
Characteristic of megaloblastic anemiaopen lacy chromatin with asynchronous maturation of the nucleus and cytoplasm
What are the causes of megalobastic anemia?Folate and B12 deficiency
Folates are required for what?DNA synthesis - purine synthesis and pyrimidine synthesis
Defective DNA synthesis increase what process that causes enlarge size?protein synthesis
Defective DNA synthesis causes what to granulocytes?abnormal nuclear segmentation
Defective DNA synthesis causes what to RBC precursors leading to what?early death leading to ineffective hematopoiesis
Folate deficiency cause what to homocystein, methymalonic acid level?INC homocystein, normal methymalonic
Vit B12 deficiency cause what to homocystein, methymalonic acid level?INC homocystein, INC methymalonic
Folate is absorbed where?proximal jejunum
What splits folate into polyglutamates into monglutamates?intestinal conjugates
Vit B12 is derived from where?bacteria, and mold
Intrinsic factor is secreted by what cell?gastric parietal cells
R-binder binds to Vit B12 where?Stomach
Intrinsic factor – Vit B12 is absorbed where in the GI?ileum
What carries Vit B12 to liver and other body parts?transcobalamin II
Vit B12 deficiency also leads to what problem that’s not in folate deficiency?neuropathy
Pathology of Vit B12 deficiency 4stomatitis, chelitis and gastrointestinal symptoms, pernicious anemia
Lab Vit B12 and folate deficiency – Hb, Reticdec Hg, dec retic,
PB smear of Vit B12 and folate deficiency 3oval macrocytes, anisocytosis, and hypersegmented neutrophils
What other test can be done for vit B12 deficiency?schilling test (vit B12 absorption), intrinsic factor AB
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Hemolytic Anemia

Question Answer
Hemolytic anemia dignosed when Hb falls below what level?11g/dL F, 12 g/dL M
Lab test for Hemolytic Anemia - serum bilirubin, LDH, urine urobilinogen, fecal sterocbiliongen, haptoglobin, free Hbinc serum bilirubin, inc LDH, inc urine urobilinogen, inc fecal sterocbiliongen, dec haptoglobin, dec free Hb
What are the clinical features of Hem/Anemia 4pallor mucous membranes, jaundice/icterus, splenomegaly, pigmented gallstones
Hemolytic anemia have what effect on BM?inc reticu, erthroid hyperplasia in BM
PB smear for Hemolytic anemiasspherocytes, schisotcytsis, polychromasia,
What cell is specific for hemolysis?schistocytes
How much normal retic count is replaced every day? RBC lifespan?1%, 120 days
Reitculocytes contain identifiable structure that’s can be stain by methylene or flow cytometry?Inc RNA
Intrinsic Hem/Anemembrane disorders, enz deficiency, Hb disorder
Extrinsic Hem/Anemechanical trauma, infection, hypersplenism, AB mediated, chemical injury
What are the two cytoskeleton defects?spherocytosis, elliptocytosis
What disorder is typical of a membrane defect?paroxysmal nocturnal hemoglobinura
Hereditary spherocytosis patter of inheritance?autosomal dominant
Hereditary spherocytosis membrane protein defect?spectrin
Hereditary spherocytosis extravascular hemolysis occurs where?RES
Hereditary spherocytosis is destroyed where? And causes what?spleen, splenomegaly
Test for hereditary spherocytosisosmotic fragility
Tx for hereditary spherocytosissplenectomy
Hypotonic solution cause what to spherocytosis?cause RBC to lysis
Hereditary elliptocytosis cause what symptoms?asymptomatic, mild anemia
PNH membrane defect in what?GPI anchor
PNH flow cytometric assayCD55, CD59 absent/decrease
PNH cause RBC sensitive to what hemolysis mediated action?complement intravascular hemolysis
G5PD deficiency pattern of inheritance?X-linked recessive
G6PD deficiency more server in what group?wester/Mediterranean
G6PD deficiency exposed to what cause more problem?fava bean, certain medicine
G6PD deficiency cause in increase of what oxidant?H202
What cell will appear in G6PD deficiency?precipitated Heinz bodies in RBC, leads to bite cell
Lab test for G6PD enz only after what?Several weeks
G6PD enz higher and lower in what cell?higher – young RBC, Lower – older RBC
Mechanical hemolytic anemia PB smear shows what?schistocytes
Hemolysis due to what infections of parasite?plasmodium, bebesiosi,
Hemolysis due to what bacteria?clostridium perfringens
What can cause hypersplenism? 4chronic liver disease, leukemia/lymphoma, CHF, hemolytic anemia
What Ig of mom can cross the placenta and attack fetal RBC?IgG
Hemolytic disease of newborn is most lethal to baby when mom is what?Rh-neg
ABO HDN causes what to the baby?swelling, cardiac failure
HDN need to keep what low to prevent mental problem?bilirubin level
Warm AIHA Ab type, caused by what?(IgG) SLE, CLL, NHL drugs
Warm AIHA coated RBC is removed by what?MAC in RES, lead to splenomegaly
Warm AIHA Lab test should show a pos what?DAT or IAT pos
Warm AIHA PB smearmicrospherocytes, polychromasia
Cold AIHA Ab type, caused by what?(IgM) secondary infection
Cold AIHA lab testDAT C3 on RBC
Cold AIHA produce AB against what RBC antigen?I antigen
Drug induced hemolytic anemia caused by what drug?cephalosporin
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Blood and Tissue Dwelling Protozoa

Question Answer
Intracellular parasite, sporozoaplasmodium
Flagellate parasitetrypanosomes
Pseudopodia typeentamoeba
Protozoa are like what kind of cell?Eukaryotic cells
What parasite with endocytosis intracellular vesicle - phagocytosis RBC?entamoeba histolytica
P. falciparum cause high parasitemia in what RBC?young and adult RBC stage causing server cerebral malaria
P. falciparum have what kind of fever peaks compared to P. vivax / ovale?short duration between fever peaks
Characteristic of P. falciparum gametocytes?banana-shaped
P. vivax infects what kind of cell?young RBC
Mosquito nets effective with impregnated with what?insecticides
Trypanosoma brucie causes what disease?Sleeping sickness (Africa)
Typanosoma curizi causes what disease?Chagas’s disease
What are some characteristic of trypanosomes?unicellular parsite w/ flagellum
Trypansomoma brucei transmission by what?tsetse fly (sub-saharan Africa)
Trypanosoma brucei gambiense duration? Location?chronic form, west africa
Trypanosoma brucei rhodesiense duration? Location?acute form, east Africa (more sever)
Teste fly are active at what time?during the day
What are the signs of sleeping sickness?swollen lymph nodes (winterbottom’s sign)
What is the 2nd stage of sleeping sickness?invasion of CNS
Late state of sleeping sickness?fatal death b/c of 2nd infection
Medication of sleeping sickness?eflornithine, melarsoprol
What help T. brucei evade immune responseVSG – antigenic variation (1000 gene)
T. cruzi chagas’s disease is transmitted byTriatome bug – kissing bug
T. cruiz can infect what part of the body?GI smooth muscle (megacolon) and heart muscle (acute myocarditis)
What are other facial signs of Chagas disease?romana’s sign – edema of the eyelid
T. cruzi form what in heart muscle?intracellular amastigotes
What is the heart pathology of Chagas’ disease?myocarditis, tachycardia, heart block, emboli, aneurysms
When does triatomine bug that transmit T. Curzi?bite at night
Leishmaniasis transmitted by what insect?sandfly
Leishmaniasis infect what cell?MAC and DC
Cutaneous L. immune response through what?Th1 cells & INF-Y
What L. type causes mucocutaneous L. ?L. braziliensis & L Mexicana
Mucocutaneous L. infect cutaneous that spread to where?mucosa and cartilage
Visceral L. (kala-azar) causes what clinical sign? 3splenomegaly, hepatomegaly, developmental retardation
What L. causes visceral L. (kala-azar)?L donovani
Liver section with intracellular amastigote forms can be seen in what L.?L. donovani
Treatment of Kala-azar Visceral L. with what and how long?pentostam for 1 month
Toxoplasmosis transmission throughfecal –oral (cat liter) & oral (under cooked meat)
Toxplasmosis highest risk for what group?immunocompromised individuals
Toxoplasma gondii - Feline are the definitive host that produce what?infective oocysts
Intermediate host for Toxoplasma gondii?any warm-blooded mammal or bird
Occyste of toxo killed by what?Heat 70C for 10min
Tox infection in immunocompromised pt can lead to what?cerebral toxoplasmosis
Congenital toxoplasmosis can cause what?hydrocephalus
What tox form can transmit through the placenta?tachyzoites
What organelle help tox down regulate host immune system? Down regulate what cytokine?Rhoptry , IL-12
Tox tachyzoites evade immune system by hiding in where?host cell vacuole
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