Hematopoiesis and Erythropoiesis Quiz

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Questions and Answers

What is a common cause of normocytic normochromic anemia?

  • Vitamin B12 deficiency
  • Hemolytic anemia (correct)
  • Aplastic anemia
  • Iron deficiency

Which type of anemia is characterized by an MCV greater than $95$ fL?

  • Macrocytic anemia (correct)
  • Sideroblastic anemia
  • Normocytic anemia
  • Microcytic anemia

What symptom is most likely associated with severe anemia?

  • Diarrhea
  • Seasonal allergies
  • Palpitations (correct)
  • Increased appetite

What is a possible neurological symptom of anemia?

<p>Headache (C)</p> Signup and view all the answers

Which condition could lead to renal insufficiency related to anemia?

<p>Erythropoietin deficiency (A)</p> Signup and view all the answers

In which scenario would you expect to see pallor as a sign?

<p>Anemia (B)</p> Signup and view all the answers

What is a common sign of congestive heart failure in the context of anemia?

<p>Oedema in lower limbs (B)</p> Signup and view all the answers

Which condition is NOT a cause of macrocytic anemia?

<p>Chronic renal failure (D)</p> Signup and view all the answers

What is the definition of anemia?

<p>Reduction in hemoglobin concentration, RBCs, and hematocrit values below normal. (D)</p> Signup and view all the answers

What is the normal hemoglobin range for adult males according to the WHO?

<p>14-16 gm/dl (C)</p> Signup and view all the answers

Which type of anemia is characterized by decreased RBC formation due to bone marrow infiltration?

<p>Aplastic anemia (A)</p> Signup and view all the answers

Which of the following is classified as a microcytic hypochromic anemia?

<p>Iron deficiency anemia (D)</p> Signup and view all the answers

What causes anemia due to excess RBC loss?

<p>Hemorrhagic anemia (A)</p> Signup and view all the answers

Which classification of anemia is linked to iron deficiency and thalassemias?

<p>Microcytic hypochromic anemia (B)</p> Signup and view all the answers

What hemoglobin level indicates anemia in adult females according to WHO guidelines?

<p>Less than 12 g/dl (C)</p> Signup and view all the answers

Which of the following is a non-classifiable cause of anemia?

<p>Anemia due to lead poisoning (B)</p> Signup and view all the answers

What is the primary site of iron absorption in the body?

<p>Duodenum (C)</p> Signup and view all the answers

Which of the following factors enhances iron absorption?

<p>Ferrous form (D)</p> Signup and view all the answers

Which symptom is commonly associated with iron deficiency anemia?

<p>Brittle nails (C)</p> Signup and view all the answers

Which of the following laboratory findings is indicative of iron deficiency anemia?

<p>Microcytic hypochromic anemia (B)</p> Signup and view all the answers

What is an effective oral iron supplement recommended for iron deficiency?

<p>Ferrous sulphate (B)</p> Signup and view all the answers

Which condition is NOT a cause of iron deficiency?

<p>Excessive iron intake (B)</p> Signup and view all the answers

Which condition is indicated by an increased serum iron and ferritin level?

<p>Thalassemia (C)</p> Signup and view all the answers

What effect does increased serum hepcidin have on iron absorption?

<p>Reduces iron absorption (D)</p> Signup and view all the answers

Which of the following indicates ineffective erythropoiesis as a factor enhancing iron absorption?

<p>Reduced serum hepcidin (B)</p> Signup and view all the answers

What characteristic finding is associated with sideroblastic anemia?

<p>Ringed sideroblasts in bone marrow (D)</p> Signup and view all the answers

What indicates hemolysis in the context of normocytic anemia?

<p>Increased reticulocyte count (C)</p> Signup and view all the answers

What test is used specifically for detecting hereditary spherocytosis?

<p>Osmotic fragility test (C)</p> Signup and view all the answers

What laboratory finding is common in megaloblastic anemia?

<p>Large erythroblasts with failure of nuclear maturation (B)</p> Signup and view all the answers

What would you expect from a Schilling test in patients with vitamin B12 deficiency?

<p>Decreased absorption of 57Co (A)</p> Signup and view all the answers

Which of the following findings is typical in iron deficiency anemia?

<p>Microcytic hypochromic anemia (B)</p> Signup and view all the answers

In cases of aplastic anemia, what would the bone marrow analysis show?

<p>Increased fatty spaces with decreased cellularity (D)</p> Signup and view all the answers

Which condition is associated with spoon-shaped nails and angular stomatitis?

<p>Iron deficiency anemia (B)</p> Signup and view all the answers

What type of anemia is characterized by increased reticulocyte count?

<p>Hemolytic anemia (A)</p> Signup and view all the answers

Which of the following is NOT a cause of pancytopenia?

<p>Iron deficiency anemia (C)</p> Signup and view all the answers

In anemia of chronic disease, which of the following changes in laboratory values is typically seen?

<p>Decreased S. Iron and TIBC (D)</p> Signup and view all the answers

Which type of anemia is specifically indicated by the examination of bone marrow if leukemia is suspected?

<p>Pancytopenia (A)</p> Signup and view all the answers

What is the characteristic feature of microcytic anemia in terms of iron profile?

<p>Decreased serum iron and increased TIBC (A)</p> Signup and view all the answers

Which symptom is likely associated with vitamin B12 deficiency leading to subacute combined degeneration?

<p>Pain and paresthesia (C)</p> Signup and view all the answers

What is the typical reticulocyte count in bone marrow failure situations?

<p>Decreased reticulocyte count (C)</p> Signup and view all the answers

What is the primary function of erythrocytes?

<p>To transport oxygen from the lungs to tissues (D)</p> Signup and view all the answers

What is the lifespan of a normal red blood cell?

<p>120 days (B)</p> Signup and view all the answers

What percentage of hemoglobin in adults is Hemoglobin A (HbA)?

<p>95%-98% (D)</p> Signup and view all the answers

Which type of hemoglobin contains two alpha and two beta chains?

<p>Hemoglobin A (HbA) (C)</p> Signup and view all the answers

What is the main structural component of each heme molecule?

<p>Porphyrin ring + iron (Fe+2) (C)</p> Signup and view all the answers

What cell type gives rise to mature enucleated erythrocytes?

<p>Reticulocytes (B)</p> Signup and view all the answers

Which of the following hemoglobins is found in the lowest percentage in adults?

<p>Hemoglobin F (HbF) (B)</p> Signup and view all the answers

What process is responsible for the formation of blood cells?

<p>Hematopoiesis (A)</p> Signup and view all the answers

Flashcards

Hematopoiesis

The process of blood cell formation.

Reticulocytes

Immature red blood cells that are released into the bloodstream.

Erythrocyte

A mature red blood cell that has lost its nucleus.

Hemoglobin

The protein responsible for carrying oxygen in the blood.

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Heme

The iron-containing molecule in hemoglobin.

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Globin

The protein chains that are part of hemoglobin.

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Hemoglobin A (HbA)

The most common type of hemoglobin in adults.

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Transport oxygen

The primary function of red blood cells.

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Normocytic Normochromic Anemia

A type of anemia where red blood cells are smaller than normal, but their hemoglobin content is normal.

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Anemia of Chronic Disease

Anemia caused by insufficient production of red blood cells due to various conditions like chronic infections, inflammation, or autoimmune diseases.

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Hemorrhagic Anemia

Anemia caused by excessive loss of red blood cells, often due to bleeding.

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Macrocytic Anemia

Anemia characterized by larger than normal red blood cells, often caused by vitamin B12 or folic acid deficiency.

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Megaloblastic Anemia

Anemia caused by a deficiency in vitamin B12 or folic acid, leading to abnormal DNA synthesis and red blood cell production.

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Hemolytic Anemia

An anemia characterized by a decrease in the number of red blood cells due to an increased rate of their destruction, often caused by genetic disorders or immune system problems.

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Bone Marrow Failure Anemia

An anemia caused by the failure of the bone marrow to produce sufficient red blood cells, often due to cancer, leukemia, or other bone marrow disorders.

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Renal Insufficiency Anemia

Anemia that occurs due to a decreased production of erythropoietin, a hormone essential for red blood cell production, often associated with kidney failure.

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Anemia

A condition where the body's red blood cell count (RBC) is lower than normal, resulting in decreased oxygen carrying capacity.

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Iron Deficiency Anemia

A deficiency of iron in the body, leading to reduced production of hemoglobin and red blood cells.

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Thalassemias

A group of genetic disorders that affect the production of hemoglobin, resulting in smaller red blood cells.

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Anemia of Chronic Disorders (ACD)

Anemia caused by chronic diseases, such as inflammatory conditions, infections, and cancer.

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Microcytic Hypochromic Anemia

Anemia characterized by smaller than normal red blood cells (microcytic) and reduced hemoglobin content (hypochromic).

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Serum Iron Level

A test that measures the amount of iron in the blood. Important for diagnosing iron deficiency anemia.

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Serum Ferritin

A test that measures the amount of ferritin in the blood. Ferritin is a protein that stores iron.

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Total Iron Binding Capacity (TIBC)

A test that measures the ability of blood to bind to iron.

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Gastric Function Test

A test that checks the function of the stomach in producing gastric acid.

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Schilling Test

A test used to diagnose pernicious anemia which involves deficiency of vitamin B12 absorption.

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Direct Coombs' Test

A test that uses a direct Coombs' test to detect antibodies that attack red blood cells, leading to hemolysis.

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Koilonychia and Angular Stomatitis

Spoon-shaped nails, and mouth sores (angular stomatitis) often occur due to insufficient iron in the blood.

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Jaundice

Yellowing of the skin (jaundice) can happen due to red blood cell breakdown (hemolytic anemia) or issues with Vitamin B12 (megaloblastic anemia).

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Bone Deformity & Mongoloid Facies

Bone deformities and a characteristic facial appearance resembling Down Syndrome occur in thalassemias.

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Leg Ulcers

Leg ulcers are common in sickle cell anemia due to impaired blood flow and oxygen delivery to the limbs.

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Purpura & Infection

Purple spots on the skin (purpura) and frequent infections are signs of bone marrow problems.

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Beefy Red Tongue

A beefy-red, painful tongue is a classic sign of vitamin B12 deficiency.

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Pain & Parasthesia

Pain and tingling sensations (paraesthesia) are signs of nerve damage, commonly caused by vitamin B12 deficiency.

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Red Blood Cell Indices

A low red blood cell count (anemia) can be classified based on the size of the red blood cells: normal (normocytic), small (microcytic), or large (macrocytic).

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Where is iron absorbed?

The duodenum is where iron is primarily absorbed into the bloodstream.

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Which type of iron is better absorbed?

Iron in the form of heme (found in red meat) is more easily absorbed than non-heme iron (found in plant-based foods).

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What enhances iron absorption?

Factors that increase iron absorption include:

  • Eating iron-rich foods with vitamin C
  • Having lower levels of hepcidin (a hormone that regulates iron absorption)
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What reduces iron absorption?

Factors that decrease iron absorption include:

  • Eating iron-rich foods with antacids
  • Having inflammation or increased levels of hepcidin
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What are the signs of iron deficiency anemia?

Anemia caused by iron deficiency is characterized by small, pale red blood cells and low iron levels in the blood.

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What causes iron deficiency anemia?

Common causes of iron deficiency anemia include blood loss, increased iron demands (pregnancy, growth), and poor dietary intake.

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How is iron deficiency anemia diagnosed?

Diagnostic tests for iron deficiency anemia include a complete blood count (CBC) to evaluate red blood cells, serum iron levels, and ferritin levels.

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How is iron deficiency anemia treated?

Iron therapy, including oral iron supplements, is used to treat iron deficiency anemia.

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Study Notes

Hematopoiesis

  • Hematopoiesis is the process of blood cell formation
  • It involves the maturation and differentiation of blood stem cells

Erythropoiesis Stages

  • Erythropoiesis is the development of red blood cells
  • The process occurs in phases:
    • Phase 1: Ribosome synthesis
    • Phase 2: Hemoglobin accumulation
    • Phase 3: Ejection of the nucleus
  • Reticulocytes develop into mature, enucleated erythrocytes in the peripheral blood over a day
  • During development, the erythrocyte loses its nucleus

Hemoglobin Structure

  • Red blood cells contain millions of hemoglobin molecules
  • These transport oxygen
  • Hemoglobin consists of four polypeptide chains: two alpha and two beta chains
  • Each chain has a heme group containing iron

Types of Hemoglobin

  • Hemoglobin A (HbA) makes up 95-98% of adult hemoglobin
  • It has two alpha and two beta chains
  • Hemoglobin A2 (HbA2) makes up 1.5-3.2% of adult hemoglobin
  • It has two alpha and two delta chains
  • Hemoglobin F (HbF) makes up about 1% of adult hemoglobin
  • It has two alpha and two gamma chains

Primary Function of Erythrocytes

  • Transport oxygen from the lungs to tissues and organs
  • The red blood cell mass represents the body's oxygen-carrying capacity
  • Normal red blood cell lifespan is ~120 days

Anemia Definition

  • Anemia is defined as a reduction in hemoglobin, red blood cell, and hematocrit values below normal
  • Values vary based on age, sex, and WHO standards

Normal Adult Red Blood Cell Values

  • Hemoglobin (g/dL) values differ between males and females
  • PCV/HCT values also differ
  • Red blood cell count (x10^12 /L) varies between males and females
  • Values for MCV, MCH, and MCHC differ between sexes

Classification of Anemias

  • Anemias are classified into categories based on etiology or morphology:
    • Etiological classification considers the cause of reduced red blood cell formation (e.g., decreased BM function, excess RBC loss)
    • Morphological classification is based on the characteristics of red blood cells, such as microcytic, normocytic, and macrocytic

Microcytic Hypochromic Anemia

  • Causes include iron deficiency, thalassemia, and lead poisoning
  • Diagnostic indicators often include decreased MCV, MCH, and MCHC, which can indicate iron deficiency

Normocytic Normochromic Anemia

  • Causes include hemolytic anemias, bone marrow failure, and anemia of chronic disease

Macrocytic Anemia

  • Causes include vitamin B12 and folic acid deficiency
  • Diagnosis often involves MCV greater than 95 fL

Clinical Manifestations of Anemia

  • Symptoms depend on the onset speed, severity, patient age, and underlying conditions such as cardiovascular issues (CVS)
  • Low cardiac output (COP) symptoms, such as shortness of breath during exertion, palpitation, and angina, could occur
  • Symptoms, such as headaches, tinnitus, vision changes, and bone pain, might be experienced in more severe cases

Laboratory Investigations

  • Include RBC indices (normocytic, microcytic, macrocytic), reticulocyte count, WBCs and platelets, and bone marrow examination
  • Specific diagnostic tests might be recommended based on suspected underlying causes

Investigations According to Morphology

  • Different investigations can be used based on the type of anemia suspected (e.g., iron levels, hemoglobin electrophoresis, or bone marrow analysis)

Iron Deficiency Anemia

  • One of the most common types
  • Factors affecting iron absorption include those enhancing it (e.g., HCl, vitamin C), and those reducing it (e.g., inflammation, increased hepcidin)
  • Site of iron absorption is the duodenum

Clinical Features of Iron Deficiency Anemia

  • Specific features, such as pale conjunctiva, brittle nails, and smooth tongue, can be indicative of iron deficiency anemia
  • Additional laboratory tests (like serum ferritin, total iron-binding capacity, etc.) might be necessary for proper diagnosis

Treatment of Iron Deficiency Anemia

  • Oral iron therapy (e.g., ferrous sulphate) is often the first course of treatment
  • Parenteral iron therapy may be an alternativeหากมีการดูดซึมเหล็กไม่ดี

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