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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    Description

    Test your knowledge on the processes of hematopoiesis and erythropoiesis. This quiz covers the stages of red blood cell development, the structure of hemoglobin, and the different types of hemoglobin present in adults. Dive into the fascinating world of blood cell formation and function!

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