Overview of Hema

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary function of embryonic hemoglobin during the first few weeks of gestation?

Providing oxygen to rapidly growing embryonic tissues (correct)

Transporting carbon dioxide from tissues

Regulating iron levels in the blood

Facilitating the production of red blood cells in adults

Which type of hemoglobin is predominantly produced from 12 weeks of gestation to 6 months post-birth?

Fetal Hemoglobin (HbF) (correct)

Hemoglobin Gower 2

Hemoglobin Portland

Hemoglobin Gower 1

In the context of iron deficiency anemia, what does an elevated RDW indicate?

Heterogeneity in red blood cell size (correct)

Reduction in hemoglobin concentration

Consistent red blood cell size

Increased maturation of red blood cells

The transition from embryonic hemoglobin to fetal hemoglobin involves which form of globin chains at approximately 12 weeks gestation?

Two alpha and two gamma Signup and view all the answers

What is a characteristic hematological finding in iron deficiency anemia?

Microcytosis Signup and view all the answers

Which of the following globin chain combinations represents Hemoglobin Gower 1?

ζ₂ε₂ Signup and view all the answers

Which clinical finding is indicative of reduced oxygen-carrying capacity in iron deficiency anemia?

Low hemoglobin levels Signup and view all the answers

What type of hemoglobin is characterized as having minor physiological significance in humans?

Hemoglobin Portland Signup and view all the answers

Which of the following types of anemia is characterized by microcytic, hypochromic red blood cells with normal or elevated ferritin levels?

Thalassemia Signup and view all the answers

What laboratory finding is commonly associated with sideroblastic anemia?

Basophilic stippling and ringed sideroblasts Signup and view all the answers

In hemolytic anemia, which of the following findings would likely be present?

Spherocytes and reticulocytosis Signup and view all the answers

What morphological finding is NOT typically associated with iron deficiency anemia?

Nucleated RBCs Signup and view all the answers

What distinguishes thalassemia from iron deficiency anemia in terms of RBC morphology?

Presence of small blue dots inside RBCs Signup and view all the answers

Which condition may cause low Vitamin B12 levels?

Dietary deficiency Signup and view all the answers

What characteristic does a high reticulocyte count indicate?

Effective erythropoiesis Signup and view all the answers

Which test is most appropriate for diagnosing hemoglobinopathies?

Hemoglobin Electrophoresis Signup and view all the answers

Which marker is NOT typically associated with hemolytic anemia?

Prothrombin Time Signup and view all the answers

Elevated levels of creatinine and urea nitrogen are indicators of which condition?

Chronic kidney disease Signup and view all the answers

Which test can suggest chronic inflammatory disease as a cause for anemia?

C-Reactive Protein (CRP) Signup and view all the answers

In which condition might a peripheral blood smear show microcytic red blood cells?

Iron deficiency anemia Signup and view all the answers

What is the likely result of prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT)?

Potential bleeding disorders Signup and view all the answers

Which of the following is a potential cause of macrocytic anemia?

Vitamin B12 deficiency Signup and view all the answers

Which vitamin deficiency is most commonly investigated in cases of suspected megaloblastic anemia?

Folic acid Signup and view all the answers

What condition is characterized by a reduction in hematopoietic cells, leading to insufficient blood cell production?

Aplastic anemia Signup and view all the answers

Which of the following hemoglobin functions assists in maintaining blood pH?

Buffering capacity Signup and view all the answers

In which condition would you expect to see increased hematopoiesis?

Myeloproliferative disorders Signup and view all the answers

How many molecules of oxygen can one hemoglobin molecule carry?

Four Signup and view all the answers

What is one potential consequence of bone marrow failure?

Fat infiltration in red marrow Signup and view all the answers

What primarily influences hemoglobin's oxygen-binding capacity?

Partial pressure of oxygen and pH Signup and view all the answers

Which type of anemia is characterized by a failure to produce enough red blood cells due to bone marrow issues?

Aplastic anemia Signup and view all the answers

Hemoglobin also plays a role in which aspect of gas exchange?

Carbon dioxide transport Signup and view all the answers

What might be a physiological symptom of hemoglobin deficiency?

Pallor Signup and view all the answers

Which stage of hematopoiesis involves the differentiation of stem cells into committed progenitors?

Progenitor stage Signup and view all the answers

Which type of anemia is characterized by a deficiency of iron, leading to microcytic and hypochromic red blood cells?

Iron deficiency anemia Signup and view all the answers

What laboratory test is most essential for evaluating iron deficiency anemia?

Serum ferritin Signup and view all the answers

How does erythropoietin regulate red blood cell production?

Stimulates the production of erythrocytes from bone marrow Signup and view all the answers

Which physiological mechanism primarily causes pallor in anemia?

Reduced red blood cell count Signup and view all the answers

Which type of hemoglobin is primarily present in adults and is responsible for oxygen transport?

Hemoglobin A Signup and view all the answers

What changes in the bone marrow can be observed during anemia?

Hyperplasia of red cell precursors Signup and view all the answers

In cases of microcytic anemia, what is often the result of impaired hemoglobin synthesis?

Decreased mean corpuscular volume Signup and view all the answers

How can thalassemia be distinguished from iron deficiency anemia?

Presence of target cells on peripheral blood smear Signup and view all the answers

Which of the following is NOT a typical laboratory finding in iron deficiency anemia?

High mean corpuscular volume Signup and view all the answers

What is the role of reticulocytes in diagnosing anemia?

Reflect the bone marrow's response to red blood cell loss Signup and view all the answers

Study Notes

Patient Information

Patient ID: C.A.
Age: 18
Sex: Female
Marital Status: Single
Location: Camalig, Albay

Chief Complaint

Fatigue and pallor (paleness) for 3 months

History of Present Illness

Progressive fatigue after minimal exertion, including climbing stairs or carrying groceries.
Dizziness, shortness of breath with exertion, and difficulty concentrating in school, observed over the past month.
Heavy menstrual bleeding for the past month (7-8 days, requiring more than 8 pads a day).
No intermenstrual or post-coital bleeding.
No significant weight loss, fever, night sweats, or unusual bruising.
Diet mostly rice, vegetables, and fish, with occasional meat.
Skips meals occasionally due to a busy school schedule.

Past Medical History

No previous hospitalizations or surgeries.
No known allergies
Immunization status up-to-date.
No prior diagnosis of anemia or blood disorders

Family History

No family history of anemia, bleeding disorders, or chronic illnesses
Parents and siblings healthy

College student living with parents
No smoking, alcohol consumption, or illicit drug use.
No recent travel or exposure to infectious diseases.

Physical Examination (Handout 2)

General Appearance: Alert, oriented, but pale and tired.
Vital signs: Temperature 36.7°C, Blood Pressure 100/60 mmHg, Heart Rate 92 bpm (regular), Respiratory Rate 18 breaths/min
Skin: Pale, no jaundice, cyanosis, or petechiae. No rashes, petechiae, or ecchymosis.
HEENT: Pale conjunctiva, no icterus, oral mucosa dry, no lymphadenopathy, thyroid not enlarged, no neck vein distention or carotid bruits.
Cardiovascular: Tachycardia, regular rhythm, no murmurs, rubs, or gallops.
Respiratory: Symmetrical chest expansion, clear breath sounds bilaterally.
Abdomen: Soft, non-tender, no organomegaly, normoactive bowel sounds. No venous hum or abdominal bruits.
Extremities: No edema, nails show koilonychia.
Neurological: Intact cranial nerves, normal motor strength and sensation, 5/5 strength in all extremities, normal sensation and reflexes, no focal neurological deficits.

Review of Systems

Fatigue, pallor, occasional dizziness
Shortness of breath on exertion
Mild palpitations with exertion, no chest pain
No abdominal pain, nausea, vomiting, or changes in bowel habits
Heavy menstrual bleeding, no dysuria or hematuria
No headaches, limb weakness, difficulty concentrating

Initial Diagnostic Tests (Handout 3)

Complete Blood Count (CBC): Hemoglobin and hematocrit low, Mean Corpuscular Volume (MCV) low, Red Cell Distribution Width (RDW) elevated.
Peripheral Blood Smear: Hypochromic, microcytic red blood cells.
Serum Iron Studies: Serum Iron low, Total Iron Binding Capacity (TIBC) high, Ferritin low.
Reticulocyte Count low
Stool Occult Blood Test: Negative
Urinalysis: Normal
Pelvic Ultrasound: Not specified

Assessment

Signs and symptoms of iron deficiency anemia likely secondary to chronic blood loss from menorrhagia and suboptimal dietary intake.

Plan

Iron supplementation (oral ferrous sulfate 325 mg once daily, with vitamin C to enhance absorption).
Dietary counseling to increase intake of iron-rich foods
Referral to gynecologist for evaluation and management of heavy menstrual bleeding.
Follow-up: Repeat CBC and iron studies in 4 weeks to assess response to treatment

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.