Myelophthisic Anemias Overview
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Questions and Answers

What role does iron play after being separated from transferrin?

  • It is primarily excreted from the body.
  • It is used for producing hemoglobin or enzyme synthesis. (correct)
  • It aids in cellular breathing.
  • It is converted to transferrin.

    • How is excess iron stored in cells?

  • By binding to hemoglobin.
  • By binding to apoferritin, which transforms into ferritin. (correct)
  • By being excreted into the blood.
  • By converting to transferrin.

    • What is the average lifespan of a red blood cell (RBC)?

  • 150 days
  • 90 days
  • 120 days (correct)
  • 60 days

    • Which process primarily recycles iron in the body?

    <p>Phagocytosis of red blood cells</p> Signup and view all the answers

    What is the daily iron requirement for adult men?

    <p>1.0 mg</p> Signup and view all the answers

    What happens if an individual's iron absorption is lower than the body’s requirements?

    <p>Bone marrow becomes hypoproliferative, causing microcytic hypochromic anemia.</p> Signup and view all the answers

    What is the main source of additional iron needed by the body?

    <p>Dietary sources.</p> Signup and view all the answers

    What mechanisms are involved in iron loss from the body?

    <p>Menstrual cycles, shedding of epithelial cells, and mucosal loss.</p> Signup and view all the answers

    What is the primary feature indicated by a leukoerythroblastic smear pattern in the diagnosis of myelofibrosis?

    <p>Presence of nucleated red blood cells</p> Signup and view all the answers

    Which condition is NOT classified under the diseases causing secondary myelofibrosis?

    <p>Hemophilia</p> Signup and view all the answers

    What is a characteristic of the anemia observed in patients with myelofibrosis?

    <p>Normocytic and normochromic</p> Signup and view all the answers

    Which of the following processes occurs due to the proliferation of fibroblasts in the bone marrow?

    <p>Myeloid metaplasia</p> Signup and view all the answers

    What is the impact of myelofibrosis on hematopoietic progenitor cells?

    <p>Ineffective production of healthy blood cells</p> Signup and view all the answers

    What is a common early symptom of iron deficiency before anemia develops?

    <p>Weakness and early fatigue</p> Signup and view all the answers

    Which group of diseases does NOT cause secondary myelofibrosis?

    <p>Alzheimer's disease</p> Signup and view all the answers

    What is myeloid metaplasia?

    <p>The occurrence of hematopoietic cells at extramedullary sites</p> Signup and view all the answers

    Which level of hemoglobin indicates that an individual may start experiencing symptoms of anemia?

    <p>10 mg per deciliter</p> Signup and view all the answers

    In the context of myelofibrosis, what does pancytopenia indicate?

    <p>Reduction in red, white, and platelet counts</p> Signup and view all the answers

    Which of the following conditions is characterized by strictures in the esophagus due to iron deficiency?

    <p>Plummer-Vinson syndrome</p> Signup and view all the answers

    What does pica refer to in the context of iron deficiency?

    <p>An abnormal craving for unusual food items</p> Signup and view all the answers

    Which symptoms are considered specific and more commonly associated with advanced stages of iron deficiency?

    <p>Glossitis and angular stomatitis</p> Signup and view all the answers

    What is the function of cytochrome enzymes that can be affected by iron deficiency?

    <p>Aiding in energy production</p> Signup and view all the answers

    What basic test is commonly used to diagnose iron deficiency anemia?

    <p>Complete blood count (CBC)</p> Signup and view all the answers

    Which rare manifestation might be observed in an individual with iron deficiency?

    <p>Koilonychia (spoon-shaped nails)</p> Signup and view all the answers

    What indicates a definitive diagnosis of iron deficiency anemia?

    <p>A series of blood iron tests known as the iron profile</p> Signup and view all the answers

    What does a Transferrin Saturation (TS) value below 20% indicate?

    <p>Iron deficiency</p> Signup and view all the answers

    Which of the following tests is NOT part of the iron profile used for diagnosing iron deficiency anemia?

    <p>Measurement of hemoglobin</p> Signup and view all the answers

    What is a characteristic finding in hypochromic microcytic anemia observed in blood smears?

    <p>Increased variation in the size of RBCs (anisocytosis)</p> Signup and view all the answers

    What are the normal ferritin levels for adult males in ng/mL?

    <p>50-100</p> Signup and view all the answers

    What happens to ferritin levels during the development of iron deficiency?

    <p>Ferritin levels drop below 50 ng/mL</p> Signup and view all the answers

    Which type of anemia is characterized by small RBCs that are smaller than the nucleus of a lymphocyte?

    <p>Microcytic anemia</p> Signup and view all the answers

    What does RDW indicate in the context of blood tests?

    <p>Red blood cell volume distribution</p> Signup and view all the answers

    What is the primary role of iron in mammals?

    <p>Oxygen transport</p> Signup and view all the answers

    Which protein in blood plasma is primarily responsible for transporting iron?

    <p>Transferrin</p> Signup and view all the answers

    What form of transferrin has the highest affinity for its receptors?

    <p>Diferric transferrin</p> Signup and view all the answers

    What is the average amount of iron lost by the human body daily?

    <p>1 to 2 mg</p> Signup and view all the answers

    What is the main stored form of iron within cells?

    <p>Ferritin</p> Signup and view all the answers

    What happens to iron-bound transferrin upon interaction with transferrin-specific receptors?

    <p>It is internalized by the cell</p> Signup and view all the answers

    Which type of cells have the highest concentration of transferrin receptors?

    <p>Developing erythroblasts</p> Signup and view all the answers

    Why is free iron considered toxic to the body?

    <p>It reacts with free radicals</p> Signup and view all the answers

    What is a significant feature of patients with bone marrow fibrosis?

    <p>Bone marrow is often 'tap dry' during aspiration attempts.</p> Signup and view all the answers

    What condition frequently leads to increased WBC counts and can result in a leukemoid reaction?

    <p>Infections and inflammatory processes</p> Signup and view all the answers

    Which red blood cell characteristics can indicate iron deficiency anemia?

    <p>Teardrop-shaped red blood cells and hypochromia</p> Signup and view all the answers

    What percentage of young women and adolescents in the United States is estimated to suffer from iron deficiency?

    <p>2% to 5%</p> Signup and view all the answers

    What is the primary function of hemoglobin in red blood cells?

    <p>To carry oxygen</p> Signup and view all the answers

    What should be investigated first when facing secondary myelofibrosis?

    <p>Treatable underlying diseases</p> Signup and view all the answers

    Which of the following is a common cause of microcytic anemia?

    <p>Iron deficiency</p> Signup and view all the answers

    What can be observed in the peripheral blood smear of patients with myelofibrosis?

    <p>Presence of myeloblasts and promyelocytes</p> Signup and view all the answers

    Study Notes

    Myelophthisic Anemias

    • Fibrosis in bone marrow can be primary (primary myelofibrosis or myeloid metaplasia) or secondary (myelophthisis or secondary myelofibrosis)
    • Secondary myelofibrosis can be caused by various factors.
      • Cancerous conditions: Metastatic cancers (breast, lung, prostate, neuroblastomas)
      • Infectious diseases: Mycobacterial infections (tuberculosis, atypical mycobacteria), fungal infections, HIV, sarcoidosis
      • Hematologic disorders: Multiple myeloma, lymphomas, hairy cell leukemia, chronic myeloid leukemia (CML)

    Pathophysiology of Bone Marrow Fibrosis

    • Fibroblast proliferation: Myelofibrosis is caused by extensive fibroblast proliferation within the bone marrow, directly impacting hematopoiesis.
    • Extramedullary hematopoiesis: Hematopoietic cells spread to other organs (long bones, spleen, liver, lymph nodes). This process is known as myeloid metaplasia.
    • Ineffective erythropoiesis: Despite high proliferation, erythrocytes are inefficiently produced and have a reduced lifespan. This often leads to various cytopenias (e.g., pancytopenia).

    Anemia in Myelofibrosis

    • Anemia is frequently a prominent feature of secondary fibrosis.
    • Anemia is generally normocytic and normochromic.
    • Peripheral blood smears show leukoerythroblastosis (nucleated red blood cells, teardrop-shaped red blood cells, and various abnormal RBC shapes).
    • White blood cell (WBC) counts can be elevated (leukemoid reaction, which can range from 30,000-50,000). Immature myeloid cells (myeloblasts, promyelocytes, myelocytes) may also be seen in the peripheral blood.
    • Platelet counts are sometimes significantly elevated and platelets display enlarged size.

    Bone Marrow Biopsy

    • Bone marrow biopsies in cases of fibrosis are often "tap dry", meaning it is difficult to aspirate marrow due to extensive fibrosis.

    Treatment

    • Treatment depends on the underlying cause of secondary myelofibrosis.
    • Treatable diseases (infections) should be targeted
    • Blood transfusions may be required to alleviate symptoms.

    Iron Deficiency Anemia

    • RBCs are responsible for carrying oxygen, requiring hemoglobin, which needs iron.
    • Iron deficiency can lead to hypochromic microcytic anemia.
    • Symptoms include fatigue, pallor and weakness.
    • Diagnosed via blood tests that assess iron levels (e.g., serum iron, TIBC, ferritin).

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    Myelophthisic Anemias PDF

    Description

    This quiz explores the causes and pathophysiology of myelophthisic anemias, focusing on both primary and secondary myelofibrosis. Learn about the various cancerous conditions, infectious diseases, and hematologic disorders that contribute to this condition, as well as the impact on bone marrow and blood cell production.

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