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Questions and Answers
Which index measures the average volume of red blood cells?
Which index measures the average volume of red blood cells?
- Mean cell hemoglobin concentration (MCHC)
- Red cell distribution width (RDW)
- Mean cell hemoglobin (MCH)
- Mean cell volume (MCV) (correct)
What is the average total body iron mass for men?
What is the average total body iron mass for men?
- 5.0 g
- 4.5 g
- 2.5 g
- 3.5 g (correct)
What does the mean cell hemoglobin (MCH) represent?
What does the mean cell hemoglobin (MCH) represent?
- Concentration of hemoglobin in the serum
- Average volume of packed red cells
- Average mass of hemoglobin per red cell (correct)
- Average size of red cells in femtoliters
Which test would be used to analyze hemoglobin types in a sample?
Which test would be used to analyze hemoglobin types in a sample?
Which of the following constitutes the majority of functional body iron?
Which of the following constitutes the majority of functional body iron?
How much iron is typically absorbed from heme sources in a Western diet?
How much iron is typically absorbed from heme sources in a Western diet?
Which of the following indices assesses red cell volume variation?
Which of the following indices assesses red cell volume variation?
What is the most common cause of iron deficiency anemia in the Western world?
What is the most common cause of iron deficiency anemia in the Western world?
What parameters are included in serum iron indices?
What parameters are included in serum iron indices?
Which group is most likely to experience iron deficiency due to poor bioavailability in their diet?
Which group is most likely to experience iron deficiency due to poor bioavailability in their diet?
Which measurement is expressed in grams per deciliter?
Which measurement is expressed in grams per deciliter?
What is the average serum iron level for women?
What is the average serum iron level for women?
Which component is NOT typically evaluated in the diagnosis of anemia?
Which component is NOT typically evaluated in the diagnosis of anemia?
Which condition is typically indicated by elevated plasma unconjugated bilirubin?
Which condition is typically indicated by elevated plasma unconjugated bilirubin?
What percentage of the total body iron is contained in the iron storage pool?
What percentage of the total body iron is contained in the iron storage pool?
How much iron is lost daily in the body?
How much iron is lost daily in the body?
What characterizes intravascular hemolysis?
What characterizes intravascular hemolysis?
Which of the following is a clinical feature of hereditary spherocytosis?
Which of the following is a clinical feature of hereditary spherocytosis?
What is the main mechanism leading to hemolysis in G6PD deficiency?
What is the main mechanism leading to hemolysis in G6PD deficiency?
Which factor is associated with extravascular hemolysis?
Which factor is associated with extravascular hemolysis?
Which symptom is indicative of hemolytic anemia?
Which symptom is indicative of hemolytic anemia?
What is a common complication of hereditary spherocytosis?
What is a common complication of hereditary spherocytosis?
Which laboratory finding is generally observed in patients with hereditary spherocytosis?
Which laboratory finding is generally observed in patients with hereditary spherocytosis?
What is a potential benefit of splenectomy in hereditary spherocytosis?
What is a potential benefit of splenectomy in hereditary spherocytosis?
What is a characteristic morphology of megaloblastic erythroid progenitors?
What is a characteristic morphology of megaloblastic erythroid progenitors?
What is the earliest change observed in peripheral blood for patients with megaloblastic anemia?
What is the earliest change observed in peripheral blood for patients with megaloblastic anemia?
What factors can lead to folate deficiency anemia?
What factors can lead to folate deficiency anemia?
Which of the following statements about giant metamyelocytes is true?
Which of the following statements about giant metamyelocytes is true?
Which of the following drugs is known to interfere with folate absorption?
Which of the following drugs is known to interfere with folate absorption?
What does an MCV greater than 110 fL indicate in a patient?
What does an MCV greater than 110 fL indicate in a patient?
What is the relationship of acidic foods to folate absorption?
What is the relationship of acidic foods to folate absorption?
What is a common characteristic of megaloblastic anemia regarding platelet appearance?
What is a common characteristic of megaloblastic anemia regarding platelet appearance?
Which condition is characterized by demyelination of the posterior and lateral columns of the spinal cord?
Which condition is characterized by demyelination of the posterior and lateral columns of the spinal cord?
What is a characteristic clinical feature of vitamin B12 deficiency?
What is a characteristic clinical feature of vitamin B12 deficiency?
What is the main treatment approach for anemia of chronic inflammation?
What is the main treatment approach for anemia of chronic inflammation?
What laboratory finding is associated with pernicious anemia?
What laboratory finding is associated with pernicious anemia?
Which factor primarily contributes to the pathogenesis of anemia of chronic inflammation?
Which factor primarily contributes to the pathogenesis of anemia of chronic inflammation?
Which of the following diseases is NOT a known cause of disruption in the distal ileum function?
Which of the following diseases is NOT a known cause of disruption in the distal ileum function?
What is a common clinical feature of aplastic anemia?
What is a common clinical feature of aplastic anemia?
Which demographic is most likely affected by anemia of chronic inflammation?
Which demographic is most likely affected by anemia of chronic inflammation?
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Study Notes
Red Cell Indices
- Mean Cell Volume (MCV): Average volume per red blood cell, measured in femtoliters.
- Mean Cell Hemoglobin (MCH): Average mass of hemoglobin per red cell, expressed in picograms.
- Mean Cell Hemoglobin Concentration (MCHC): Average concentration of hemoglobin in packed red cells, in grams per deciliter.
- Red Cell Distribution Width (RDW): Measures the variation in red cell volume.
Pathological Classification of Anemia
- Other blood tests assess serum iron indices, plasma unconjugated bilirubin, haptoglobin, lactate, folate, vitamin B12, hemoglobin electrophoresis, and the Coombs test.
- Hemolytic anemia is classified into intravascular (red cell destruction in circulation) and extravascular (phagocytosis by spleen).
Intravascular vs. Extravascular Hemolysis
- Intravascular hemolysis leads to hemoglobinemia, hemoglobinuria, and hemosiderinuria with possible splenomegaly and iron loss.
- Extravascular hemolysis results in bilirubin-rich gallstones and post-splenectomy increased risk of cholelithiasis.
Hereditary Spherocytosis
- An inherited defect in red cell membrane, leading to spherocyte formation, typically autosomal dominant.
- Clinical features include anemia, jaundice, splenomegaly, and increased osmotic fragility; splenectomy can improve anemia symptoms.
Glucose-6-Phosphate Dehydrogenase Deficiency
- Vulnerability to hemolysis due to oxidative stress, affecting mainly populations in developing countries.
- Total body iron mass varies: approximately 2.5g for women and 3.5g for men; majority is in hemoglobin.
Iron Metabolism
- Iron storage is primarily in the liver, spleen, and bone marrow; serum iron levels average 120 µg/dL in men, 100 µg/dL in women.
- Daily iron loss is 1 to 2 mg, balanced by dietary absorption, mainly from meat (heme) and vegetables (non-heme).
Iron Deficiency Anemia (IDA) Causes
- Chronic blood loss is key in the West; common sources include gastrointestinal tract bleeding.
- In developing countries, low intake and malabsorption due to vegetarian diets are prevalent.
- Increased iron demand occurs during pregnancy and infancy; malabsorption issues also contribute.
Megaloblastic Anemia
- Characterized by hypercellular bone marrow containing megaloblasts with immature nuclear chromatin.
- Peripheral blood shows macroovalocytes, hypersegmented neutrophils, and large platelets.
Folate Deficiency
- Results from inadequate dietary intake, malabsorption, or increased metabolic needs; affected by acidic foods and certain medications.
- Neurologic involvement may lead to demyelination; clinical features include jaundice and neurological symptoms.
Anemia of Chronic Inflammation
- Common in hospitalized patients; linked to inflammation suppressing erythropoiesis.
- Caused by chronic infections, immune disorders, and neoplasms; treatment focuses on addressing the underlying cause.
Aplastic Anemia
- Results from suppression of multipotent myeloid stem cells, leading to bone marrow failure and pancytopenia.
- Can occur due to both extrinsic (immune-mediated) and intrinsic (stem cell abnormalities) factors.
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