Hemapatology: Red Blood Cell
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Questions and Answers

Which type of anemia is characterized by a decreased mean corpuscular volume (MCV)?

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

    • In iron deficiency anemia, which of the following is the primary cause of the reduced red blood cell production?

  • Insufficient production of erythropoietin
  • Destruction of bone marrow tissue
  • Increased rate of red blood cell destruction
  • Decreased availability of iron for hemoglobin synthesis (correct)

    • Which of the following is a characteristic feature of thalassemia?

  • Increased mean corpuscular volume (MCV)
  • Increased red blood cell distribution width (RDW)
  • Increased red blood cell production
  • Decreased hemoglobin levels (correct)

    • In a patient with hemolytic anemia, which of the following compensatory mechanisms is typically observed in the bone marrow?

    <p>Increased rate of erythropoiesis</p> Signup and view all the answers

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

    <p>Autoimmune disease</p> Signup and view all the answers

    What is the primary physiological effect of anemia on the body?

    <p>Decreased oxygen delivery to the tissues</p> Signup and view all the answers

    Which of the following is the hallmark feature of sickle cell anemia?

    <p>Hemoglobin S disease with an AA substitution in the beta chain, leading to Glutamic acid being replaced by Valine</p> Signup and view all the answers

    Which of the following is the most common cause of megaloblastic anemia?

    <p>Folic acid deficiency due to dietary deficiency or malabsorption</p> Signup and view all the answers

    What is the characteristic physical appearance associated with beta-thalassemia major?

    <p>Chipmunk facies due to bone marrow expansion</p> Signup and view all the answers

    Which of the following is the definitive treatment for sickle cell anemia?

    <p>Bone marrow transplant</p> Signup and view all the answers

    Which of the following is a common complication of polycythemia vera?

    <p>Increased blood viscosity leading to thrombotic events</p> Signup and view all the answers

    Which of the following is the main treatment for beta-thalassemia major?

    <p>Blood transfusions to manage iron overload</p> Signup and view all the answers

    What is the most common cause of iron deficiency anemia?

    <p>Chronic blood loss</p> Signup and view all the answers

    Which of the following is a characteristic feature of the anemia of chronic disease?

    <p>Microcytic and hypochromic red blood cells</p> Signup and view all the answers

    What is the most common cause of megaloblastic anemia due to vitamin B12 deficiency?

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

    Which of the following is a characteristic feature of thalassemia?

    <p>Microcytic and hypochromic red blood cells due to impaired hemoglobin synthesis</p> Signup and view all the answers

    Which of the following is a characteristic of hemolytic anemia?

    <p>Increased rate of red blood cell destruction</p> Signup and view all the answers

    What is the primary mechanism of red blood cell destruction in extravascular hemolytic anemia?

    <p>Phagocytosis by macrophages in the spleen and liver</p> Signup and view all the answers

    Which of the following is a hereditary cause of hemolytic anemia?

    <p>Sickle cell anemia</p> Signup and view all the answers

    In the case of chronic blood loss, how does the bone marrow compensate?

    <p>By increasing reticulocyte production</p> Signup and view all the answers

    Which of the following is a characteristic of thalassemia?

    <p>Decreased production of normal hemoglobin</p> Signup and view all the answers

    What is the primary mechanism of red blood cell destruction in intravascular hemolytic anemia?

    <p>Direct lysis of red blood cells in the circulation</p> Signup and view all the answers

    Which of the following is a characteristic feature of iron deficiency anemia?

    <p>Pica (eating dirt or ice)</p> Signup and view all the answers

    What is a common gastrointestinal syndrome that can lead to folic acid deficiency anemia?

    <p>Celiac disease</p> Signup and view all the answers

    Which of the following is a key symptom of megaloblastic anemia?

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

    What is the main treatment for anemia of chronic disease?

    <p>Erythropoietin therapy</p> Signup and view all the answers

    In which population is the mutation for β-thalassemia most common?

    <p>Mediterranean, African, and Asian</p> Signup and view all the answers

    What is the primary cause of microcytic and hypochromic red cells in iron deficiency anemia?

    <p>Impaired hemoglobin synthesis</p> Signup and view all the answers

    What is the underlying cause of polycythemia vera?

    <p>Low oxygen levels causing overproduction of EPO</p> Signup and view all the answers

    Which of the following conditions can increase the risk of neural tube defects like spina bifida due to folic acid deficiency?

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

    What is the hallmark physical appearance associated with beta-thalassemia major?

    <p>Chipmunk facies</p> Signup and view all the answers

    What is the primary treatment for megaloblastic anemias caused by vitamin B12 deficiency?

    <p>Vitamin B12 replacement therapy</p> Signup and view all the answers

    Study Notes

    Blood Composition and Lifecycle

    • Old red blood cells undergo lysis; some heme components are excreted while others are reused.
    • Reticulocytes serve as precursors to mature erythrocytes (red blood cells).
    • Senescent RBCs are phagocytosed by macrophages in the spleen and liver.
    • Average life span of RBCs is approximately 120 days.

    Erythropoietin and Iron Requirements

    • Erythropoietin is produced by kidneys in response to hypoxia, stimulating the production of erythroblasts in bone marrow.
    • Bone marrow can increase RBC formation rate to about 30 million cells per second during recovery from blood loss.
    • Hemoglobin synthesis necessitates dietary iron, which comprises roughly 65% of the body's iron stores (around 4,000 mg).

    Red Blood Cell Disorders

    • Disorders include underproduction (anemia) and overproduction (polycythemia).
    • Diagnosis relies on RBC indices via complete blood count (CBC) and microscopic examination of blood smears.

    Reference Ranges for Red Blood Cells

    • Hematocrit (%): Men 39-49, Women 33-43
    • Red Cell Count (106/μL): Men 4.3-5.9, Women 3.5-5.0
    • Hemoglobin (gm/dL): Men 13.6-17.2, Women 12.0-15.0
    • Mean Cell Volume (μm³): 82-96
    • Mean Corpuscular Hemoglobin (pg): 27-33
    • Normal hemoglobin levels in children: 11.0 to 16.0 g/dL

    Anemia Overview

    • Anemia results in impaired oxygen delivery due to reduced red blood cell proportion.
    • It is classified as blood loss (hemorrhagic), increased destruction (hemolytic), or insufficient production due to deficiencies or bone marrow failure.

    Anemia Symptoms and Signs

    • Common symptoms include weakness, pallor, and shortness of breath.
    • Physical signs may include tachycardia, hypotension, and cold skin.
    • Additional effects can include pica (eating non-food substances) and koilonychia (spoon-shaped nails).

    Anemia Classification by Erythrocyte Size

    • Microcytic Anemia: MCV <80 fL (e.g., Iron deficiency anemia).
    • Normocytic Anemia: MCV 80-100 fL.
    • Macrocytic Anemia: MCV >100 fL (e.g., Vitamin B12 deficiency).

    Blood Loss and Anemia

    • Acute blood loss conditions can arise from trauma or surgery and may lead to shock.
    • Chronic blood loss is often linked to gastrointestinal or genitourinary sources, depleting iron reserves and leading to iron deficiency anemia.

    Hemolytic Anemia Characteristics

    • Occurs when RBC destruction exceeds production.
    • Involves increased levels of bilirubin and reticulocyte count due to compensatory bone marrow activity.
    • Hemolysis can be categorized as intravascular or extravascular.

    Types of Hemolytic Anemia

    • Hereditary Spherocytosis: Autosomal dominant condition; RBC membrane issue leads to spherocyte formation.
    • Sickle Cell Anemia: Autosomal recessive mutation in β-globin causing sickling of RBCs, leading to pain crises and tissue ischemia.
    • Thalassemia: Genetic defect resulting in abnormal hemoglobin production.

    Clinical Manifestations of Hemolytic Anemia

    • Patients may present with anemia and splenomegaly (enlarged spleen) in hereditary spherocytosis and other symptoms like retinopathy in sickle cell anemia.

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