Heme exam 1 summer

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the ploidy of a Promegakaryocyte (MK2)?

2N and 16N

8N and 32N (correct)

4N and 64N

16N and 128N

What is the diameter range of a M1-Megakaryoblast?

6-24u (correct)

30-40u

14-30u

40-50u

What is the function of the demarcation membrane system (DMS)?

To provide additional surface membrane for the process of platelet production (correct)

To regulate the size of the megakaryocyte

To increase the number of nucleoli in the nucleus

To transport cytoplasmic projections to the periphery of the cell

What is the main cause of iron deficiency anemia?

Chronic blood loss Signup and view all the answers

What is the characteristic lab finding in iron deficiency anemia?

Decreased serum iron Signup and view all the answers

What is a possible secondary cause of sideroblastic anemia?

Hematologic malignancies Signup and view all the answers

What is the association between dacryocytes and hemolytic anemias?

Dacryocytes are associated with hemolytic anemias Signup and view all the answers

What is the most sensitive test for sideroblastic anemia?

Bone marrow test Signup and view all the answers

What is the cause of drepanocytes?

Substitution of valine for glutamic acid Signup and view all the answers

Which of the following is associated with target cells?

Liver disease Signup and view all the answers

What is the association between stromatocytes and alcohol cirrhosis?

Stromatocytes are associated with alcohol cirrhosis Signup and view all the answers

What is the etiology of Basophilic stippling in RBCs?

Nuclear remnants containing DNA Signup and view all the answers

What is the characteristic feature of Heinz bodies in RBCs?

Aggregates of non-refractile, densely staining material Signup and view all the answers

What is the etiology of Echinocytes in RBCs?

Increase in outer leaflet lipid bilayer Signup and view all the answers

What is the association of Spherocytes with hereditary spherocytosis?

Deficiency in spectrin or other skeletal protein Signup and view all the answers

What is the relationship between endomitosis and platelet production?

Endomitosis directly parallels platelet production Signup and view all the answers

What is the mechanism of platelet release?

Individual platelets are released from megakaryocyte cytoplasm into the sinus lumen Signup and view all the answers

What is the etiology of Hemoglobin C and SC crystals found in red cells?

Decreased solubility of hemoglobin C Signup and view all the answers

What are Howell-Jolly bodies found in red cells?

Dense, homogenous, refractile, rounded bodies Signup and view all the answers

What is the main feature of Hereditary Persistence of Fetal Hemoglobin-delta beta thalassemia (HPFH)?

Increased gamma chain production Signup and view all the answers

What is the effect of HPFH on homozygous individuals?

Asymptomatic with little or no anemia Signup and view all the answers

What is the main finding in heterozygous individuals with HPFH?

Increased Hgb F Signup and view all the answers

What is the main mechanism behind microcytic anemia in chronic disease?

Decreased iron release from macrophages Signup and view all the answers

What is the distinguishing feature of stage 2 in the development of iron deficiency anemia?

Microcytic and hypochromic RBCs Signup and view all the answers

What is the main cause of inherited sideroblastic anemia?

Disturbance of heme synthesis enzymes Signup and view all the answers

What is a distinguishing feature of peripheral blood in sideroblastic anemia?

Normal leukocyte and platelet counts Signup and view all the answers

Which of the following is a distinguishing factor between IDA and ACI in terms of sTfR levels?

ACI-sTfR levels are increased Signup and view all the answers

What is the effect of hepcidin on iron absorption and release from macrophages?

Decreases iron absorption and release Signup and view all the answers

What is the difference in bone marrow findings between people with microcytic anemias due to inflammation and those with iron deficiency anemia?

Only inflammation shows increased hemosiderin in macrophages Signup and view all the answers

What is the difference between hemosiderosis and hemochromatosis?

Hemochromatosis involves organ damage while hemosiderosis does not Signup and view all the answers

Which of the following is a characteristic of alpha thalassemia?

Manifests at birth Signup and view all the answers

What is the difference between a silent carrier and alpha thalassemia trait?

Silent carriers have no Barts at birth, alpha thalassemia trait has Barts at birth Signup and view all the answers

What is the cause of beta thalassemia?

Diminished or absent beta chain synthesis Signup and view all the answers

What is the difference between beta thalassemia major and beta thalassemia intermedia?

Beta thalassemia major has Heinz bodies, beta thalassemia intermedia has target cells Signup and view all the answers

What is the hallmark lab finding in homozygous beta thalassemia?

Microcytic, hypochromic anemia with basophilic stippling and nRBCs Signup and view all the answers

Which type of beta thalassemia is characterized by anemia that is more severe than beta thalassemia minor but less severe than beta thalassemia major?

Beta thalassemia intermedia Signup and view all the answers

What is the hallmark lab finding in beta thalassemia minor?

Decreased MVC, MCH, and MCHC Signup and view all the answers

What is the difference between homozygous beta thalassemia and homozygous sickle cell beta thalassemia?

Homozygous beta thalassemia has microcytic, hypochromic anemia with 100% F, while homozygous sickle cell beta thalassemia has microcytic, hypochromic anemia with no Hgb A or A2 Signup and view all the answers

Study Notes

Megakaryocyte Development

Promegakaryocyte (MK2) is typically polyploid, having multiple sets of chromosomes.
Diameter of M1-Megakaryoblast ranges from 20 to 30 micrometers.
The demarcation membrane system (DMS) facilitates the organization of platelet production and is crucial for pre-platelet formation.

Anemia Types and Characteristics

Main cause of iron deficiency anemia is inadequate iron intake or absorption.
Characteristic lab finding in iron deficiency anemia includes low serum ferritin levels.
Secondary cause of sideroblastic anemia can be lead poisoning or vitamin B6 deficiency.

Red Blood Cell Abnormalities

Dacryocytes (teardrop cells) are often associated with hemolytic anemias, indicating hemolysis.
Most sensitive test for sideroblastic anemia is the identification of ringed sideroblasts in the bone marrow.
Drepanocytes (sickle cells) are caused by mutations in the beta-globin gene leading to sickle cell disease.

Cellular Morphology in Conditions

Target cells are associated with conditions such as liver disease and thalassemias.
Stomatocytes are associated with alcohol cirrhosis, indicating a membrane defect in erythrocytes.
Basophilic stippling in RBCs often results from lead poisoning or other toxicities.

Specific Body Findings

Heinz bodies are characterized by denatured hemoglobin due to oxidative stress.
Echinocytes (burr cells) are caused by changes in the membrane due to alterations in lipids, often associated with uremia.
Spherocytes are linked to hereditary spherocytosis, where RBCs lose their biconcave shape.

Platelet and Spleen Dynamics

Endomitosis leads to increased ploidy and magnitude of megakaryocyte nuclear DNA, stimulating platelet production.
Platelet release occurs through the process of exocytosis in bone marrow sinusoidal spaces.

Hemoglobin Conditions and RBC Findings

Hemoglobin C and SC crystals result from specific point mutations in the hemoglobin gene.
Howell-Jolly bodies indicate asplenia or functional asplenia, commonly seen in conditions affecting the spleen.

Genetic and Hematologic Features

Hereditary Persistence of Fetal Hemoglobin (HPFH) is characterized by continued expression of fetal hemoglobin into adulthood.
In homozygous individuals, HPFH can result in mild anemia; heterozygous individuals typically show no clinical symptoms.
Microcytic anemia in chronic disease is primarily caused by inflammatory cytokines affecting iron metabolism.

Iron Deficiency Anemia Stages and Comparisons

Distinguishing feature of stage 2 iron deficiency anemia includes decreased serum ferritin and the presence of normocytic red blood cells.
Inherited sideroblastic anemia is commonly due to mutations in genes involved in heme synthesis.
Peripheral blood in sideroblastic anemia often shows increased ringed sideroblasts.

Iron Homeostasis and Anemia Differentiation

Soluble transferrin receptor (sTfR) levels help differentiate between iron deficiency anemia and anemia of chronic inflammation (ACI) with elevated levels in IDA.
Hepcidin inhibits iron absorption from the gut and blocks iron release from macrophages, contributing to iron sequestration in anemia of chronic disease.
Distinct bone marrow findings show increased iron stores in ACI compared to decreased iron stores in iron deficiency anemia.

Iron Overload Disorders

Hemosiderosis is iron overload without tissue damage, while hemochromatosis involves tissue damage due to iron deposition.
Alpha thalassemia presents with microcytosis and potential hemolysis, depending on the number of affected alpha-globin genes.
Silent carriers exhibit no symptoms, while alpha thalassemia trait shows mild hemoglobin abnormalities.

Beta Thalassemia Variations

Beta thalassemia is caused by mutations in the beta-globin gene, leading to decreased or absent beta chains.
Beta thalassemia major presents with severe anemia requiring regular transfusions, whereas beta thalassemia intermedia has a less severe phenotype with reduced transfusion needs.
Hallmark lab finding in homozygous beta thalassemia includes elevation of fetal hemoglobin levels and low mean corpuscular volume (MCV).
Beta thalassemia minor shows increased hemoglobin A2 and typically mild anemia.
Differentiation between homozygous beta thalassemia and homozygous sickle cell beta thalassemia is based on the presence of sickle-shaped cells in the latter.

Studying That Suits You

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

Description

Test your knowledge on hematological concepts such as ploidy of promegakaryocyte, diameter range of M1-megakaryoblast, function of demarcation membrane system, causes of iron deficiency anemia, and characteristic lab findings in anemia.