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Pathoma Study Guide: Questions & Complete Answers
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Pathoma Study Guide: Questions & Complete Answers
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Pathoma Study Guide: Questions & Complete AnswersAnemia Right Ans - Reduction of circulating RBC mass
Presents w/ hypoxia
Hemoglobin is made of Right Ans - Heme & Globin
Heme is composed of Iron and protoporphyrin
Decrease in any of these:
Microcytic Anemia (MCV<80)
Iron deficiency Anemia Right Ans - Dec. iron in body
(either dietary lack or blood loss)
Pt undergoes gastrectomy, what happens w/ iron absorption? Right Ans -
Less acid, therefore iron remains in Fe3+ state (less absorbed)
Serum ferritin Right Ans - How much iron is stored intracellularly in body
(Norm m = 7-340)
(Norm f = 7-75)
Transferrin Right Ans - Binds iron in blood for delivery to bone & marrow
macrophage
Anemia
Koilonychia (spoon shaped nails)
Pica (pt chews on things) Right Ans - Iron deficiency
(Rx: Ferrous Sulfate)
Iron deficiency anemia
Esophageal web
& Atrophic glossitis
"beefy red tongue" Right Ans - Plummer Vinson Syndrome
Anemia associated w/ chronic inflammation or cancer.
Inc in Hepcidin (sequesters iron)
so it can't be used for infection. Right Ans - Anemia of Chronic Disease
Anemia from defect in protoporphyrin synthesis
,(Commonly Vit B6 def causing dec Aminolevulinic Acid Synthase) Right
Ans - Sideroblastic Anemia
(Iron present w/in mitochondria)
Rx. w/ Isoniozide
Inherited gene mutation in thalassemia has protective mechanism against:
Right Ans - Plasmodium Falciparum Malaria
Beta globulin chains form tetramers (HbH) Right Ans - Alpha Thalassemia
(3 genes deleted - severe)
Gamma globulin chains form tetramers in fetus (Hb Barts) Right Ans -
Alpha Thalassemia (4 gene deletion - lethal in utero)
"Hydrops Fetalis"
B/B+
B = Normal beta chain
B+ = diminished beta chain Right Ans - Beta Thalassemia Minor
B^o/ B^o
(B^o = absent beta chain)
Alpha tetramers form Right Ans - Beta Thalassemia Major
"expansion erythropoiesis in the skull & face)
Macrocytic Anemias (MCV > 100) most commonly due to: Right Ans -
Folate or Vit B12 Deficiency
Hypersegmented neutrophils & macroovalocytes
What drug that inhibits dihydrofolate reductase can cause folate deficiency
Macrocytic Anemia? Right Ans - Methotrexate
Macrocytic RBCs w/ hypersegmented neutrophils
Glossitis
Dec. serum folate
Inc serum homocysteine
**Normal methylmalonic acid (0-0.4) Right Ans - Macrocytic anemia from
Folate deficiency
, Autoimmune destruction of parietal cells of stomach causing decreased IF
Right Ans - Pernicious Anemia
(Binding of IF to Vit B12 needed for absorption in ileum)
Due to either peripheral destruction of RBC's or Underproduction of RBCs
Right Ans - Normocytic Anemia (MCV 80-100)
Reticulocyte count > 3% Right Ans - Normocytic Anemia w/ peripheral
destruction of RBCs
Hereditary defect of RBC cytoskeletal proteins Spectrin, Ankyrin, Band 3.1
Right Ans - Hereditary Spherocytosis
Howell-Joly bodies in RBC Right Ans - Hereditary Spherocytosis
AR mutation in B chain of hemoglobin
Mutation from glutamic acid --> Valine Right Ans - Sickle Cell Anemia
HbS --> sickle shaping
(Protective against Falciprum Malaria)
AR mutation in Beta chain
Mutation from Glutamic Acid --> Lysine
HbC Right Ans - Hemoglobin C
"Hemoglobin C has Lycccene!"
Acquired defect in myeloid stem cell
Dec. expression of GPI (anchoring) protein (lack of CD55 marker)
RBCs susceptible to rupture from Complement Right Ans - Paroxysmal
Nocturnal Hemoglobinuria
(Intravascular hemolysis @ night!)
X-linked recessive disorder that increases susceptibility of RBC to oxidative
stress
Protective role against Falciprum Malaria Right Ans - G6PD Deficiency
(Normocytic anemia)
"Bite cell" - heinz bodies removed by splenic macrophage
Immune Hemolytic Anemia resulting in spherocytes
Assoc. w/ SLE, CLL, some drugs Right Ans - IgG mediated IHA
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