Xbl Week 1

Front 1

What are the RBC characteristics? (6)

Back 1

1. Biconcave disc
2. Enucleate
3. Deformable
4. Rouleaux Formation
5. High Concentration of carbonic anhydrase
6. Hb content and binding to gases (O2, CO2, NO)

Front 2

what is Haemoblobin when Fe2+ turn to Fe3+?

Back 2

Methaemoglobin

Front 3

In the bone marrow, where does erythropoiesis occur?

Back 3

Erythroblastic islands.

Front 4

How does multipotent stem cell mature into erythrocyte?

Back 4

1. Multipotent stem cell
2. Blast forming unit erythroid
3. Colony forming unit erythorid
4. Proerythroblast
5. Basophilic erythroblast (early normoblast)
6. Polychromatic erythroblast (intermediate normoblast)
7. (Late) Normoblast
8. Reticulocyte
9. Erythrocyte

Front 5

Where is erythropoietin produced?

Back 5

Fetus: Liver
Adults: Peritubular interstitial cells of kidney
(Brain astrocyte & neuron, spleen, testis, lung)

Front 6

What stimulates EPO production?

Back 6

Kidney O2 sensor detecting tissue hypoxia

Front 7

What is porphyrias

Back 7

Disorder of haem synthesis due to abnormal accumulation of porphyrin precursors or porphyrins in the bone marrow or liver

Front 8

The ability of RBC to change shape depends on (3)

Back 8

1. Biconcave shape
2. Viscosity of the cytoplasm
3. Deformability

Front 9

What are the Integral and Peripheral proteins in an RBC and how are they connected?

Back 9

Integral: Glycophorin, Band 3 (Anion transporter)
Peripheral: Spectrin, Actin

Glycophorin is connected to spectrin via Protein 4.1
Band 3 is connected to spectrin via Ankyrin

Front 10

What are the major and sub-pathway for energy generation in RBC?

Back 10

Major: Emden-Meyerhof pathway
Minor:
Methaemoglobi-Reductase Pathway
Rapaport-Luebering Shunt
Hexose Monophosphate Shunt

Front 11

RBC requires energy for? (4)

Back 11

1. Maintaining ion gradients
2. Transporting ion across membrane
3. Preserving membrane structures
4. Maintaining haemoglobin in O2 carrying state

Front 12

What is the purpose of Methaemoglobin-Reductase pathway?

Back 12

Maintain Hemoglobin in a reduced state

Front 13

What is the purpose of Rapaport-Luebering Shunt?

Back 13

Produce 2,3 BPG which regulates hemoglobin oxygen binding affinity

Front 14

What is the purpose of Hexose Monophosphate Shunt?

Back 14

Produce reduced glutathione

Front 15

Reducing power in important in RBC for? (3)

Back 15

1. Preventing membrane lipid oxidation
2. Detoxifying oxidants
3. Prevention of globin oxidation and denaturation

Front 16

What are the complications of Beta Thalassemia?

Back 16

- Osteoprosis
Transfusion related problems:
- Endocrine failure (Iron overload)
- Transfusion Hemosiderosis (CHF, liver cirrhosis & carcinoma)
- Infection & transfusion reaction

Front 17

What are some disease of RBC (3 categories)

Back 17

Hemoglobin: Beta-thalassemia, Sickle Cell Anemia
Membrane: Hereditary Spherocytosis, Hereditary Elliptocytosis, Hereditary Pyropoikilocytosis, Hereditary Stomatocytosis
Enzyme: G6PD Deficiency, Pyruvate Kinase Deficiency

Front 18

What causes Hereditary Spherocytosis?

Back 18

Mutation in "Vertical support components"

Front 19

What is Splenic conditioning

Back 19

Progressive loss of membrane of RBC during each cycle through the spleen.

Front 20

What is the treatment of Hereditary Spherocytosis?

Back 20

- Folate supplement
- Spleen protection
- Splenectomy

Front 21

What causes Hereditary Spherocytosis?

Back 21

Mutation in "Horizontal support components"

Front 22

What is Hereditary Pyropoikilocytosis?

Back 22

Sensitivity of RBCs to heat

Front 23

What causes Hereditary Stomatocytosis?

Back 23

Defect in membrane ionic transport proteins in RBC

Front 24

What causes South Asian Ovalocytosis?

Back 24

Mutation in Band 3 protein in RBC

Front 25

How much iron do we lose in a day?

Back 25

Men: 1 mg/day
Women 2 mg/day

Front 26

What transport iron into and out of enterocytes?

Back 26

In: DMT1 (Ferrous Iron Transporter)
Out: Ferroportin

Front 27

What protein transport iron in blood?

Back 27

Transferrin

Front 28

What protein is responsible for iron storage in cells?

Back 28

Ferritin
Hemosiderin

Front 29

What is the key regulator of iron metabolism?

Back 29

Hepcidin

Front 30

What is Erythrocyte Protoporphyrin?

Back 30

Measure of Zinc Protoporhphyrin, which indicate iron available for hemoglobin production.

Front 31

What is protoporphyria?

Back 31

A hereditary disease caused by a deficiency of ferrochelatase. Associated with very high FEP values.

Front 32

What disease do labs check for blood donors?

Back 32

- HIV, HTLV
- Hep B & C
- CMV
- Syphilis

Front 33

In transfusion, the collected blood is separated into what components?

Back 33

- Packed Red Cell
- Platelet
- Plasma
- Cryoprecipitate

Front 34

Why should blood products be Leukoreduced?

Back 34

1. Decreased Febrile reactions
2. Decrease transmission of intracellular infections
3. Decreased HLA alloimmunization

Front 35

What is in Cryoprecipitate?

Back 35

- Fibrinogen
- Factor VIII
- von Willebrand factor

Front 36

What are the manufactured blood products?

Back 36

- Albumin
- IVIG
- Factor VIIa, VIII

Front 37

For blood transfusion, what does recipient testing involve?

Back 37

1. Type and Screen
2. Crossmatch

Front 38

During transfusion, how does the body respond to carbohydrate and protein?

Back 38

Carbohydrate: IgM (Acute Hemolytic Transfusion Reaction)
Protein: IgG (Delayed Hemolytic Transfusion Reaction, Hemolytic Disease of Newborne)

Front 39

Which autoantibodies are considered cold and warm?

Back 39

Cold: IgM
Warm: IgG

Front 40

Indications for giving packed RBC

Back 40

1. Increase O2 carrying capacity
2. Dilute sickled red cells

Front 41

Indications for giving Platelets

Back 41

1. Decreased platelet counts + bleeding/bruising
2. Prophylasix (Pre-op or < 10)
3. Dysfunctional platelets + bleeding/bruising

Front 42

Contraindications for giving Platelets

Back 42

Relative:
1. ITP
2. Hypersplenism
Absolute:
1. TTP
2. HITT

Front 43

Indications for giving Fresh Frozen Plasma

Back 43

1. "Global" Factor Deficiency + bleeding/bruising (Excess Coumadin, Vit K deficiency, DIC, Liver Disease)
2. Prophylaxis (Pre-op)

Front 44

Indications for Cryoprecipitate

Back 44

1. Decreased Fibrinogen + bleeding/bruising
2. Dysfunctional Fibrinogen + bleeding/bruising
3. Last resort for Von Willebrand or hemophilia patients

Front 45

What are the 4 types of transfusion reactions?

Back 45

1. Immune
2. Infectious
3. Fluid
4. Electroytes/Irons

Front 46

What does immune transfusion reaction consist of?

Back 46

- AHTR
- DHTR
- Febrile
- Allergic
- Anaphylactic

Front 47

What does fluid transfusion reaction consist of?

Back 47

- Fluid overload
- Hypothermia

Front 48

What does Electrolyte transfusion reaction consist of?

Back 48

- Inc K+
- Inc Fe2+
- Dec Ca2+

Front 49

What is the definition of anemia?

Back 49

Reduced hemoglobin concentration relative to "normal"

Front 50

What can cause microcytic anemia?

Back 50

- Iron Deficiency
- Thalassemia
- Anemia of chronic disease
- Hemoglobinopathies
- Lead Toxicity

Front 51

What can cause punctate basophilia? (4)

Back 51

- Thalassaemia
- Siderblastic anaemia
- Severe megaloblastic anemia
- Lead poisoning

Front 52

What can cause normocytic anemia?

Back 52

- Hemolytic Anemia
- Anemia of Chronic Disease
- Renal Failure
- Combined B12 & Folate
- Endocrine abnormalities
- Aplastic Anemia
- Acute Hemorrhage

Front 53

What can cause macrocytic anemia?

Back 53

- B12/Folate Deficiency
- Antimetabolite Chemotherapy
- Liver Disease
- Reticulocytosis
- Hypothyroidism
- Myelodysplastic Syndrome

Front 54

What can cause oval macrocytes?

Back 54

- MDS
- Megaloblastic

Front 55

What can cause target cells?

Back 55

- Thalasemia
- Liver disease
- Iron deficiency

Front 56

What can cause Pencil cells?

Back 56

Iron deficiency anemia

Front 57

What can cause Howell-Jolly body

Back 57

Sickle Cell Anemia

Front 58

What can cause Rouleaux Formation?

Back 58

Multiple myeloma