Module 3

Question 1

Formation of Red Blood Cells (RBC)

Answer 1

1. Hematopoietic Stem Cells
2. Pronormoblast
3. Basophilic Normoblast
4. Polychromatophilic Normoblast
5. Orthochromatic Normoblast
6. Reticulocytes
7. Erythrocytes (Red Blood Cells)

Question 2

Visual assessment of red blood cell size and shape

Answer 2

Peripheral Blood Smear

Question 3

Normal Red Blood Cell Morphology

Answer 3

• Biconcave disk
• Red in color
• 7-8 micrometers diameter
• No nucleus
• Smooth and even

Question 4

Investigates if bone marrow produces healthy red blood cells

Answer 4

Bone Marrow biopsy

Question 5

A reduction in the proportion of red blood cells

Answer 5

Anemia

Question 6

Three types of anemia based on size

Answer 6

1. Microcytic Anemia (MCV<80)
2. Normocytic Anemia (MCV=80-100)
3. Macrocytic Anemia (MCV>100)

Question 7

Two types of anemia based on cause of hemolysis

Answer 7

1. Extravascular hemolysis - Premature RBC are destroyed or removed by liver or spleen
2. Intravascular hemolysis - Lysis of RBC in circulation

Question 8

Two classifications of hemolysis

Answer 8

1. Acquired - Due to external factors
2. Hereditary - Due to genetic conditions

Question 9

Pathophysiology of Anemia

Answer 9

1. Hemolytic anemia
2. Blood loss (acute, short term, or chronic, long term)
3. Defective erythropoiesis

Question 10

Two types of Anemia diseases

Answer 10

Sickle cell anemia and Iron deficiency anemia

Question 11

Hemoglobin structure

Answer 11

• Contains 2 pairs of polypeptide chains called globins
• Contains 4 prosthetic heme groups
• Has 1 ferrous iron for each heme group

Question 12

2 Forms of Heme in the Human Body

Answer 12

Heme Iron and Non-Heme Iron

Question 13

Iron in ferrous state (Fe2+) that is used in hemoglobin and myoglobin, derived from meat diet

Answer 13

Heme Iron

Question 14

Iron in ferric state (Fe3+) that is used as storage material, derived from vegetables

Answer 14

Non-Heme Iron

Question 15

Causes of Iron Deficiency Anemia

Answer 15

• Low iron intake
• Low iron absorption
• High iron demand
• High iron loss

Question 16

Lab Diagnosis for Iron Deficiency Anemia

Answer 16

Peripheral Blood Smear
Blood Test
Bone Marrow Biopsy

Question 17

Iron Metabolism

Answer 17

• Ferrireductase reduces Fe3+ to Fe2+ which then binds to ferritin which temporarily stores iron
• When iron is needed, hephaestin converts heme iron to non-heme iron which binds to transferrin

Question 18

A Genetic disorder that turns RBC into sickle-like shape making it easier for them to be destroyed (autosomal recessive)

Answer 18

Sickle Cell Anemia

Question 19

Causes of sickle cell anemia

Answer 19

• Defective hemoglobin
• Sickling

Question 20

Extramedullary hematopoiesis

Answer 20

Expansion of medullary cavities in the skull caused by bone marrow increasing production of reticulocytes because of anemia or production of RBC in the liver

Question 21

Effects of sickle cell anemia

Answer 21

• Vaso-occlusion (clogging of the blood flow)
• Dactylitis in bones of hands and feet of infants
• Spleen sequestration
• Stroke and moya moya disease
• Acute chest syndrome
• Necrosis
• Painful and prolonged erection

Question 22

Lab Diagnosis for Sickle Cell Anemia

Answer 22

Peripheral Blood Smear
Blood Test

Question 23

Basophilic nuclear remnants inside red blood cells

Answer 23

Howell Jolly Body

Question 24

Also known as erythrocytosis, it is a blood disorder where there are too many blood cells, which makes blood thicker and harder to flow

Answer 24

Polycythemia

Question 25

Pathophysiological classifications of Polycythemia

Answer 25

Absolute polycythemia and relative polycythemia

Question 26

Total RBCs are normal but hematocrit increases due to a decrease in plasma volume. Causes: dehydration, vomiting, severe burns

Answer 26

Relative Polycythemia

Question 27

Also known as stress polycythemia, RBC is high end of normal and plasma volume is low end of normal Cause: stress

Answer 27

Spurious Polycythemia

Question 28

2 Types of Absolute Polycythemia

Answer 28

Primary and Secondary Polycythemia

Question 29

Caused by overproduction of RBC in the bone marrow

Answer 29

Primary Polycythemia

Question 30

Caused by mutation in the JAK2 gene

Answer 30

Polycythemia Vera

Question 31

Caused by increase in RBC production due to an appropriate rise in erythropoietin (EPO) levels

Answer 31

Secondary polycythemia

Question 32

Lab Diagnosis for Polycythemia

Answer 32

Complete Blood Count (CBC) Peripheral Blood Smear Erythropoietin (EPO) Test JAK2 Mutation Analysis

Question 33

is classified as hypochromic microcytic anemia due to lack of ferrous iron that forms the heme structure of hemoglobin.

Answer 33

Iron Deficiency Anemia