p.7
Differential Diagnosis of Anemia
What does a hematocrit level of 20% indicate?
It indicates anemia as RBCs are less.
p.41
Laboratory Tests and Diagnostic Methods
What are the two types of hemoglobin electrophoresis?
Cellulose acetate electrophoresis (pH 8.4) and citrate electrophoresis (pH 6.2).
p.42
Hemolytic Anemias and Their Classification
What does the graph show regarding hemoglobin?
Different peaks for different types of hemoglobin based on elution time.
p.8
Laboratory Tests and Diagnostic Methods
What is the purpose of the capillary tube in blood sampling?
To collect a blood sample and observe how much has settled.
p.30
Hemolytic Anemias and Their Classification
What vaccinations are recommended prior to splenectomy?
Vaccination against encapsulated organisms.
p.27
Cellularity and Aging
What is the inheritance pattern of hereditary spherocytosis (HS)?
Mostly autosomal dominant (ankyrin) and rarely autosomal recessive (spectrin).
p.22
Differential Diagnosis of Anemia
What is a characteristic finding in hypochromic anemia?
Presence of macrocytes and macroovalocytes.
p.25
Iron Metabolism and Deficiency Anemia
What is the role of folic acid in the conversion of histidine?
Folic acid is used to convert FIGLU to glutamate.
p.4
Staining Techniques for Blood Analysis
Why should alcohol not be used in staining reticulocytes?
Because RNA will vanish, hence no methanol fixation.
p.40
Sickle Cell Anemia and Thalassemia
What is the purpose of the Sickling Test?
To differentiate between a normal case and a case of sickle cell disease.
p.31
Hemolytic Anemias and Their Classification
What are spherocytes associated with?
AIHA, HS, and G6PD deficiency.
p.2
Erythropoiesis and Red Blood Cell Development
What type of cells are red blood cells?
They are without a nucleus.
p.6
Laboratory Tests and Diagnostic Methods
What does an up-to-down reading indicate in Wintrobe's tube?
Erythrocyte Sedimentation Rate (ESR).
p.10
Iron Metabolism and Deficiency Anemia
What indicates hypochromia in RBCs?
More than normal central pallor, appearing wide.
p.16
Differential Diagnosis of Anemia
What causes Sideroblastic Anemia?
Enzyme deficiencies or vitamin B6 deficiency.
What is a risk factor associated with atrophic gastritis due to pernicious anemia?
Increased risk for gastric adenocarcinoma.
p.34
Laboratory Tests and Diagnostic Methods
What does the Gel Card Analysis Test consist of?
CD59, CD55, and a control.
p.14
Iron Metabolism and Deficiency Anemia
What blood findings are associated with iron deficiency anemia?
Low Hb, Low MCV, Low MCH, Low MCHC, High RDW.
p.12
Erythropoiesis and Red Blood Cell Development
What is the marker of erythropoiesis?
Increase in serum levels of Transferrin receptor.
p.9
Laboratory Tests and Diagnostic Methods
What does MCH stand for?
Mean Corpuscular Hemoglobin.
p.6
Laboratory Tests and Diagnostic Methods
How is the Erythrocyte Sedimentation Rate (ESR) measured?
In mm/hr, not in percentage.
p.27
Cellularity and Aging
What are the defects associated with Band 5?
Specific defects related to red blood cell structure.
p.3
Erythropoiesis and Red Blood Cell Development
What is the significance of the nucleus in the stages of red blood cell development?
All blast phases have a nucleus, but mature red blood cells do not.
p.1
Bone Marrow Biopsy and Aspirate Techniques
What is a Dry Tap in bone marrow aspiration?
When the syringe only has air and no material.
p.3
Erythropoiesis and Red Blood Cell Development
When does hemoglobin first appear in red blood cell development?
In the very first cell, but only visible under an electron microscope.
p.19
Iron Metabolism and Deficiency Anemia
What cells release intrinsic factor?
Parietal cells of the stomach.
p.33
Laboratory Tests and Diagnostic Methods
What screening tests are not commonly used nowadays for PNH?
Ham's acidified serum test and sucrose lysis test.
p.36
Laboratory Tests and Diagnostic Methods
What is the LAP score in PNH?
The absence of anchors reduces the LAP (Leukocyte alkaline phosphatase) score.
p.7
Laboratory Tests and Diagnostic Methods
What is the purpose of the Westergren pipette?
It is used only for measuring ESR (Erythrocyte Sedimentation Rate).
p.25
Iron Metabolism and Deficiency Anemia
What happens to FIGLU when there is no folate available?
FIGLU is excreted via urine.
p.31
Hemolytic Anemias and Their Classification
What happens to red blood cells (RBCs) in G6PD deficiency?
The spleen starts destroying RBCs, producing spherocytes.
p.33
Hemolytic Anemias and Their Classification
What type of defect is PNH classified as?
An acquired intracorpuscular defect.
p.40
Sickle Cell Anemia and Thalassemia
What is the first step in performing the Sickling Test?
Take a clean slide and add a drop of blood.
p.4
Reticulocyte Count and Indices
What is the corrected reticulocyte count (CRC) formula?
CRC = RC × Hb of patients / Hb of a normal person (15).
p.30
Hemolytic Anemias and Their Classification
What is G6PD deficiency?
An X-linked recessive enzyme defect.
p.41
Laboratory Tests and Diagnostic Methods
What does it indicate if hemoglobin is present towards both anode and cathode?
HbAS (sickle cell trait).
p.8
Erythropoiesis and Red Blood Cell Development
What is the significance of the hematocrit or PCV?
It indicates the proportion of blood volume occupied by red blood cells.
p.10
Hemolytic Anemias and Their Classification
What does the presence of pencil cells indicate?
Poikilocytosis is present.
p.22
Differential Diagnosis of Anemia
What are the main components associated with blood problems in the picture?
RBC (Red Blood Cells) and WBC (White Blood Cells).
p.22
Differential Diagnosis of Anemia
What are Howell-Jolly bodies?
Dot-like structures on RBCs composed of DNA or nuclear remnants.
What is gastrectomy associated with in terms of intrinsic factor?
It leads to a lack of intrinsic factor.
p.22
Differential Diagnosis of Anemia
What are Cabot rings?
Structures seen in RBCs, often associated with certain anemias.
p.2
Staining Techniques for Blood Analysis
What stains are commonly used in liquid cases?
Giemsa or Leishman stain.
p.33
Hemolytic Anemias and Their Classification
What is PNH an acronym for?
Paroxysmal Nocturnal Hemoglobinuria.
p.5
Reticulocyte Count and Indices
What does an RPI less than 2 indicate?
Decreased bone marrow activity.
p.6
Laboratory Tests and Diagnostic Methods
What does a down-to-up reading indicate in Wintrobe's tube?
Packed Cell Volume (PCV).
p.3
Erythropoiesis and Red Blood Cell Development
What happens to the size of the cell as it develops from Pronormoblast to Erythrocyte?
The overall size of the cell decreases.
p.30
Hemolytic Anemias and Their Classification
What are common precipitating factors for G6PD deficiency?
Favabeans, infections, and certain drugs like anti-malarials.
p.18
Differential Diagnosis of Anemia
In a patient with severe alcohol intoxication and microcytic anemia, what are the expected findings for ferritin, TIBC, and serum iron?
Ferritin: High, TIBC: Low, Serum Iron: Low.
p.26
Hemolytic Anemias and Their Classification
What happens during Intravascular Hemolysis (IVH)?
Hemoglobin leaks out of damaged blood vessels and combines with haptoglobin, reducing serum haptoglobin levels.
p.9
Differential Diagnosis of Anemia
What is anisocytosis?
Variation in the size of RBCs.
p.25
Iron Metabolism and Deficiency Anemia
What does histidine convert to in folate deficiency?
FIGLU (Formiminoglutamic acid).
p.31
Hemolytic Anemias and Their Classification
What does oxidative stress cause in G6PD deficiency?
Denaturation of hemoglobin and formation of Heinz bodies.
p.5
Reticulocyte Count and Indices
What does an RPI greater than 3 indicate?
Increased bone marrow activity.
p.9
Laboratory Tests and Diagnostic Methods
What does MCHC stand for?
Mean Corpuscular Hemoglobin Concentration.
p.41
Laboratory Tests and Diagnostic Methods
Which hemoglobins can be differentiated using citrate electrophoresis?
Hemoglobin S and Hemoglobin D.
p.28
Hemolytic Anemias and Their Classification
What is the inheritance pattern of Hereditary Spherocytosis (HS)?
Autosomal dominant (70%) and autosomal recessive.
p.16
Erythropoiesis and Red Blood Cell Development
What is the role of Ferrochelatase in heme formation?
It helps in the fusion of iron and protoporphyrin.
p.14
Iron Metabolism and Deficiency Anemia
What is Plummer-Vinson Syndrome also known as?
Patterson Kelly Brown syndrome.
p.37
Sickle Cell Anemia and Thalassemia
What happens to hemoglobin when glutamic acid is replaced by valine?
HbA changes to sickled hemoglobin (HbS).
p.9
Laboratory Tests and Diagnostic Methods
What does RDW measure?
Variation in the size of Red Blood Cells.
p.11
Differential Diagnosis of Anemia
What type of anemia is characterized by microcytic and hypochromic features?
Microcytic Hypochromic Anemia.
p.14
Iron Metabolism and Deficiency Anemia
What does a high RDW indicate?
Variation in red blood cell size (anisocytosis).
p.2
Erythropoiesis and Red Blood Cell Development
What is erythropoiesis?
The production of red blood cells.
p.14
Iron Metabolism and Deficiency Anemia
What is the appearance of red blood cells in iron deficiency anemia?
Microcytic and hypochromic.
p.20
Iron Metabolism and Deficiency Anemia
What infection is associated with megaloblastic anemia?
Diphyllobothrium latum (fish tapeworm).
p.36
Laboratory Tests and Diagnostic Methods
Do I have to take the Meningococcal vaccine before taking Eculizumab?
Yes, the vaccine acts as prophylaxis against meningococcal infection.
p.7
Differential Diagnosis of Anemia
What hematocrit level suggests polycythemia?
A PCV/hematocrit of 55-60%.
p.22
Differential Diagnosis of Anemia
In which conditions are Howell-Jolly bodies commonly seen?
Megaloblastic anemia and post-splenectomy.
p.7
Laboratory Tests and Diagnostic Methods
How is the Westergren pipette different from a test tube?
It is open from both sides.
p.16
Differential Diagnosis of Anemia
What is the main difference between IDA and AOCD?
IDA has low ferritin, while AOCD has high ferritin.
p.44
Sickle Cell Anemia and Thalassemia
What happens to the beta chains in Thalassemia Major?
There are no beta chains available for alpha chains to combine with.
What is packed cell volume (PCV)?
The volume of red blood cells after centrifugation, roughly 45%.
p.6
Laboratory Tests and Diagnostic Methods
What is the purpose of Wintrobe's tube?
Used for estimation of PCV/Hematocrit and assessing the ESR.
p.32
Laboratory Tests and Diagnostic Methods
What is the screening test for G6PD deficiency mentioned in the text?
Methemoglobin reduction test.
p.44
Differential Diagnosis of Anemia
What are the typical laboratory findings in Thalassemia Major?
Increased HbF, increased RBC count, but decreased Hb levels.
p.37
Sickle Cell Anemia and Thalassemia
What factors contribute to sickling in sickle cell anemia?
Amount of HbS and HbA, dehydration, hypoxia, and less oxygen-rich environments.
p.1
Differential Diagnosis of Anemia
What is Myelophthisic anemia?
Anemia where something is embedded in the marrow, like metastasis or TB.
p.23
Cellularity and Aging
What is arginine used for in the killing mechanism?
In the formation of NETs (Neutrophil Extracellular Traps).
p.37
Sickle Cell Anemia and Thalassemia
What is the role of fetal hemoglobin (HbF) in sickle cell anemia?
Higher levels of HbF can reduce sickling.
p.23
Differential Diagnosis of Anemia
What does basophilic stippling indicate in cells?
Cells have a dotted appearance.
p.23
Differential Diagnosis of Anemia
What is a macrocyte?
A type of red blood cell that is larger than normal.
p.27
Hemolytic Anemias and Their Classification
What types of hemolysis are enzyme defects seen in?
Both Extravascular Hemolysis and Intravascular Hemolysis.
p.5
Reticulocyte Count and Indices
What is the Reticulocyte Production Index (RPI) formula?
RPI = CRC / Maturation Time.
p.3
Erythropoiesis and Red Blood Cell Development
What are the first four stages of red blood cell development present in the bone marrow?
Pronormoblast, Early Normoblast (Basophilic Normoblast), Intermediate Normoblast (Polychromatophilic Normoblast), Late Normoblast (Orthochromic Normoblast).
p.37
Sickle Cell Anemia and Thalassemia
What are the main types of hemoglobin in adults?
Adult hemoglobin (HbA), HbA2, and fetal hemoglobin (HbF).
p.30
Laboratory Tests and Diagnostic Methods
What can cause the shapes of blood cells to appear blurry in samples?
Prolonged exposure to EDTA.
p.19
Differential Diagnosis of Anemia
What mnemonic is used to remember the causes of macrocytic hypochromic anemia?
LHMC (Liver disorders, Hypothyroidism, Megaloblastic anemia, Chemotherapy drugs).
p.31
Differential Diagnosis of Anemia
What are the clinical features of G6PD deficiency?
Intermittent episodes, pallor, and jaundice.
p.44
Erythropoiesis and Red Blood Cell Development
What is the effect of increased HbF in Thalassemia Major?
Less oxygen reaches the tissues, stimulating the release of erythropoietin.
p.26
Hemolytic Anemias and Their Classification
What are the two types of hemolytic anemias?
Intravascular Hemolysis (IVH) and Extravascular Hemolysis (EVH).
p.1
Differential Diagnosis of Anemia
What could cause a Dry Tap during a bone marrow aspiration?
Conditions like Aplastic Anemia or Myelofibrosis.
p.33
Hemolytic Anemias and Their Classification
What happens to RBCs during nighttime in PNH?
They are broken down and eliminated via urination.
p.38
Sickle Cell Anemia and Thalassemia
How does increased oxygen affect sickling?
More oxygen results in less sickling.
p.24
Erythropoiesis and Red Blood Cell Development
What happens to the myeloid/erythroid ratio in erythroid hyperplasia?
There is a reversal of the M/E ratio.
p.38
Sickle Cell Anemia and Thalassemia
What type of genetic disease is sickle cell anemia?
Sickle cell anemia is an autosomal recessive disease.
p.42
Sickle Cell Anemia and Thalassemia
What chains make up adult hemoglobin?
Alpha (α) and beta (β) chains.
p.9
Differential Diagnosis of Anemia
What condition is indicated by elevated MCHC?
Hereditary Spherocytosis.
p.45
Erythropoiesis and Red Blood Cell Development
What does maxillary prominence indicate in the context of hematopoiesis?
Erythropoiesis occurring in bones.
p.41
Laboratory Tests and Diagnostic Methods
What does it indicate if hemoglobin moves slower and stays at the cathode end?
HbS (sickle cell anemia).
p.31
Laboratory Tests and Diagnostic Methods
What factors are identified in the diagnosis of G6PD deficiency?
The precipitating factors.
p.34
Laboratory Tests and Diagnostic Methods
What occurs when the patient's blood is added to the Gel Card?
An antigen-antibody reaction forms a complex.
What are the RBC indices typically seen in pernicious anemia?
Low hemoglobin, high MCV (>100 fL), high MCH, and normal MCHC.
p.30
Hemolytic Anemias and Their Classification
What features of chronicity are not seen in G6PD deficiency?
Splenomegaly and gallstones.
p.28
Hemolytic Anemias and Their Classification
What is the lifespan of RBCs in patients with HS?
10-20 days (normal is 120 days).
p.24
Iron Metabolism and Deficiency Anemia
What biochemical findings are associated with ineffective erythropoiesis?
Increased serum bilirubin and LDH, decreased vitamin B12, and increased homocysteine.
p.28
Hemolytic Anemias and Their Classification
What clinical features are associated with Hereditary Spherocytosis?
Pallor, jaundice, splenomegaly, and bile pigment gallstones.
p.32
Laboratory Tests and Diagnostic Methods
What is the significance of NADPH in the fluorescent spot test?
NADPH is autofluorescent and indicates normal G6PD function.
p.31
Hemolytic Anemias and Their Classification
What is the primary consequence of G6PD deficiency?
NADPH does not form, leading to oxidative stress.
p.31
Staining Techniques for Blood Analysis
How are Heinz bodies stained?
They are stained with Crystal violet stains.
p.14
Iron Metabolism and Deficiency Anemia
What is Pica?
Eating non-edible items (e.g., chalk, dirt).
p.40
Sickle Cell Anemia and Thalassemia
What substance is added to the blood in the Sickling Test to remove oxygen?
7% sodium dithionite or sodium metabisulfite.
p.14
Iron Metabolism and Deficiency Anemia
What are the three components of the triad in Plummer-Vinson Syndrome?
Sideropenic dysphagia, iron deficiency anemia, atrophic glossitis.
p.32
Laboratory Tests and Diagnostic Methods
What does sodium nitrite do in the methemoglobin reduction test?
Converts hemoglobin to methemoglobin (brown in color).
p.3
Erythropoiesis and Red Blood Cell Development
In which stage is hemoglobin visible under light microscopy?
In the Intermediate Normoblast (Polychromatophilic Normoblast).
p.11
Differential Diagnosis of Anemia
What are the four main types of microcytic hypochromic anemia?
Sideroblastic anemia, Iron deficiency anemia, Thalassemia, Anemia of chronic disease.
p.20
Iron Metabolism and Deficiency Anemia
What dietary factors can cause Vitamin B12 deficiency?
Vegetarian diet and increased demand during pregnancy, lactation, and growth.
p.19
Iron Metabolism and Deficiency Anemia
What happens to Vitamin B12 after ingestion?
It is separated from food by peptic enzymes and binds with haptocorrin.
p.39
Sickle Cell Anemia and Thalassemia
In which conditions is fish mouth vertebra observed?
Sickle cell anemia and osteoporosis.
p.2
Erythropoiesis and Red Blood Cell Development
What is referred to as the Erythroblastic Island?
A group of precursors surrounding a macrophage that provides iron.
p.19
Iron Metabolism and Deficiency Anemia
What is the importance of Vitamin B12 in the body?
It is crucial for thymidine production, which is important for nuclear maturation.
p.26
Hemolytic Anemias and Their Classification
What are the two classifications of hemolytic anemia defects?
Intra-corpuscular defects and Extra-corpuscular defects.
p.38
Sickle Cell Anemia and Thalassemia
What are some clinical features of sickle cell anemia?
Pallor, splenomegaly, jaundice, and vaso-occlusive crisis.
p.4
Reticulocyte Count and Indices
How are reticulocytes differentiated?
Based on the color given during staining.
p.42
Sickle Cell Anemia and Thalassemia
What is the effect of Hydroxyurea in the treatment of Sickle Cell Anemia?
It increases the level of fetal hemoglobin, thereby increasing oxygen affinity.
What are the three types of antibodies associated with pernicious anemia?
Type 1: Inhibits binding of B12 to intrinsic factor; Type 2: Inhibits binding of B12-IF to ileal cubilin receptors; Type 3: Antibodies against parietal cells.
p.2
Staining Techniques for Blood Analysis
What are the components of the staining solution mentioned?
Eosin Y (pink color) and Methylene Blue/Azure B (blue color).
p.9
Differential Diagnosis of Anemia
What is the diagnosis for a female with hemoglobin of 6.4 gm, MCV of 62 fl, MCH of 21 pg, and MCHC of 29 g/dL?
Microcytic Hypochromic Anemia.
p.20
Iron Metabolism and Deficiency Anemia
What neurological symptoms can arise from Vitamin B12 deficiency?
Due to decreased methionine production.
p.24
Erythropoiesis and Red Blood Cell Development
What is the characteristic finding in bone marrow during erythroid hyperplasia?
Hypercellularity (hyperplasia) with increased erythroid cells.
p.40
Sickle Cell Anemia and Thalassemia
What characteristic of sickle cells is observed in the Solubility Test?
Sickle cells are sticky and have less solubility.
p.18
Differential Diagnosis of Anemia
What type of stain is used to identify Pappenheimer bodies?
Perl's Prussian blue stain.
p.34
Laboratory Tests and Diagnostic Methods
What indicates a positive test in the Gel Card Analysis for PNH?
Presence of CD59 and CD55, with blood stopping at the top.
p.35
Hemolytic Anemias and Their Classification
What is PNH classified as?
A pre-neoplastic condition.
p.38
Sickle Cell Anemia and Thalassemia
What are the types of hemoglobin related to sickle cell disease?
HbAA (Normal), HbAS (Heterozygous), HbSS (Homozygous).
p.19
Iron Metabolism and Deficiency Anemia
What is the role of transcobalamin II?
It transports absorbed Vitamin B12.
p.35
Laboratory Tests and Diagnostic Methods
What is a significant risk associated with Eculizumab?
Risk of meningococcal infection.
p.5
Reticulocyte Count and Indices
What does an increase in bone marrow production indicate for reticulocyte levels?
Reticulocytes will also increase.
p.5
Reticulocyte Count and Indices
What is the maturation time for reticulocytes in relation to hematocrit?
It takes 1-2 days to mature, depending on hematocrit levels.
p.25
Iron Metabolism and Deficiency Anemia
What is included in the treatment for folate deficiency?
Vitamin B12 and folic acid supplements.
What are common symptoms of pernicious anemia?
Fatigue, pallor, and hyperpigmentation.
p.16
Iron Metabolism and Deficiency Anemia
What does TIBC stand for in the context of anemia?
Total Iron Binding Capacity.
p.44
Erythropoiesis and Red Blood Cell Development
What is the consequence of the absence of beta chains in Thalassemia Major?
It leads to ineffective erythropoiesis and increases the load on the bone marrow.
What is the typical cellular composition in an elderly person with no disease?
Hardly 10% of cells present.
p.43
Sickle Cell Anemia and Thalassemia
What is the clinical feature of thalassemia major?
Always dependent on transfusion.
p.16
Laboratory Tests and Diagnostic Methods
What is the mnemonic for remembering TIBC?
T: Top in, I: IDA, B: Boiling in, C: Chronic disease.
p.41
Laboratory Tests and Diagnostic Methods
What is HPLC used for?
It is a standard test for any hemoglobin disorder.
p.44
Iron Metabolism and Deficiency Anemia
What happens to iron levels in Thalassemia Major patients?
Iron levels increase due to erythroid hyperplasia and repeated blood transfusions.
p.29
Hemolytic Anemias and Their Classification
What are the parameters indicating Hemolytic Anemia (HS)?
Reduced Hemoglobin, Reduced MCV, Variable MCH, Increased MCHC (water loss), Increased RDW (variation in size), Increased reticulocyte count.
p.23
Cellularity and Aging
What is the appearance of arginine-rich mitotic spindles?
They have a figure of 8 appearance.
p.44
Cellularity and Aging
What skeletal change is associated with increased erythropoiesis in Thalassemia Major?
Crew cut skull appearance.
p.32
Laboratory Tests and Diagnostic Methods
What indicates G6PD deficiency in the methemoglobin reduction test?
Brown color persists as methemoglobin is not converted to hemoglobin.
p.12
Erythropoiesis and Red Blood Cell Development
Where does the majority of iron go after absorption?
To mitochondria for hemoglobin production.
p.34
Laboratory Tests and Diagnostic Methods
What is the role of FLAER in diagnosing PNH?
It finds the root cause of PNH.
p.35
Erythropoiesis and Red Blood Cell Development
What type of mutation is associated with spectrin in HS?
Autosomal recessive mutation.
p.6
Laboratory Tests and Diagnostic Methods
What does EGR stand for in blood analysis?
Erythrocyte Sedimentation Rate.
p.7
Laboratory Tests and Diagnostic Methods
What does the Westergren pipette measure?
It measures how much the blood has fallen (ESR).
p.8
Erythropoiesis and Red Blood Cell Development
What are the classifications of MCV based on volume?
Less than 80 fL is microcytic, 80-100 fL is normocytic, and more than 100 fL is macrocytic.
p.10
Erythropoiesis and Red Blood Cell Development
What are microcytes?
Tiny cells smaller than lymphocytes.
p.8
Laboratory Tests and Diagnostic Methods
What are the stages of Erythrocyte Sedimentation Rate (ESR)?
Stage 1: Rouleaux formation, Stage 2: Sedimentation, Stage 3: Packing.
p.31
Staining Techniques for Blood Analysis
What is a characteristic feature of Heinz bodies under Romanowsky stains?
Denatured hemoglobin may not appear, producing bite cells (degmacytes).
p.44
Erythropoiesis and Red Blood Cell Development
What does the combination of alpha chains with gamma chains produce?
Fetal hemoglobin (HbF), which has a high affinity for oxygen.
p.10
Hemolytic Anemias and Their Classification
What is poikilocytosis?
Variation in the shape of red blood cells.
What are specific clinical features of vitamin B12 deficiency?
Neurological manifestations, including subacute combined degeneration (SACD) and degeneration of spinal tracts.
p.37
Sickle Cell Anemia and Thalassemia
What is the effect of dehydration on sickle cell anemia?
It increases the amount of sickling.
p.3
Erythropoiesis and Red Blood Cell Development
What is the timeline for the development of red blood cells from Pronormoblast to Reticulocyte?
Day 1: Pronormoblast, Day 2: Basophilic Normoblast, Day 3: Polychromatophilic Normoblast, Day 4: Normoblast, Day 5-7: Reticulocyte.
p.29
Laboratory Tests and Diagnostic Methods
What is the screening test for Hemolytic Anemia?
Pink's Osmotic Fragility Test.
p.16
Iron Metabolism and Deficiency Anemia
What is the relationship between iron deficiency and Sideroblastic Anemia?
If it lacks iron, it is called iron deficiency anemia.
p.28
Hemolytic Anemias and Their Classification
What is the most common cause for the presence of spherocytes?
Autoimmune Hemolytic Anemia (AIHA).
p.20
Iron Metabolism and Deficiency Anemia
What is the relationship between hookworm and anemia?
Hookworm can cause iron deficiency anemia.
p.38
Sickle Cell Anemia and Thalassemia
What leads to irreversible sickling?
Repeated episodes of reversible sickling.
p.24
Iron Metabolism and Deficiency Anemia
What clinical feature distinguishes folate deficiency from vitamin B12 deficiency?
Neurological symptoms are not seen in folate deficiency.
p.11
Erythropoiesis and Red Blood Cell Development
What are the types of erythroblasts?
Early Erythroblasts, Intermediate Erythroblasts, Late Erythroblasts.
p.13
Iron Metabolism and Deficiency Anemia
What are some causes of iron deficiency anemia?
Inadequate iron intake, increased iron demand (pregnancy, lactation, growing child), and increased blood loss.
p.45
Erythropoiesis and Red Blood Cell Development
What is the term for hematopoiesis occurring in organs other than the bone marrow?
Extrabone marrow hematopoiesis.
p.42
Staining Techniques for Blood Analysis
What is the significance of elution time in the graph?
It helps identify different types of hemoglobin based on their peaks.
p.37
Sickle Cell Anemia and Thalassemia
What mutation causes sickle cell anemia?
A mutation at the 6th position of the beta-globin chain where glutamic acid is changed to valine.
p.33
Hemolytic Anemias and Their Classification
Which molecules are anchored by GPI anchors in PNH?
CD55/DAF, CD59/MIRL, C8 binding protein, and leukocyte alkaline phosphatase.
p.28
Hemolytic Anemias and Their Classification
What mutations are associated with autosomal dominant and recessive HS?
Autosomal dominant: ankyrin mutation; autosomal recessive: spectrin mutation.
p.45
Differential Diagnosis of Anemia
What is a peripheral smear used for in the context of thalassemia?
To analyze blood cell morphology.
p.28
Hemolytic Anemias and Their Classification
What happens to red blood cells (RBCs) with membrane defects in HS?
They pass through the spleen and are removed due to their shape.
p.16
Laboratory Tests and Diagnostic Methods
What happens when the denominator in the transferrin saturation ratio is high?
The total ratio will be less.
p.26
Hemolytic Anemias and Their Classification
What occurs when haptoglobin becomes saturated during IVH?
Hemoglobin combines with Hemopexin, which also gets saturated, leading to the formation of methemalbuminemia.
p.16
Erythropoiesis and Red Blood Cell Development
What is the significance of succinyl CoA in heme formation?
It forms ALA by ALA synthase.
p.32
Laboratory Tests and Diagnostic Methods
What happens in normal cases regarding methemoglobin conversion?
G6PD reverses the conversion of methemoglobin to hemoglobin.
p.2
Erythropoiesis and Red Blood Cell Development
What is the role of macrophages in red blood cell production?
They provide iron to erythroid precursors.
p.14
Iron Metabolism and Deficiency Anemia
What is poikilocytosis?
Variation in red blood cell shape, including pencil-like cells.
p.38
Sickle Cell Anemia and Thalassemia
What happens to red blood cells in the absence of oxygen and lower pH?
The shape of the cells changes into a sickle shape.
p.38
Sickle Cell Anemia and Thalassemia
What is reversible sickling?
Sickle-shaped cells revert back to their original shape in the presence of oxygen and normal pH levels.
p.38
Sickle Cell Anemia and Thalassemia
What causes splenomegaly in sickle cell anemia?
Due to extravascular hemolysis.
p.39
Sickle Cell Anemia and Thalassemia
What is the significance of the Erythrocyte Sedimentation Rate (ESR) in sickle cell anemia?
ESR is low because sickled cells do not settle down.
p.30
Hemolytic Anemias and Their Classification
What types of cells are present in post-splenectomy cases?
Spherocytes, echinocytes, acanthocytes, burr cells, and spike/spur cells.
p.7
Laboratory Tests and Diagnostic Methods
What is the difference between Wintrobe's tube and Westergren pipette?
The specific differences are not provided in the text.
What is atrophic glossitis also known as?
Beefy red tongue (smooth tongue).
p.10
Iron Metabolism and Deficiency Anemia
What is considered normal in RBCs regarding central pallor?
Central pallor is considered normal.
p.45
Erythropoiesis and Red Blood Cell Development
In which conditions is extramedullary hematopoiesis commonly seen?
Thalassemia and sickle cell anemia.
p.40
Sickle Cell Anemia and Thalassemia
Why is a coverslip used in the Sickling Test?
To prevent exposure to atmospheric oxygen.
p.33
Hemolytic Anemias and Their Classification
What is the clinical triad of PNH?
Hemolytic anemia, thrombosis, and pancytopenia/aplastic anemia.
p.40
Sickle Cell Anemia and Thalassemia
What limitation does the Sickling Test have?
It does not differentiate between sickle cell anemia and sickle cell trait.
p.38
Sickle Cell Anemia and Thalassemia
What is the affinity of fetal hemoglobin towards oxygen?
Fetal hemoglobin has a higher affinity towards oxygen.
p.28
Hemolytic Anemias and Their Classification
What leads to the formation of microspherocytes in HS?
Reduction in the surface area to volume ratio of RBCs.
p.12
Iron Metabolism and Deficiency Anemia
How is iron absorbed into the duodenal cell?
Via DMT1 (Divalent Metal Transporter).
p.26
Hemolytic Anemias and Their Classification
What is hemoglobinuria?
The elimination of hemoglobin in the kidneys during IVH.
p.14
Iron Metabolism and Deficiency Anemia
What happens to reticulocyte count in iron deficiency anemia?
It increases, but not in proportion to the degree of anemia.
p.24
Iron Metabolism and Deficiency Anemia
In which populations is folate deficiency commonly seen?
Alcoholics and pregnant women.
p.13
Iron Metabolism and Deficiency Anemia
What are some clinical presentations of iron deficiency anemia?
Fatigue, koilonychia (spoon-shaped nails), angular cheilitis/angulostomatitis.
p.32
Laboratory Tests and Diagnostic Methods
What role does methylene blue play in the methemoglobin reduction test?
Stimulates the pentose phosphate pathway, reducing methemoglobin.
p.37
Sickle Cell Anemia and Thalassemia
How does hypoxia affect sickle cell anemia?
It leads to more sickling.
p.34
Laboratory Tests and Diagnostic Methods
What indicates a negative test in the Gel Card Analysis for PNH?
Absence of CD59 and CD55, with blood flowing to the bottom.
p.35
Laboratory Tests and Diagnostic Methods
What is the pharmacological treatment for PNH?
Eculizumab (C5 Inhibitor).
p.39
Sickle Cell Anemia and Thalassemia
What is aplastic crisis associated with?
Parvovirus B19 infection.
p.29
Hemolytic Anemias and Their Classification
How does the osmotic fragility graph shift in HS patients?
Right shift due to high osmotic fragility (weak cells).
p.39
Sickle Cell Anemia and Thalassemia
What is the result of repeated sequestration crises in sickle cell anemia?
Auto-splenectomy due to decreased spleen size.
p.29
Hemolytic Anemias and Their Classification
How does the osmotic fragility graph shift in thalassemia patients?
Left shift due to low osmotic fragility (tougher cells).
p.35
Hemolytic Anemias and Their Classification
What are the complications of PNH?
Hemolytic anemia, thrombosis, aplastic anemia, and AML.
p.12
Erythropoiesis and Red Blood Cell Development
What happens to iron after it binds with transferrin?
It enters the bone marrow.
p.11
Iron Metabolism and Deficiency Anemia
What increases iron absorption?
Acidic pH (HCl, amino acids, ascorbic acid).
p.11
Iron Metabolism and Deficiency Anemia
What decreases iron absorption?
Alkaline pH (milk, phytate, tannins, tea, and coffee).
p.32
Laboratory Tests and Diagnostic Methods
What happens to NADPH production in G6PD deficiency?
NADPH is not produced, and fluorescence is not seen.
p.23
Differential Diagnosis of Anemia
What defines a hypersegmented neutrophil?
5% of neutrophils have 5 lobes or any neutrophil with 6 or more lobes.
p.13
Iron Metabolism and Deficiency Anemia
What is the most common nutritional deficiency in the country?
Iron deficiency anemia (IDA).
p.19
Iron Metabolism and Deficiency Anemia
Why is vegetarian food often deficient in Vitamin B12?
Because it is primarily found in animal products.
p.40
Sickle Cell Anemia and Thalassemia
What happens to the test tube during the Solubility Test?
It becomes turbid due to the formation of sickle cell polymers.
p.34
Laboratory Tests and Diagnostic Methods
Why is the Gel Card Analysis not a confirmatory test for PNH?
Due to the presence of a dual population of cells.
p.17
Erythropoiesis and Red Blood Cell Development
Where is iron present in ringed sideroblasts?
In the mitochondria, located in the perinuclear region.
p.17
Differential Diagnosis of Anemia
In which conditions are ringed sideroblasts commonly seen?
Sideroblastic anemia and myelodysplastic syndrome.
p.29
Laboratory Tests and Diagnostic Methods
What is the confirmatory test for Hemolytic Anemia?
EMA (Eosin 5' Maleimide) test.
p.26
Hemolytic Anemias and Their Classification
What is produced during the breakdown of heme in EVH?
Biliverdin, which is then converted to unconjugated bilirubin.
p.14
Iron Metabolism and Deficiency Anemia
What are the findings in iron studies for iron deficiency anemia?
Low serum iron, low transferrin saturation, low ferritin.
p.26
Hemolytic Anemias and Their Classification
What are some inherited intra-corpuscular defects?
Membrane defects (e.g., Hereditary spherocytosis), enzyme defects (e.g., G6PD deficiency), and hemoglobinopathies (e.g., Sickle cell anemia).
p.23
Differential Diagnosis of Anemia
What is hypersegmentation of neutrophils?
It is observed when neutrophils have more than the normal 3 to 5 lobes.
p.29
Hemolytic Anemias and Their Classification
What happens to RBCs during EKTAC cytometry?
They are subjected to stress and break due to weakness.
p.24
Differential Diagnosis of Anemia
What is the purpose of the Schilling Test?
To find the cause of megaloblastic anemia.
p.23
Differential Diagnosis of Anemia
What is the ultimate presentation of megaloblastic anemia?
Pancytopenia, with low RBC, WBC, and platelet counts.
p.39
Sickle Cell Anemia and Thalassemia
In which condition are sickle-shaped cells absent?
Absent in sickle cell trait.
p.34
Laboratory Tests and Diagnostic Methods
What is the purpose of flow cytometry in confirmatory tests for PNH?
To detect CD55 and CD59 and identify dual populations of cells.
p.23
Differential Diagnosis of Anemia
What are Howell-Jolly bodies associated with?
They are findings in RBCs.
p.26
Hemolytic Anemias and Their Classification
What is Paroxysmal Nocturnal Hemoglobinuria (PNH)?
An acquired defect leading to intravascular hemolysis.
p.35
Hemolytic Anemias and Their Classification
What crises are found in HS?
Aplastic crisis (Parvovirus B19) and hemolytic crisis (EBV).
p.13
Iron Metabolism and Deficiency Anemia
What is one of the functions of Hepcidin?
Inhibits iron absorption by inhibiting ferroportin.
p.28
Hemolytic Anemias and Their Classification
What are the two types of crises associated with HS?
Aplastic crisis (Parvovirus B19) and hemolytic crisis (EBV).
p.39
Sickle Cell Anemia and Thalassemia
What happens during sequestration crisis in sickle cell anemia?
All sickle cells are sequestered into the spleen, leading to multiple splenic infarcts.
p.26
Hemolytic Anemias and Their Classification
What is Autoimmune Hemolytic Anemia (AIHA)?
A type of acquired hemolytic anemia.
p.39
Sickle Cell Anemia and Thalassemia
What happens to the reticulocyte count in sickle cell anemia?
Reticulocyte count increases.
p.13
Iron Metabolism and Deficiency Anemia
What are the three stages of iron deficiency anemia?
Stage 1: Decreased storage (decrease in ferritin); Stage 2: Iron deficiency erythropoiesis (deranged iron profile); Stage 3: Iron deficiency anemia (microcytic hypochromic anemia).
p.38
Sickle Cell Anemia and Thalassemia
What can vaso-occlusive crisis affect?
It can affect different organs, such as causing stroke in the brain and myocardial infarction in the heart.
p.11
Erythropoiesis and Red Blood Cell Development
What happens to transferrin receptors in early erythroid precursors?
Increased transferrin receptors are present to facilitate hemoglobin production.
p.35
Laboratory Tests and Diagnostic Methods
What does Eculizumab inhibit?
The complement system and the Membrane Attack Complex (MAC).
