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  1. Exam 3 review

  2. Three Ways to Get Anemic Loseblood Destroy too much blood • Extracorpuscular reasons • Intracorpuscular reasons Make too little blood • Too few building blocks • Too few erythroblasts • Not enough room

  3. We went through 10 anemias (11 if you count warm and cold autoimmune hemolytic anemia separately). The next 11 slides are representative slides for each anemia, one slide per anemia. You might use them to jog your memory to see how much you remember about each type.

  4. Reticulocytes

  5. Red cells snagged on fibrin strand

  6. Warm AIHA

  7. Cold AIHA

  8. Sickle cell anemia

  9. α β γ δ birth Hgb F = α2γ2 Hgb A2 = α2δ2 Hgb A = α2β2 Hemoglobin chain development

  10. z

  11. G6PD deficiency: Heinz bodies

  12. Iron-deficiency anemia

  13. Megaloblastic anemia

  14. Empty bone marrow in aplastic anemia

  15. Which of the following red cell indices tells you how much hemoglobin is in an average red cell? A. RBC B. Hgb C. MCHC D. Hct (hematocrit) E. MCV

  16. Complete Blood Count (CBC) MCV MCHC hypochromic normochromic microcytic normocytic macrocytic

  17. What does it mean if a patient’s red cells have a lot of poikilocytosis? A. They vary a lot in size B. They have Heinz bodies C. They vary a lot in shape D. They have a lot of hemoglobin E. They are very immature

  18. Additional Red Blood Cell Properties Size variation Shape anisocytosis poikilocytosis

  19. Which anemia is characterized by the presence of these cells, called schistocytes? A. Microangiopathic hemolytic anemia B. G6PD deficiency C. Thalassemia D. Sickle cell anemia

  20. Which anemia is characterized by these inclusions, called Heinz bodies? A. Microangiopathic hemolytic anemia B. G6PD deficiency C. Thalassemia D. Sickle cell anemia

  21. What is the defect in this disorder? A. A point mutation in a beta chain gene B. A translocation between chromosomes 9 and 22 C. Absence of one or more beta chain genes D. A membrane defect that renders the cells fragile and non pliable

  22. What is the diagnosis? A. Iron-deficiency anemia B. Megaloblastic anemia C. Hereditary spherocytosis D. Warm autoimmune hemolytic anemia E. G6PD deficiency

  23. Your healthy, 15-year-old brother was found to have an abnormality on his blood smear during a routine sports physical for school. His indices are as follows: The most likely diagnosis is: A. Iron-deficiency anemia B. Thalassemia C. Megaloblastic anemia D. Aplastic anemia E. Acute myeloid leukemia RBC 7.0 x 1012/L (4.5-6.0)WBC 10 x 109/L (4-11) Plt 300 x 109/L (150-450) Hgb 10 g/dL (12-16) MCV 75 fL(80-100)

  24. What’s this called?

  25. What’s wrong with this cell? What’s wrong with the patient?

  26. What do these things signify?

  27. What’s this called?

  28. What is this called?

  29. What kind of cell is this? What is most likely wrong with this patient?

  30. How would you tell which one is benign?

  31. How could you tell which one was malignant?

  32. Leukemias Hematologic Malignancies • Acute leukemias • Chronic leukemias Lymphomas • Hodgkin lymphoma • Non-Hodgkin lymphoma Plasma cell disorders • Multiple myeloma

  33. Leukemias Hematologic Malignancies • Acute leukemias • Chronic leukemias

  34. Leukemias Hematologic Malignancies • Acute leukemias

  35. Acute myeloid leukemia Acute lymphoblastic leukemia

  36. Acute leukemia: bone marrow biopsy

  37. What is this cell?

  38. What is this cell?

  39. If this patient has an acute leukemia, what kind is it, most likely?

  40. ALL B-lineage ALL T-lineage ALL B-cell precursor ALL B-cell ALL

  41. What type of leukemia/lymphoma is this?

  42. Leukemias Hematologic Malignancies • Acute leukemias • Chronic leukemias

  43. What’s the translocation in this leukemia?

  44. What’s this disorder?

  45. What disorder is likely in this patient?