Hematology Exam 2 study guide

given results for RBC, Hb, Hct, MCV, MCH, RDW, retic count, serum iron, TIBC, ferritin. Serum B12 and RBC folate, be able to identify the typical tests results for the following anemia

IDA - low serum iron, MCV low, MCHC low, MCV low, increased TIBC, ferritin is low, Hb and Hct is low, increased RDW, retic count low

B12 and Folic acid deficiency - low RBC, Hb, Hct, serum b12, high MCV, increased RDW, TIBC decreased, serum iron decreased, normal retic count, ferritin levels are normal to increased

beta thalassemia - low MCV, low MCHC, low serum iron, TIBC low to normal, increased HgbA2, increased RBC, increased RDW, low MCH, ferritin normal to increased

anemia of chronic disease - low serum iron, increased/N ferritin, decreased TIBC, decreased MCV/MCHC

sideroblastic anemia - decreased MCHC and MCV, increased iron, decreased to normal TIBC, increased ferritin,

list arrange and match the anemia according to their cause

4 causes for vitamin b12 deficiency anemia

• dietary deficiency

• impaired absorption

• malabsorption

• competitive parasitism

• increased requirements

name the antibodies associated in patients with pernicious anemia

Anti-IF and Anti-PC

reticulocyte results seen in pernicious anemia and iron deficiency anemia

pernicious anemia - reticulocyte count is less than 2%, absolute retic count is low

iron deficiency → reticulocyte count and absolute number of retic can be normal or even slightly increased, but retic count is decreased relative to severity of anemia with RPI less than 2

identify or name specific confirmatory lab tests for specific anemia:

sickle cell disease/trait -

reticulocyte counts with hemolytic anemia

G6PD deficiency and Heinze body preps

iron and TIBC testing

Ferritin testing

Bilirubin tests

describe the absorption of vitamin b12 and identify the factors necessary for vitamin b12 absorption and transport

released from food in the stomach and bound to haptocorrin

• released in small intestine with assistance from pancreatic proteases

• bound by intrinsic factor and then able to be absorbed by enterocytes

• released from intrinsic factor and bound to transcobalamin → moves to circulation

transcobalamin II is necessary as a major transport protein of cobalamin in the plasma

intrinsic factor is also necessary for absorption