UNDERSTANDING PATHOPHYSIOLOGY
CHAPTER 40 UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS
◉ Granulocytes.
Answer: Basophils, neutrophils, and eosinophils.
◉ Anemia (definition).
Answer: A reduction in the number or volume of circulating RBCs, or
a decrease in the quality or quantity of hemoglobin. Results in
decreased O2-carrying capacity, leading to hypoxemia.
◉ Three general causes of anemia.
Answer: Impaired RBC production; acute or chronic blood loss;
increased RBC destruction.
◉ How anemias are classified (most common).
Answer: By change in cell SIZE (suffix -cytic) and change in
HEMOGLOBIN content (suffix -chromic).
◉ Size classifications of anemia.
Answer: Macrocytic, normocytic, microcytic.
,◉ Hemoglobin content classifications of anemia (-chromic suffix).
Answer: Normochromic (normal hemoglobin content) and
hypochromic (decreased hemoglobin content).
◉ Anisocytosis.
Answer: RBCs present in various SIZES.
◉ Poikilocytosis.
Answer: RBCs present in various SHAPES.
◉ General symptoms of anemia.
Answer: Fatigue, weakness, dyspnea, pallor.
◉ Clinical manifestations of anemia (from decreased O2 delivery /
hypoxemia).
Answer: Fatigue, dyspnea, syncope, angina, compensatory
tachycardia, and organ dysfunction. Manifestations can occur in all
organs and tissues.
◉ Macrocytic anemia (aka).
Answer: Megaloblastic anemia.
,◉ Macrocytic / megaloblastic anemia - characteristic cells.
Answer: Abnormally large stem cells in the marrow that mature into
very large erythrocytes.
◉ Macrocytic anemia - mechanism.
Answer: Defective DNA synthesis, secondary to B12 or folate
deficiency (coenzymes for nuclear maturation and DNA synthesis).
RNA processes occur at a normal rate.
◉ Most common cause of macrocytic anemia.
Answer: Vitamin B12 deficiency.
◉ Pernicious anemia (definition).
Answer: The specific name for megaloblastic anemia secondary to
decreased B12 absorption; the most common type of macrocytic
anemia. Can be fatal unless B12 is replaced (lifelong).
◉ Vitamin B12 (aka).
Answer: Cobalamin.
◉ Cause of pernicious anemia.
Answer: Lack of intrinsic factor (IF) from the gastric parietal cells.
, ◉ Role of intrinsic factor (IF).
Answer: IF binds B12 from the diet in the stomach; it is needed for
B12 absorption.
◉ Why gastric bypass / stomach removal causes macrocytic anemia.
Answer: Removal of the stomach = removal of intrinsic factor, which
is needed for B12 absorption.
◉ Pernicious anemia - symptom onset.
Answer: Nonspecific at first; appear when hemoglobin reaches
about 7-8 g/dL.
◉ Pernicious anemia - symptoms (at Hgb 7-8 g/dL).
Answer: Weakness, fatigue, paresthesias, difficulty walking, loss of
appetite, abdominal pain, neurologic manifestations.
◉ Pernicious anemia - treatment.
Answer: Parenteral B12 injections (bypasses stomach absorption);
lifelong replacement required.
◉ Folate (aka).
Answer: Vitamin B9.
CHAPTER 40 UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS
◉ Granulocytes.
Answer: Basophils, neutrophils, and eosinophils.
◉ Anemia (definition).
Answer: A reduction in the number or volume of circulating RBCs, or
a decrease in the quality or quantity of hemoglobin. Results in
decreased O2-carrying capacity, leading to hypoxemia.
◉ Three general causes of anemia.
Answer: Impaired RBC production; acute or chronic blood loss;
increased RBC destruction.
◉ How anemias are classified (most common).
Answer: By change in cell SIZE (suffix -cytic) and change in
HEMOGLOBIN content (suffix -chromic).
◉ Size classifications of anemia.
Answer: Macrocytic, normocytic, microcytic.
,◉ Hemoglobin content classifications of anemia (-chromic suffix).
Answer: Normochromic (normal hemoglobin content) and
hypochromic (decreased hemoglobin content).
◉ Anisocytosis.
Answer: RBCs present in various SIZES.
◉ Poikilocytosis.
Answer: RBCs present in various SHAPES.
◉ General symptoms of anemia.
Answer: Fatigue, weakness, dyspnea, pallor.
◉ Clinical manifestations of anemia (from decreased O2 delivery /
hypoxemia).
Answer: Fatigue, dyspnea, syncope, angina, compensatory
tachycardia, and organ dysfunction. Manifestations can occur in all
organs and tissues.
◉ Macrocytic anemia (aka).
Answer: Megaloblastic anemia.
,◉ Macrocytic / megaloblastic anemia - characteristic cells.
Answer: Abnormally large stem cells in the marrow that mature into
very large erythrocytes.
◉ Macrocytic anemia - mechanism.
Answer: Defective DNA synthesis, secondary to B12 or folate
deficiency (coenzymes for nuclear maturation and DNA synthesis).
RNA processes occur at a normal rate.
◉ Most common cause of macrocytic anemia.
Answer: Vitamin B12 deficiency.
◉ Pernicious anemia (definition).
Answer: The specific name for megaloblastic anemia secondary to
decreased B12 absorption; the most common type of macrocytic
anemia. Can be fatal unless B12 is replaced (lifelong).
◉ Vitamin B12 (aka).
Answer: Cobalamin.
◉ Cause of pernicious anemia.
Answer: Lack of intrinsic factor (IF) from the gastric parietal cells.
, ◉ Role of intrinsic factor (IF).
Answer: IF binds B12 from the diet in the stomach; it is needed for
B12 absorption.
◉ Why gastric bypass / stomach removal causes macrocytic anemia.
Answer: Removal of the stomach = removal of intrinsic factor, which
is needed for B12 absorption.
◉ Pernicious anemia - symptom onset.
Answer: Nonspecific at first; appear when hemoglobin reaches
about 7-8 g/dL.
◉ Pernicious anemia - symptoms (at Hgb 7-8 g/dL).
Answer: Weakness, fatigue, paresthesias, difficulty walking, loss of
appetite, abdominal pain, neurologic manifestations.
◉ Pernicious anemia - treatment.
Answer: Parenteral B12 injections (bypasses stomach absorption);
lifelong replacement required.
◉ Folate (aka).
Answer: Vitamin B9.
