MMSC 433 Final Exam with accurate detailed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
solutions
iron absorption - correct answer✔✔-ferric iron is taken in from diet
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferric iron is reduced by duodenal cytochrome B to become ferrous iron
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferrous iron is absorbed into enterocytes by DMT 1 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-absorbed iron is stored as ferritin, or sent into portal hepatic circulation and carried by
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
transferrin to developing RBCs ||//\\|| ||//\\|| ||//\\||
transferrin - correct answer✔✔plasma carrier protein for ferrous iron ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
high iron level regulation - correct answer✔✔-hepcidin is released from hepatocytes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferroportin is inactivated, leading to decreased iron being transported into circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
low iron level regulation - correct answer✔✔-hepcidin is down regulated by hepatocytes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferroportin becomes activated and transports iron out of the enterocytes and into circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
ferrous iron - correct answer✔✔the form of iron that is able to be utilized in the body for
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
developing red cells ||//\\|| ||//\\||
prussian blue stain - correct answer✔✔stain that is used to identify iron in tissues and bone
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
marrow
stage 1 iron deficiency (progressive loss of storage iron) - correct answer✔✔-asymptomatic
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-RBCs develop normally ||//\\|| ||//\\||
-*serum ferritin low* ||//\\|| ||//\\||
,stage 2 iron deficiency (exhaustion of iron storage pool) - correct answer✔✔-subclinical
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
symptoms
-hemoglobin in retics is decreased, *hemogram appears normal still* ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-iron deficiency erythropoiesis is occurring
||//\\|| ||//\\|| ||//\\|| ||//\\||
-hepcidin decreased ||//\\||
-serum iron and ferritin decreased ||//\\|| ||//\\|| ||//\\|| ||//\\||
-RDW, TIBC and sTRs increased ||//\\|| ||//\\|| ||//\\|| ||//\\||
-prussian blue stain of BM is negative for iron ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
stage 3 iron deficiency (frank anemia) - correct answer✔✔-patient exhibits fatigue, weakness,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
pallor, glossitis, koilonychia and pica
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-*H/H decreased* ||//\\||
-*hypochromic/ microcytic anemia* ||//\\|| ||//\\||
-FEP, TIBC and sTR increased
||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferritin, hepcidin and serum iron decreased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
sideroblastic anemia - correct answer✔✔-iron deposits in the mitochondria of erythroblast ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cells in the bone marrow interfere with biosynthesis of heme
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-caused by genetic inheritance, drugs/ bone marrow toxins (*lead*, antibiotics,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
chemotherapeutics)
-*ringed sideroblasts* are highly indicative of the disease ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-basophillic stippling is common in lead poisoning ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-normocytic normochromic cells ||//\\|| ||//\\||
iron deficiency anemia (IDA) - correct answer✔✔-caused by inadequate intake, increased
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
need or malabsorption of iron, poor diet or chronic blood loss
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-symptoms: fatigue, weakness, pallor, spooning of the nails (koilonychia) and pica ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,-*H/H decreased* ||//\\||
-microcytic, hypochromic cells ||//\\|| ||//\\||
-marked poikilocytosis (target cells, spherocytes, tear drop cells and schistocytes)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-FEP, sTR and TIBC increased
||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferritin, hepcidin and serum iron decreased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anemia of chronic inflammation - correct answer✔✔-anemia occurring secondary to
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
underlying condition (chronic inflammatory disease, chronic infection or malignancy) that ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
causes release of cell products ||//\\|| ||//\\|| ||//\\|| ||//\\||
-hepcidin, lactoferrin and inflammatory cytokines cause decreased iron status and anemia ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-low Hgb ||//\\||
-*low TIBC* (hepcidin is increased due to acute phase reaction)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-normocytic normochromic anemia ||//\\|| ||//\\||
-serum iron decreased ||//\\|| ||//\\||
-ferritin (acute phase reactant) and FEP increased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hereditary hemochromatosis (HH) - correct answer✔✔-inheritance of mutated HFE gene ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
inhibits production of hepcidin, leading to constant activation of ferroportin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-increased levels of iron in circulation are exposed to oxygen and produce damaging ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
superoxide ions ||//\\||
-symptoms: begin between 30-40, iron deposits on organs (pancreas), bronzed diabetes, cell ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
death, release of lysosomal enzymes ||//\\|| ||//\\|| ||//\\|| ||//\\||
-increased serum ferritin and transferrin saturation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-genetic testing reveals mutated HFE gene ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hereditary hemochromatosis treatment - correct answer✔✔-therapeutic phlebotomy: 500 mL ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of blood is removed per week to decrease serum iron
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, megaloblastic anemia - correct answer✔✔-impaired DNA synthesis due to deficiency of ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Vitamin B12 and/ or folate leads to decreased number of cell divisions
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-produces large macrocytes with immature nuclei ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-symptoms: fever, glossitis, loss of appetite, neurologic abnormalities (pins and needles, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
numbness, hallucinations and paranoia/ megaloblastic madness) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-pancytopenia
-decreased H/H ||//\\||
-macrocytosis
-increased MCV, high RDW ||//\\|| ||//\\|| ||//\\||
-hypersegmented neutrophils ||//\\||
-nuclear cytoplasmic asynchrony ||//\\|| ||//\\||
_M:E ratio 1:1 to 1:3
||//\\|| ||//\\|| ||//\\|| ||//\\||
-teardrop cells, schistocytes and microspherocytes in PB ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Howell jolly bodies (DNA remnants) and cabot rings (figure 8)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-increased bilirubin and LDH ||//\\|| ||//\\|| ||//\\||
G6PD deficiency - correct answer✔✔-decrase in G6PD enzyme causes underproduction of
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
NADPH, leading to inability to reduce glutathione for detox of H2O2
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-H2O2 oxidizes hemoglobin in the RBCs, leading to formation of *heinz bodies*
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-can be induced by oxidative drugs
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-symptoms: jaundice, anemia, hyperbilirubinemia ||//\\|| ||//\\|| ||//\\||
-N/N anemia||//\\||
-anisocytosis, poikilocytosis ||//\\||
-spherocytes and schistocytes in PB ||//\\|| ||//\\|| ||//\\|| ||//\\||
-*heinz bodies seen with crystal violet* ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-G6PD activity decreased ||//\\|| ||//\\||
-fluorescent spot test negative ||//\\|| ||//\\|| ||//\\||
solutions
iron absorption - correct answer✔✔-ferric iron is taken in from diet
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferric iron is reduced by duodenal cytochrome B to become ferrous iron
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferrous iron is absorbed into enterocytes by DMT 1 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-absorbed iron is stored as ferritin, or sent into portal hepatic circulation and carried by
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
transferrin to developing RBCs ||//\\|| ||//\\|| ||//\\||
transferrin - correct answer✔✔plasma carrier protein for ferrous iron ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
high iron level regulation - correct answer✔✔-hepcidin is released from hepatocytes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferroportin is inactivated, leading to decreased iron being transported into circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
low iron level regulation - correct answer✔✔-hepcidin is down regulated by hepatocytes
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferroportin becomes activated and transports iron out of the enterocytes and into circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
ferrous iron - correct answer✔✔the form of iron that is able to be utilized in the body for
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
developing red cells ||//\\|| ||//\\||
prussian blue stain - correct answer✔✔stain that is used to identify iron in tissues and bone
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
marrow
stage 1 iron deficiency (progressive loss of storage iron) - correct answer✔✔-asymptomatic
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-RBCs develop normally ||//\\|| ||//\\||
-*serum ferritin low* ||//\\|| ||//\\||
,stage 2 iron deficiency (exhaustion of iron storage pool) - correct answer✔✔-subclinical
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
symptoms
-hemoglobin in retics is decreased, *hemogram appears normal still* ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-iron deficiency erythropoiesis is occurring
||//\\|| ||//\\|| ||//\\|| ||//\\||
-hepcidin decreased ||//\\||
-serum iron and ferritin decreased ||//\\|| ||//\\|| ||//\\|| ||//\\||
-RDW, TIBC and sTRs increased ||//\\|| ||//\\|| ||//\\|| ||//\\||
-prussian blue stain of BM is negative for iron ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
stage 3 iron deficiency (frank anemia) - correct answer✔✔-patient exhibits fatigue, weakness,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
pallor, glossitis, koilonychia and pica
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-*H/H decreased* ||//\\||
-*hypochromic/ microcytic anemia* ||//\\|| ||//\\||
-FEP, TIBC and sTR increased
||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferritin, hepcidin and serum iron decreased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
sideroblastic anemia - correct answer✔✔-iron deposits in the mitochondria of erythroblast ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cells in the bone marrow interfere with biosynthesis of heme
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-caused by genetic inheritance, drugs/ bone marrow toxins (*lead*, antibiotics,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
chemotherapeutics)
-*ringed sideroblasts* are highly indicative of the disease ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-basophillic stippling is common in lead poisoning ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-normocytic normochromic cells ||//\\|| ||//\\||
iron deficiency anemia (IDA) - correct answer✔✔-caused by inadequate intake, increased
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
need or malabsorption of iron, poor diet or chronic blood loss
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-symptoms: fatigue, weakness, pallor, spooning of the nails (koilonychia) and pica ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,-*H/H decreased* ||//\\||
-microcytic, hypochromic cells ||//\\|| ||//\\||
-marked poikilocytosis (target cells, spherocytes, tear drop cells and schistocytes)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-FEP, sTR and TIBC increased
||//\\|| ||//\\|| ||//\\|| ||//\\||
-ferritin, hepcidin and serum iron decreased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
anemia of chronic inflammation - correct answer✔✔-anemia occurring secondary to
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
underlying condition (chronic inflammatory disease, chronic infection or malignancy) that ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
causes release of cell products ||//\\|| ||//\\|| ||//\\|| ||//\\||
-hepcidin, lactoferrin and inflammatory cytokines cause decreased iron status and anemia ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-low Hgb ||//\\||
-*low TIBC* (hepcidin is increased due to acute phase reaction)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-normocytic normochromic anemia ||//\\|| ||//\\||
-serum iron decreased ||//\\|| ||//\\||
-ferritin (acute phase reactant) and FEP increased ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hereditary hemochromatosis (HH) - correct answer✔✔-inheritance of mutated HFE gene ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
inhibits production of hepcidin, leading to constant activation of ferroportin
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-increased levels of iron in circulation are exposed to oxygen and produce damaging ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
superoxide ions ||//\\||
-symptoms: begin between 30-40, iron deposits on organs (pancreas), bronzed diabetes, cell ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
death, release of lysosomal enzymes ||//\\|| ||//\\|| ||//\\|| ||//\\||
-increased serum ferritin and transferrin saturation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-genetic testing reveals mutated HFE gene ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hereditary hemochromatosis treatment - correct answer✔✔-therapeutic phlebotomy: 500 mL ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
of blood is removed per week to decrease serum iron
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, megaloblastic anemia - correct answer✔✔-impaired DNA synthesis due to deficiency of ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Vitamin B12 and/ or folate leads to decreased number of cell divisions
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-produces large macrocytes with immature nuclei ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-symptoms: fever, glossitis, loss of appetite, neurologic abnormalities (pins and needles, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
numbness, hallucinations and paranoia/ megaloblastic madness) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-pancytopenia
-decreased H/H ||//\\||
-macrocytosis
-increased MCV, high RDW ||//\\|| ||//\\|| ||//\\||
-hypersegmented neutrophils ||//\\||
-nuclear cytoplasmic asynchrony ||//\\|| ||//\\||
_M:E ratio 1:1 to 1:3
||//\\|| ||//\\|| ||//\\|| ||//\\||
-teardrop cells, schistocytes and microspherocytes in PB ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Howell jolly bodies (DNA remnants) and cabot rings (figure 8)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-increased bilirubin and LDH ||//\\|| ||//\\|| ||//\\||
G6PD deficiency - correct answer✔✔-decrase in G6PD enzyme causes underproduction of
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
NADPH, leading to inability to reduce glutathione for detox of H2O2
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-H2O2 oxidizes hemoglobin in the RBCs, leading to formation of *heinz bodies*
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-can be induced by oxidative drugs
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-symptoms: jaundice, anemia, hyperbilirubinemia ||//\\|| ||//\\|| ||//\\||
-N/N anemia||//\\||
-anisocytosis, poikilocytosis ||//\\||
-spherocytes and schistocytes in PB ||//\\|| ||//\\|| ||//\\|| ||//\\||
-*heinz bodies seen with crystal violet* ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-G6PD activity decreased ||//\\|| ||//\\||
-fluorescent spot test negative ||//\\|| ||//\\|| ||//\\||
