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32
Medical
Professional
01/05/2010

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Term
Later Stage Cytokines
Definition
G-CSF increases Neutrophils
Erythropoietin increases Erythrocytes
Thrombopoietin increases Megakaryocytes
Term
G-CSF
Definition
Later stage cytokine.
Increases Neutrophil production.
Released by endothelial cells and macrophages due to inflammation.
Useful for Chemotherapy patients due to neutropenia.
Term
Heme is produced in...
Definition
Normoblasts and Reticulocytes.
BFU-E lineage.
Not in RBCs because no nucleus.
Term
Heme Synthesis Rate-limiting enzymes
Definition
ALA-Synthase (first) and Ferrochelatase (last)
Term
ALA-Synthase
Definition
Rate limiting enzyme in Heme synthesis, first enzyme.
Vitamin B6 is cofactor.
IRE binds the mRNA unless iron is there.
Term
Lead Poisoning
Definition
Causes Sideroblastic Anemia
ALA-dehydratase and Ferrochelatase are affected in heme synthesis.
Causes increased ALA and Protoporphryn IX levels.
Term
Congenital ALA Synthase Deficiency
Definition
causes Sideroblastic Anemia.
X-linked inheritance.
Term
Acute Intermittent Porphyria
Definition
due to inhibition of PBG deamination.
Reduced heme production and increased ALA-Synthase levels.
Term
Congenital Erythropoietic Porphyria
Definition
Accumulation of heme synthesis intermediates.
They become oxidized and can cause scarring especially with sun exposure.
Term
Globin Alpha-like Genes
Definition
On Chromosome 16. Have Hypersensitivity Domain (HS)
Term
Globin Beta-like genes
Definition
Chromosome 11. Have Locus Control Region (LCR). Highly coordinated with Alpha-like genes.
Term
Regulation of Globin synthesis
Definition
Occurs at Translational level.
Heme-Control Inhibitor (HCI) binds mRNA. Heme binds HCI to release it and allow translation of Globin.
Term
Alpha Thalassemia
Definition
Less Alpha Globin Produced.
Due to gene deletions.
4 genes (two on each chromosome) - varying severities of the disease.
Term
Beta Thalassemia
Definition
Less Beta Globin Produced.
Due to Point Mutations.
The excessive alpha chains precipitate forming Heinz bodies.
Only 2 genes.
Homozygotes are often fatal.
Term
Methemoglobinemia
Definition
Ferrous Iron converted to Ferric Iron in Hemoglobin. Irreversibly Oxidized. Curve shifts far left because it won't give up the O2.
Cyanosis, black tongue, Heinz bodies.
Term
Erythrocytes Metabolisms
Definition
Anaerobic Glycolysis to make ATP (no mitochondria).
Rapaport Luebering Pathway to make 2,3BPG.
HMP Shunt uses G6PD to make Glutathione (the RBC antioxidant).
Methemoglobin Reductase Pathway to revert methemoglobin back to hemoglobin.
Term
Neutralizing Reactive Oxygen Species (ROS)...
Definition
Superoxide Dismutase converts radicals to O2 or H2O2, Glutathione Peroxidase breaks H2O2 into water and O2.
Term
G6PD Deficiency
Definition
Intrinsic Defect that shortens RBC lifespan.
Most common RBC Metabolic disorder.
X-Linked Inheritance.
Hemolytic Anemia (episodic) in response to oxidants because Glutathione isn't made.
"Bite Cells" on blood smear.
Term
Pyruvate Kinase Deficiency
Definition
Most common defect of glycolytic pathway.
Autosomal recessive inheritance.
Reduced ATP production.
2,3BPG accumulation decreases O2 carrying capacity of hemoglobin.
Causes Hemolytic Anemia.
Term
Iron Uptake
Definition
Uptaken by Enterocytes in intestinal mucosa.
1. Ferric form reduced to Ferrous form.
2. Brought in with H+ using DMT-1
3. Either stored in Ferritin or moved to blood through Ferroportin then transported using Transferrin.
Term
Hereditary Hemochromatosis
Definition
Mutations that affect Ferritin, Ferroportin, and accessory receptor proteins.
Autosomal Recessive
Term
Cyanide Poisoning
Definition
Binds to Cytochrome Oxidase (Complex IV) in the ETC.
Severe metabolic Acidosis/CNS poisoning.
Nitrite is used to make MetHb that picks up the CN-.
Term
Hematocrit
Definition
% whole blood occupied by RBCs
Term
MCV
Definition
"Mean Corpuscular Volume"
Average volume of RBCs.
Either Microcytic, Normocytic, or Macrocytic.
Term
RDW
Definition
"Red Cell Distribution Width"
Measures homogeneaity of RBC size on bell curve.
Term
Reticulocyte Count
Definition
Measures production of new RBCs by the bone marrow.
Term
Mechanisms of Anemia
Definition
-Excessive RBC Loss
-Shortening of RBC Lifespan
-Decreased RBC Production
Term
Signs of Shortened RBC lifespan...
Definition
Increased Reticulocyte Count.
Increased EPO levels.
Increased LDH levels due to RBC lysis.
Increased Bilirubin levels due to metabolism of dead RBCs.
Decreased Haptoglobin because it is used up clearing heme out of the blood.
Term
Hereditary Spherocytosis
Definition
Intrinsic Defect that shortens RBC lifespan.
Mutations in Ankyrin and Band-3 cause damage to RBC membrane.
Elevated Reticulocyte count.
Splenomegaly.
Spherocytes in blood smear.
Term
Sickle Cell Disease
Definition
Intrinsic Defect that shortens RBC lifespan.
Episodic Painful Crises.
Chronic Erythroid Hyperplasia of Bone Marrow, "Crew Cut" X-Ray appearance.
Normocytic Anemia, sickle cells in blood smears, high reticulocyte count.
Parvovirus causes "Aplastic Crisis".
HbF causes less sickling.
Term
Hydroxyurea
Definition
An alkylating agent used in chemotherapy and to increase HbF to help sickle cell patients.
Term
Microangiopathic Anemias
Definition
Physical mediators of hemolysis that decrease RBC survival time.
"DAMM"
-Disseminated Intravascular Coagulation
-Arteritis
-Malignant Hypertension
-Mechanical Heart Valves
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