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ECM Extracellukar Matrix > anaemia > Flashcards

anaemia Flashcards

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1
Q

anaemia definition

A

condition in which the number of red blood cells or their oxygen carrying capacity is insufficient to meet physiological needs which vary by age, sex, altitude, smoking and pregnancy status

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2
Q

what is the name of the stem cells that make red blood cells

A

haemotopoetic stem cells in the bone marrow in the process of haematopoeisis.

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3
Q

explain the process of haematopoeisis

A

begins with a multipotent haematopoetic stem cell, develops into a common lymphoid progenitor which can differentiate into t cell, b cell or NK cell (natural killer). if the hps cell develops into a common myeloid progenitor then it can diffrentiate into erythrocytes, mast cells or mega karyocytes which can diffrentiate into platelets, or the common myeloid progenitor can differentiate into neutrophil, monocyte or osteoclast.

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4
Q

what is the daily production of red blood cells

A

200 billion

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5
Q

what is the lifespan of a red blood cell

A

120 days +- 20 days

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6
Q

how many red blood cells are destroyed per second

A

2.5 million red blood cells

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7
Q

what are early red blood cells or new red blood cells called

A

reticulocytes
no nucleus but has rna

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8
Q

how does the reticulocyte turn into a mature red blood cell

A

loses rna.
has no rna and no nucleus

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9
Q

what happens in the bone marrow stage of rbc production

A

red blood cell precursors begin to mature

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10
Q

briefly outline how erythropoiesis occurs

A

in the bone marrow, haematopatic stem cells produce RBC. the red blood cell precursors begin to mature causing a reticulocyte to form which is a new red blood cell. although it has no nucleus, it still has rna. as the reticulocyte matures into a red blood cell, it loses its rna.

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11
Q

what is the major function of a red blood cell

A

oxygen carrier, provides oxygen to tissues.

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12
Q

explain how red blood cells act as oxygen carriers

A

red blood cell contains lots of haemoglobin protein which allows oxygen molecules to bind in the lungs, this blood then travels to tissues and releases oxygen into tissue cells , oxyhaemoglobin unloads the oxygen at the tissues.

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13
Q

describe the major protein haemoglobin

A

tetramer of 4 globin folded proteins
2 alpha chains and 2 beta chains
fe2+ haem groups

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14
Q

describe haem group

A

contains fe iron
oxygen binding capacity

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15
Q

what does DO2 represent in the oxygen delivery equation

A

the oxygen delivery

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16
Q

what does Q represent in the oxygen delivery equation

A

cardiac output

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17
Q

what does HB represent in the oxygen delivery equation

A

haemoglobin

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18
Q

what does saO2 represent in the oxygen delivery equation

A

arterial oxygen saturation

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19
Q

what does PaO2 represent in the oxygen delivery equation

A

amount of dissolved oxygen in the blood

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20
Q

what is the oxygen delivery equation

A

DO2= Q x (hbxSaO2) x 1.34 + (pao2 x 0.003)

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21
Q

how is erythropoiesis regulated

A

1) low oxygen blood level is detected
2) stimulus causes kidneys to increase production of EPO (erythropoietin)
3) erythropoietin hormone released by kidneys stimulates RBC production
3) stem cells increase red blood cell production
4) oxygen blood level returns to normal
5) normal oxygen levels in blood
6) stimulus is resolved

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22
Q

explain erythropoiesis regulation including jak 2

A

EPO binds to receptor on bone marrow erythroid progenitor, the binding of the receptor to the epo induces conformational changes in jak 2 that cause stats, mapk, akt/p13k. this occurs on the extracellular membrane cytoplasm

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23
Q

what happens at the end of the life cycle of the red blood cells

A

1) red blood cell death and phagocytosis
2) globin is broken down into amino acids that can be reused for protein synthesis
3) the haem in the red blood cell can be broken down into billiverdin which is eventually broken down into billirubin which is secreted in the gut and some of it is absorbed.

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24
Q

where are red cells produced

A

in the bone marrow

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25
what is the main function of a red blood cell
transport oxygen to the tissues
26
27
what stimulates erythropoietin by the kidneys to stimulate red cell production
hypoxia- low oxygen levels in the blood
28
how many days do red blood cells live
120 days and are recycled by the reticulo endothelial system.
29
what procedure can we carry out to diagnose anaemia in the lab
venepuncture and then passing the sample through the automated blood count analyser
30
what does a full blood count show us or tell us
-haemoglobin -white cell count -platelet count
31
what method is used to directly measure haemoglobin
photometric method expressed as a concentration g/L
32
what are red cell indices
mean cell volume red cell distribution width rdw packed cell volume red cell count reticulocyte count
33
what is mean cell volume if measured directly expressed as
FL 10^-15
34
what is the reference range for mean cell volume
80-99fl
35
what mean cell volume indicates microcytic cells
MCV<80fl
36
what is a normal mcv mean cell volume
80-100fl
37
what mean cell volume is macrocytic
mcv>100fl
38
what pathway follows if the mean cell volume is less than 80fl (microcytic)
-next step is to check ferritin levels (ferritin is a protein which carries iron) if ferritin is too low than this indicates iron deficiency anaemia- mean cell volume low but rdw high.
39
if mean cell volume is lower than 80fl and ferritin levels are high than indicates thalassemia
thalassemia, inherited anaemia normal rdw normal distribution width
40
when the mean cell volume is normal 80-100 what is the next steps
to check reticulocyte count
41
if cell is normocytic and reticulocyte count is lower than what is the anaemia diagnosis
anaemia of chronic disease marrow hypoplasia
42
if reticulocyte count is higher after determining cell is normocytic what is the next test
if alot of haemolysis, conduct a DAT test if DAT test positive than autoimmune haemolysis if DAT test negative- hbss g6pd mechanical
43
if cells are macrocytic, the mcv is higher than 100fl than what is the next step
test for b12 folate and if b12 low than diagnose as b12 folate deficiency anaemia. if b12 folate is normal or high than diagnosis is active haemolysis so conduct DAT tests to determine whether anaemia is autoimmune or g6pd anaemia.
44
what is the reference range for red cell distribution width
11-15%
45
what is anaemia diagnosed by having
hb levels less than lower limit of reference range
46
what can we look at to determine cause of anaemia
blood film, fbc parameters
47
what does a normal rdw indicate
that cells are more or less uniform size
48
anaemia is a lack of what
haemoglobin
49
most common worldwide anaemias
iron deficiency thalassemia
50
what are the two main mechanisms of anaemia
-insufficient production or excessive loss of red blood cells -laboratory investigations can help tell them apart
51
what is g6pd deficiency
glucose 6 phosphate dehydrogenase deficiency showing irregularly contracted cells. mutation in enzyme pivotal in krebs cycle so when theres oxidative stress triggers such as drugs, cells cannot cope and haemolyse.
52
signs of iron deficiency
spooning of nails pallor conjunctivitis angular cholitis
53
what are some signs and symptoms of severe anaemia
-angina chest pain -heart attack -fainting
54
what are some respiratory symptoms of anaemia
shortness of breath
55
what are some blood vessel signs of anaemia
low blood pressure
56
what is a sign of anaemia related to spleen
enlargement of spleen
57
what is a intestinal sign of anaemia
changed stool colour
58
what are some muscular symptoms of anaemia
weakness
59
what are some skin symptoms of anaemia
pallor coldness yellowing eyes yellow as well
60
what are some heart related symptoms and signs of anaemia
palpitations rapid heart rate chest pain angina heart attack
61
what are some central symptoms of anaemia
fainting dizziness fatigue
62

ECM Extracellukar Matrix (16 decks)

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