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Flashcards in Anemia Deck (63)
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1

Define Anemia

Insufficient red cell mass to adequately deliver oxygen to peripheral tissues

2

Anemia - influence of gender, age, etc demands

Females lower
High at birth, drops, then increase
pregnancy/menstration decrease HCT/HGB

3

Define Reticulocytes

Presence of mRNA in RBC first say in systemic circulations. Larger and darker - immature

4

Count and Absolute count RET

percent of RBC; a definite number of RBC

5

Reticulocyte index

way to measure RBC production by correcting RET count for concentration and stress reticulocytosis (1.5 - mild, 2.0 mod, 2.5 severe)
RI < 1 = anemia = decrease production of RBC
RI > 2 = loss of RBC, destruction/bleeding

6

MCV 80-100 =?

normocytic anemia

7

MCV >100
MCV < 80

macro and microcytic anemia

8

RET is normal --> consider which factors?

hemolysis or hemorrhagic causes

9

Iron more soluble at ____ pH

low

10

Distribution of Fe in hemoglobin, muscle, intracellular

65, 6, 25

11

Intracellular Fe storage by ____ and ____

ferritin and hemosiderin

12

Fe absorbed in __

duodenum

13

Iron transportation steps from duodenum across BL membrane

Fe3+ --> DCYTB to Fe2+ --> Enter cell DMT1 --> Fe stored in ferritin --> transported BL membrane --> ferrous exit via ferroportin --> Hephaestin oxidize to Fe3+ to plasma apotransferrin

14

Iron transportant from plasma to endocytosis

Fe3+ in plasma --> transferrin --> transferrin receptor on normoblast --> invagination --> endosome --> pH drops --> Fe released --> leaves DMT1 --> Fe in ferritin --> Transferrin/TR to cell surface

15

Transferrin is a _____ _______

plasma transporter

16

Ferritin is a _______ ______

intracellular Fe storage

17

Iron deficiency - stages 1, 2, 3 described as?

1: iron stores decreased (ferritin lvl)
2: iron deficient erythropoiesis - decrease in serium ion, increase iron binding capacity - decrease in percent sat
(Iron loading of normoblast impaired, no change in RBC)
3: Transferrin increase, serum iron low, sat low - microcytic/hypochromic; Red cell protoporhyrin increase

18

Causes of iron deficiency

Excessive losses - bleed, Failure to accumulate Fe, inability to gain Fe during growth

19

hepcidin - define and fcn

25 amino acid peptide - regulates iron absorption
binds to ferroportin + degradation = loss of Fe export out of epithelial cell --> response from (increased accumulation of Fe/infection/inflammation)

20

Koilonychia - define

bowing of nail

21

Achlorhydria - define

low production of gastric acids

22

Decreased RBC causes (by categories)

iron deficiency
chronic infection/inflammation
malignant disease
renal insufficiency
endocrine disorder
lead intoxication
Mal nutrition

23

Hemoglobin synthesis

Heme + globin

24

Heme synthesis

Protoporphyrin synthesis + Fe

25

Lead effect on Hgb

Pb prevents synthesis of protoporphyrin + enzyme that ligates iron to proto

26

Chronic disease: TNF --> effect

Decrease iron, decrease EPO

27

Chronic disease INF-B --> effect

Inhibits erythropoiesis

28

TNF/INF B defect occurs during _____ and _____?

malignancies (neoplasm) and sepsis

29

Chronic infection/inflammation affect which 2 factors

IL1 / INF Y

30

IL1 effect on RBC

Decrease iron and EPO