Anemia (Exam 1b) Flashcards

(51 cards)

1
Q

Anemia

A

Lack of RBC’s

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2
Q

Role of Hemoglobin

A

What provides the oxygen carrying capacity in a RBC

Within each chain, there is a heme unit with iron at the center

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3
Q

HgB reversibly binds

A

O2 and CO2 for transport

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4
Q

Functioning hemoglobin is necessary for

A

Oxygen delivery to the tissues

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5
Q

The Bus Analogy

A

RBC = Bus

HgB = The seats

Iron = What seats are made of

O2= Passengers

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6
Q

Anemia can be related to either

A

The quantity or quality of RBC’s

Regardless of the cause all disease of RBC’s mean less o2 is able to be transported to the tissues

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7
Q

Anemia from loss of Iron or Key nutrients

A

Abnormal Hemoglobin = Sickle Cell Diseae

Decrease HgB content = Hypochromic/pale = Loss of iron and Loss of key nutrients

Decreased number of circulation erythrocytes = decreased production and increased destruction and loss

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8
Q
A
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9
Q

One way we can tell what time of Anemia is going on is by looking at the red blood cells

A

Macrocytic - Normochromic

Microcytic - Hypochromic

Normocytic - Nromochromic

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10
Q

Macrocytic - Normochromic

A

-Large, abnormally shaped erythrocytes

-Hemoglobin concentrations normal

-B12 and folate deficiencies

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11
Q

Microcytic - Hypochromic

A

Small, abnormally shaped erythrocytes

Reduced Hgb concentrations

Iron deficeincy

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12
Q

Normocytic - Normochromic

A

-Normal size

-Normal hemoglobin function

-Blood less, sickle cell, aplastic anemia

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13
Q

Iron Deficiency: Cell Morphology

A

-Iron is essential to normal HgB production

-Is. microcytic, hypochromic

-Is considered a microcytic anemia causes rbcs are smaller than normal. Measured through a MCV (mean corpuscular volume) (decreased)

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14
Q

Vit B12 or Folate deficiency

A

-They are needed for DNA synthesis of RBC’s

-Megaloblastic / Macrocytic anemias

-MCV increase (MCV should be on CBC)

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15
Q

The main way determine Anemia

A

HgB levels are the best indicators

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16
Q

Most people do not seek out care or have symptoms until anemia levels…

A

are very low. Our body is good at compensating

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17
Q

Clinical manifestations of ALL anemias: Mild to moderate

A

Fatigue - Weakness - Tachycardia - Dyspnea

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18
Q

Clinical manifestations of ALL anemias: Moderate - Severe

A

Increased HR and RR - Hypotension - Pallor - Faintness - Cardiovascular symptoms

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19
Q

Pathophysiological cause of the clinical manifestation seen with anemia

A

SS and PPS

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20
Q

Iron Deficiency Anemia

A

Small and Pale RBC’s

Microcytic Hypochromic

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21
Q

Etiology: Iron Deficiency Anemia

A

-Most common anemia

-Decreased intake of iron
-Impaired absorption of iron
-Increased demand for iron
-Excessive loss (Gi bleeding or menstruation)

Remember we can’t make hemoglobin without IRON

22
Q

Who is at risk of iron deficiency anemia

A

Elderly

Teenage girls

Women childbearing age

23
Q

Iron deficiency Clinical Manifestations

A

-Smooth tongue / Glossitis / Mouth ulcers / Cheilosis

-Koilonychia “spoon nails”

-PICA - “Craving non-food items”
-Ice chips
-Hard peppermint Candies
-Dirt

24
Q

Anemia from B12 deficiency

A

Megaloblastic

Macrocytic Normochromic

25
What is megaloblastic anemia?
A condition in which the bone marrow produces unusually large immature RBC's (megaloblasts) Leading cause is B12 and folic acid deficiency Most common in elderly
26
Causes of Deficiency of V B12 Anemia
-Atrophic Gastritis - The stomach lining has thinned (body is not producing intrinsic factor) -Conditions that affect the small intestine, such as Crohn's disease, celiac disease, bacterial growth, or parasite -Autoimmune system disorder - Pernicious Anemia (very common cause)
27
Clinical Manifestations Specific to B12 deficiency
-S and S of anemia plus -Neuropathy -Ataxia (gait problems) -Glossitis -Dementia
28
Anemia related to Folate Deficiency
Folate is B9 vitamin that is needed for RBC formation Folate needs increase greatly during pregnancy. Low folate more likely to have babies with low birth weight and neural defects Not a problem with absorption, but with decreased intake (alc-diet-cirrhosis)
29
What anemia is most common is malnourished population
Folate Anemia because it is a problem with intake not absorption
30
Anemia of Chronic Kidney Disease
Impaired erythropoietin production. This tells bone marrow to make RBC's so when this is broke bone marrow doesn't make new RBC's Hgb/Hct correspond with the DEGREE of kidney insufficiency
31
Clinical manifestations of chronic kidney disease anemia
General s/s anemia
32
Aplastic Anemia
Primary condition of BONE marrow stem failure Rare Autoimmune most common cause -blood cells in the bone marrow attacked
33
Classification of aplastic anemia
-Congenital -Acquired
34
Aplastic Anemia is characterized by
Pancytopenia Lack of erythrocytes, leukocytes, and platelets
35
Aplastic Anemia: Treatment
Whole blood transfusions Bone marrow transplant Immunosuppressants Corticosteroids Drugs to stimulate erythropoiesis (bold)
36
Causes of Aplastic Anemia
Idiopathic = don't know High dose of exposure to toxic agents: Radiations and chemical/toxins (Bone marrow cancer) (Insecticides) Autoimmune mechanism: complication of infection
37
Increased Destruction of RBC's
Abnormal hemoglobin Acquired hemolytic anemia Sickle Cell Anemia (decrease life span) Thalassemia
38
Acquired Hemolytic Anemia
Premature destruction of RBC's caused by some external agent
39
What are common causes of acquired hemolytic anemia
-Autoimmune attack -Blood incompatibilities (give wrong blood type) -Drug reactions -Severe Burn or Microangiopahties
40
Hemolytic Anemia: What happens?
-Formation of IMMUNE COMPLEXEs -These complexes kill normal RBC's
41
Hemolytic Anemia: What do you look for?
-Low hemoglobin -Increase Reticulocyte count (immature red blood cell) (Body starts making more and releasing them young) -Mild Jaundice
42
Anemia Abnormal Hemoglobin
Sickle Cell Disease Thalassemia
43
Sickle Cell Anemia
-Genetic disorder -Inability to bind hemoglobin -Hemoglobin S sitors shape, especially when O2 is low. Fragile sickle shaped cells deliver less O2 to tissues -Clog blood vessels and break into pieces that disrupt blood flow leading to ischemia and necrosis
44
Sickle Cell Anemia: Clinical manifestations
Swelling of hands and feet with fever Painful episodes / crisis from ischemia and necrosis from clogged vessels
45
Sickle Cell Crisis Triggers
-Dehydration -Stress -High altitudes -Fever -Extreme temperatures
46
Sickle Cell Anemia: Treatment
O2 therapy Hydration Pain management Hydroxyurea Blood transfusions and CRISPR and Bone marrow transplants Treat pain and increase oxygenations
47
Thalassemia Anemia: Patho
Genetic disorder occurring mostly in person of mediterranean descent Severe cases lead to death in childhood from heart failure Moderate cases with treatment live to 30
48
Thalassemia: Characterized by
Abnormal hemoglobin Lack of one of two proteins that make up hemoglobin - alpha and beta globin
49
Thalassemia: Treatment
Blood Transfusion (weekly) Bone marrow transplant Splenectomy
50
thalassemia: Clinical maifestations
Delayed growth Fatigue Dyspnea Jaundice Bone deformities Hepatomegaly Splenomegaly
51
Acute blood loss: Anemia
Hemorrhage Manifestations depends on speed of blood loss Result from gross or occult Rate of blood loss is important Can not compensate with acute and rapid blood loss vs slow