Anemia Pathophysiology Important Terms Flashcards
(30 cards)
What is Anemia?
- Blood as reduced capacity to deliver oxygen
- Reduced amount of ⬆️ hematocrit, hemoglobin, RBC
What are the 3 disorder/disease groups that anemia is an indication for? (anemia triad)
1) Blood loss, 2) Inadequate productio of normal RBC 3) Red blood cell destruction
What conditions lead to anemia triad?
- **Heavy periods & ulcers & surgery **(blood loss)
- A diet low in iron, folic acid, vitamin B12 (inadequate RBC production)
- Sickle cell anemia (inadequate production of normal RBCs)
- Lack of erythropoietin (inadequate RBC production)
- Pregnancy (blood ‘loss’, inadequate production)
- Kidney disease requiring dialysis & Hemolytic anemia (RBC destruction)
Symptoms of Anemia: ACUTE
- Tachycardia (fast heart rate), palpitations
- Hypotension, lightheadedness
- Dyspnea (shortness of breath)
Symptoms of Anemia: CHRONIC
- Chronic
- Weakness, fatigue
- Headache, vertigo, faintness
- Sensitivity to cold, pallor, loss of skin tone
Symptoms of Anemia: Other
Other (typically when Hgb falls to 90 g/L or less):
Tongue pain, smooth tongue, pica, pagophagia (ice eating)
Erythropoiesis
The production of RBC. Important catalyst for this process is the hormone eryhtropoietin (EPO)
Erythropoiesis: 4 points+ location about the bone marrow part
- Hemoglobin and iron are being incorporated
- Nucleus becomes smaller as the cell matures
- Cell size decreases
- Process takes about a week
Location: Vertebrae, ribs, sternum, clavicle, pelvic crest, long bones
Which cell in the erythropoiesis pathway is first to get hemoglobin?
Polychromatic erythroblast
Which cell in the erythropoiesis pathway is first to get iron?
PROerythroblast
What and where is hemoglobin made?
Increased number of ribosomes make hemoglobin in basophilic erythroblast
What are the 5 ways EPO can increase RBC?
- Stimulate stem cells to differentiate into proerythroblasts
- Increase rate of mitosis in each cell maturation stage
- Prevent breakdown of erythoid precursor cells
- Increase release of reticulocytes into circulation
- Increase hemoglobin production
What is Transferrin? (3 points+ 1 about extra iron)
- Plasma transport protein
- Delivers iron to the bone marrow, to be incorporated into maturing RBC
- circulating transferrin is ~30% saturated with iron [20-50%]
- EXTRA IRON- delivers extra iron to storage sites-> which are: macrophages in liver, marrow, and spleen.
What is Ferritin? What is Hemosiderin?
stored iron is called ferritn, and compacted stored iron is called hemosiderin
Reticuloendothelial system
- Bone marrow for erythopoiesis
- Reticuoendothelial system (liver, spleen) storage of iron
- Other cells and tissues ( myoglobin, respiratory enzymes, immune system)
Percentages of where Iron is stored
75%- hemoglobin/erythropoiesis
10-20% ferritin
5-15% other processes
Hemoglobin releases oxygen to tissues when:
INCREASES IN:
– Concentration of carbon dioxide
– Concentration of hydrogen ions (¯ pH)
– temperature
– 2,3- diphosphoglycerate (an oxygen affinity regulator)
2,3-Diphosphoglycerate (2,3-DPG)
Increase in this, causes right shift by decreasing the affinity to oxygen, causing the release of it
Ways you can classify anemia
3 different approaches:
1. Morphology (size, shape, colour)
2. Etiology (cause of the anemia)
3. Pathophysiology
Microcytice Size
Check reference
Normocytic Size
Check notes
Macrocytic Size
Check Notes
Anemia size distribution: RDW
Red Cell Distribution Width (RDW)
-A measure of variation in RBC size expressed as a percentage
-normal RDW (11-16%) variation
-high RDW (>16%) variation
Causes: Vitamin/mineral/iron deficiencies, pts with blood transfusions
Low reticulocyte when anemic is due to?
- Anemia is due to impaired bone marrow function and bone marrow unable to compensate for anemia
- Iron & B12 deficiency, anemia of chronic disease, malnutrition, renal insufficiency, malignancy
