Anemias

Question 1

Erythrocytes (RBCs)

Answer 1

• biconcave, disk-like
• anuclear
• 120day lifespan
• hemoglobin comprises 95% of protein in RBC
• 70% of body’s iron is in circulating RBCs, 20% stored as ferritin, primarily in liver

Question 2

what is anemia

Answer 2

abnormally low hemoglobin concentration in whole blood - below the reference range

Question 3

main function of erythrocytes is to

Answer 3

transport O2 via hemoglobin

Question 4

what happens to body when kidneys sense hypoxia?

Answer 4

in healthy individuals -> stimulate erythropoiesis
in unhealthy individuals -> inability to respond

Question 5

response to hypoxia due to RBC loss

Answer 5

stimualtes production of 2 million RBCs per second

Question 6

at the end of RBCs life, they are

Answer 6

digested by macrophages in the spleen, liver and bone marrow

Question 7

dying RBCs must be replaced continuously by erythropoiesis to

Answer 7

maintain adequate oxygenation to organs

Question 8

Erythropoietin is produced in the

Answer 8

kidney in response to hypoxia and travels to bone marrow to signal proliferation, maturation and release of RBCs

Question 9

Erythropoiesis production line

Answer 9

pluripotent stem cell –> myeloid stem cell –> BFU-E –> CFU-E –> Proerythroblast –> red blood cell

Question 10

EPO or erythropoietin signals for

Answer 10

proliferation, maturation, and release of RBCs precursors that mature into RBCs

Question 11

Reticulocytes retain ribosomal network and continue Hb synthesis for

Answer 11

4 days

Question 12

3 days in ___ and 1 day in ___ before maturing into RBCs

Answer 12

• bone marrow
• circulating blood

Question 13

healthy adults contain ____ reticulocytes in circulating blood

Answer 13

0.5-2%

Question 14

Reticulocyte production increases in response

Answer 14

to blood loss or premature RBC destruction (hemolytic anemias)

Question 15

requirements for normal response to hypoxia

Answer 15

• responsive bone marrow (stem cells)
• at least one healthy kidney
• adequate nutrition to support: hemoglobin synthesis and cell division of erythroid cells

Question 16

to support adequate hemoglobin synthesis

Answer 16

iron, protein

Question 17

to support adequate DNA synthesis and cell division of RBC precursors

Answer 17

vitamin B12, folate, protein

Question 18

anemia is present when hemoglobin conc in whole blood is

Answer 18

lower than the reference range

Question 19

Anemia symptoms and cause?
pallor of skin in palms, nail beds, face or conjuctiva of eyes

Answer 19

decreased RBCs and O2 delivery to peripheral tissues

Question 20

Anemia symptoms and cause?
dizziness

Answer 20

decreased RBCs and O2 transport to brain

Question 21

Anemia symptoms and cause?
easily fatigued

Answer 21

decreased RBCs and O2 supply to tissues (muscles)

Question 22

Anemia symptoms and cause?
easily fatigued

Answer 22

decreased RBCs and O2 supply to tissues (muscles)

Question 23

Causes of anemia

Answer 23

• premature RBC destruction or blood loss
• insufficient stimulation of erythropoiesis
• insufficient RBC production

Question 24

peripheral blood smears and stains along with RBC indices form the

Answer 24

initial lab assessment of erythropoiesis

Question 25

[RBC] red blood cell concentration (count):

Answer 25

number of erythrocytes/RBCs in a given VOLUME OF WHOLE BLOOD

Question 26

[HGB] hemoglobin concentration

Answer 26

the conc. of hemoglobin in a GIVEN VOLUME of whole blood

Question 27

[HCT] hematocrit (packed cell volume):

Answer 27

the percentage volume of blood that is composed of RBCs

Question 28

Corpuscular indices

Answer 28

calculated values to assess RBC morphology and hemoglobin content in classification of anemias

Question 29

anemias characterized as having:

Answer 29

- fewer RBCs that are normal size and have normal HGB content - fewer RBCs that are smaller with less HGB - fewer RBCs that are larger with more HGB

Question 30

mean corpuscular volume (MCV) is the

Answer 30

average volume of circulating RBCs

Question 31

MCV <80 = MCV 80-100 = MCV >100 =

Answer 31

microcytic normocytic macrocytic

Question 32

mean corpuscular hemoglobin (MCH) is the

Answer 32

quantity of hemoglobin in an average circulating RBC reference range = 26-32pg

Question 33

mean corpuscular Hb concentration (MCHC) is the

Answer 33

concentration of hemoglobin in the average circulating RBC MCHC = (HGB/HCT) * 100 or (MCH/MCV) *100 reference range is 33.4-35.5

Question 34

MCHC < 33.4 = MCHC 33.4 - 35.5 =

Answer 34

hypochromic normochromic

Question 35

MCH and MCHC generally parallel MCV values bc

Answer 35

protein content can impact cell size

Question 36

routinely low MCHC is diagnostic for

Answer 36

iron deficiency anemia

Question 37

low MCHC, low MCV =

Answer 37

microcytic, hypochromic

Question 38

MCHC is normal in B12/folate deficiency anemia

Answer 38

RBCs become larger due to continued HGB production MCH will be high MCHC is in ref. range bc cell volume increases proportionately; fewer but larger RBCs