Diseases and Disorders of the blood

Question 1

what does the blood transport?

Answer 1

oxygen, carbon dioxide, water, nutrients, proteins, hormones, & cells

Question 2

What is the blood made of?

Answer 2

plasma, and formed elements, which include red
blood cells, white blood cells, and platelets.

Question 3

What is plasma?

Answer 3

mostly water, carries nuyrtients, wastes, ions, hormones, clotting factors, albumin (promtoes blood’s ability t ohold water and maintain pressure insdie the bv) and antibodies

Question 4

What are erythrocytes?

Answer 4

aka red blood cells (RBCs), make up 1/2 of bloods volumes, most abundant cell in the human body, have no nucleus

carries oxygen w/ iron-rich oxygen carrying protein called hemoglobin

Question 5

how many erythrocyes in human body?

Answer 5

5 million/mm^3 in males and about 4.5 million/ mm^3 in females

Question 6

What is hemoglobin?

Answer 6

protein in RBC composed of a protein called glovin and iron containing heme molecule

turns into oxyhemoglobin when binded to oxygen and turns into carbhemoglobin when binded with carbon dioxide

Question 7

What is sepcial abt RBC?

Answer 7

no nucleus so cant grow or repair themselves = only alive for 120 days

Question 8

how to RBC get removed and recreated?

Answer 8

removed from body by liver and spleen
made in red marrow of bones such as vertebrae and body of sternum

Question 9

What is erythoropoeisis?

Answer 9

red blood cell formation - regulated by hormone erythropoietin

begins as large nucleated stem cells before emerging as mature red blood cell (hemoglobin accumulates cytoplasm and nucleus disappear)

Question 10

what r reticulocytes?

Answer 10

mature red blood cells emerging from the bone marrow `

Question 10

what r reticulocytes?

Answer 10

mature red blood cells emerging from the bone marrow ``

Question 11

What are leukocytes?

Answer 11

white blood cells including neutrophils, eosinophils, basophils, monocyes, and lymphocytes

Question 12

what are platelets?

Answer 12

produced in bone marrow and r essential for blood clotting

Various clotting factors are formed in the liver, enter the blood, and become active in response to injury

during injury platelets become sticky and trigger the deposition of an insoluble clotting protein called fibrin that forms a dnese mesh at wound

Question 12

what are platelets?

Answer 12

produced in bone marrow and r essential for blood clotting

Various clotting factors are formed in the liver, enter the blood, and become active in response to injury

during injury platelets become sticky and trigger the deposition of an insoluble clotting protein called fibrin that forms a dnese mesh at wound

Question 13

what vitamin is required for synthesis of the prothrombin and thrombin clotting factors

Answer 13

vitamin k

Question 14

What are some ofthe diagnostic test and procedures for the blood?

Answer 14

blood tests- measure total blood countrs (RBC, WBC, platelents), hemoglobin, hematocrit, serum chemsitry and enzyme and hormone levels in the body

Differential blood analysis - qualitive info such as sieze, shape and ratio of one cell to another

bone marrow smear - used to diagnose malignant blood disorders and increases/decreases in blood count by obtaining bone marrow smaples from needle aspiration fo the bone marrow from bone marrow cavity

Question 15

What is anemia?

Answer 15

abnormally low number of red blood cells that leads to reduced delivery of oxygen and nutrients to the tissues

caused by hemorrhage, excessive destruction of red blood cells, nurtitioanl deficiency and chronic disease, impaired prodcuton of RBCs, anorexia nervosa, hemolytic-hemoglobin disorders

Question 16

s/s of anemia

Answer 16

• tissue hypoxia (lack of o2)
• acute hemorrhage, fatigue
• decreased tolerance for exercise
• dyspnea
• palpitations
• pallor
• jaundice and enlargement of the spleen caused by hemolysis (RBC death)
• tachycardia
• heart murmurs
• weakness
• listlessness
• cardiac enlrgement
• mental sluggishness

Question 17

How to diagnose anemia?

Answer 17

Diagnose - microscopic examination, analysis of
red blood cells, complete history on dietary habits, family history of anemia

Question 18

what is iron-deficiency anemia?

Answer 18

anemia in which there is evidence of iron deficiency (iron deficiency is the leading cause of anemia)

prevalence of iron-deficiency anemia is greatest amongst preschool children and adolescent and adult females

Question 19

what are the risk factors and treatment for iron-deficient anemia?

Answer 19

excessive blood loss, menstruation, pregnancy,
and rapid growth during adolescence

treat by taking a dietary intake or supplementary iron (require 1.0-1.4 mg of iron per day)

Question 20

what are is the first stage of developing an iron deficiency anemia?

Answer 20

1. negative iron balance (demand for iron exceeds body’s ability to absorb iron from diet) (can result from blood loss, pregnancy, rapid growth spurts, and inadequate dietary intake)

Question 21

what are is the second stage of developing an iron deficiency anemia?

Answer 21

when the iron store in the body become depleted (synthesis of hemoglobin becomes impaired, RBC loos shape and appear cigar/ pencil shaped under microscopic analysis on a peripheral blood smear)

Question 22

What are the s/s of iron deficiency?

Answer 22

weakness, fatigue, can affect cognitive performance, behavior and growth in preschool and school-age children, during pregnancy it can lead to infant mortality or death

Question 23

what is the most frequent cause of iron deficiency in each group (men and postmenopausal women, premenopausal women, young children)?

Answer 23

men and postmenopausal women - GI bleeding premenopausal women - menstruation and during pregnancy young children - in intake of iron does not keep pace with rapid growth and development

Question 24

What is anemia of chronic diseases?

Answer 24

anemia that occurs in pt as a result of chronic inflammatory, infectious and autoimmune diseases which is usually bc of a defect in erythropoiesis

Question 25

What is the severity of anemia of chronic diseases associated with?

Answer 25

severe anemia - rheumatoid arthritis or tuberculosis ((bc depletion of iron stores) moderate anemia - associated w/ cardiac conditions like angina pectoris and exercise intolerance

Question 26

How to treat anemia of chronic disease?

Answer 26

treating underlying diseases or using erythropoietin, a hormone secreted by the kidney that stimulates synthesis of RBC

Question 27

What is anemia of renal diseases?

Answer 27

chronic kidney failure results in moderate to severe anemia caused by kidney's failure to produce adequate amounts of erythropoietin ppl with anemia of renal disease usually have normal serum iron

Question 28

What is megaloblastic anemia?

Answer 28

caused by impaired DNA synthesis megaloblastic red blood cells r large, have an increased ratio of RNA to DNA underlying cause of impaired erythropoiesis in megaloblastic anemia is a vitamin B12 deficiency and/or folic acid deficiency

Question 29

What is vitamin B12 Deficiency Anemia?

Answer 29

aka as pernicious anemia inadequate absorption or intake of B12 or a deficiency in a protein called intrinsic factors (produced in stomach and is essential for the absorption of vitamin B12 from small intestine) considered macrocytic anemia immature RBCs r larger than normal hemoglobin volume is reduced w/ subsequent reduction in oxyfen-carryinf capacity

Question 30

Where is vitamin B12 stored?

Answer 30

Vitamin B12 can only be taken in by diet (min rec is 2.5 micrograms) 2 micrograms r in liver and 2 micrograms r stored else where takes 3-6 yrs for a normal individual to become deficient in vitamin B12

Question 31

What happens when RBC dont have B12 or intrinsic factor??

Answer 31

RBC rupture easily within blood = anemia and reduced o2 carrying capacity

Question 32

What are causes of pernicious anemia?

Answer 32

inadequate diet, impaired absorption, increased requirement or increased excretion of vitamin B12 vegetarians develop pernicious anemia bc vitamin b12 is found in animal food products bacteria growth in small intestines and bowel disorders can = pathological changes that either impair or increase the elimination of vitamin b12 90% of pt with pernicious anemia have anti-parietal cell antibodies which can be cytotoxic to the parietal cells anti-intrinsic factor antibodies

Question 33

s/s of pernicious anemia?

Answer 33

abd distress nausea and vomiting burning of the tongue numbness weakness yellow and blue color blindness sore tongue tingling and numbness in extremities lips, tongue, and gums appear pale sclera and skin appear slightly jaundiced distrurbances in digestion (anorexia, nausea, vomiting, diarrhea, constipation, flatulence and wt.loss) vulnerable to infection demyelination of perippheral nerves and eventually the spinal (neuritis, peripheral weakness, numbness, and paresthesia ataxia light-headedness altered vision tinnitus optic muscle atrophy fatigue palpitations dyspnea tachycardia premature ventricular contractions congestive heart failure

Question 34

Where to find folic acid?

Answer 34

found in many diff types of plants bacterias (mainly fruits and vegetables) min requirement of folic acid is abt 50 micrograms (body stores abt 5-20 mcg in body, 1/2 of which is in the liver)

Question 35

Where is folic acid deficiency common?

Answer 35

western world bc consumption of raw fruits and veggies r low also folic acid absorption can be impaired by inflammation of the bowel as in Crohn's disease, meds, preg and lactating females who abuse alc and indv. with kidney diseases

Question 35

Where is folic acid deficiency common?

Answer 35

western world bc consumption of raw fruits and veggies r low also folic acid absorption can be impaired by inflammation of the bowel as in Crohn's disease, meds, preg and lactating females who abuse alc and indv. with kidney diseases

Question 36

How to detect + treat folic acid deficiency anemia?

Answer 36

detect : measurement of serum folic acid levels treat : oral folic acid supplementation

Question 37

What is hemolytic anemia + etiology?

Answer 37

reduction in circulating red blood cells caused by accelerated destruction of RBC may be bc ... hemoglobin defects enzyme defects membrane defects Infectious agents certain medications immune disorders

Question 38

S/s of hemolytic anemia

Answer 38

similar symptoms to other anemias, main diff is hemolytic anemia produces incrased serum levels oof bilirubin that results from degradation of heme in destroyed RBCs = haundicied appearance in tissue, urine and feces

Question 39

How to treat hemolytic anemia

Answer 39

depends on etiology inherited hemolytic anemia - spleenectomy (decreases risk of gallstones, sever episodes of hemolysis and pathological hanges to the bone marrow) severe blood loos such as trauma - blood transfusions infectious - antibodies immune disorders - immunosuppressive therapies

Question 40

how to diagnose and treat pernicious anemia

Answer 40

diagnose - clinical findings, lab testing, Schilling test for presence of anti-parietal cell or anti-intrinsic factor antibodies, decrease in Hgb level, RBC count and increased mean cell volume (MCV), RBCs and platelets r large and malformed, hypersegmented neutrophils on peripheral blood smear treat - intramuscular injections of vitamin B12 bc ppl with pernicious anemia cant absorb vitamin b12

Question 41

What is blood dyscrasias?

Answer 41

deviation or malfunction of blood production = blood dyscrasis, either bc of impairement in formation of blood composnents or bc of unsual destruction of cells

Question 42

What are anemias classified as (other than causative factor)

Answer 42

color of RBC (hypochromic, normochromic, or hyperchromic (spherocytosis) and by size as microcytic, normocytic, or macrocytic

Question 43

What is folic acid deficinecy anemia?

Answer 43

- insufficient amounts of folic acid r available for DNA synthesis, thus preventing maturation of blood cells - can be consequence of dietary deficiency and is clinically similar to pernicious anemia

Question 44

What is aplastic anemia?

Answer 44

- result from an insult to hematopoietic cells (stem cells) - RBC, WBC, platelet production is reduced bc of exposure to myelotxins, certain drugs and instectides, and radiation

Question 45

How to diagnose and treat anemia?

Answer 45

- reduced Bc numbers, reduced hemoglobin levels and hematocrit, changes in morphology of corpuscles, bone marrow studies treat - based on cause, dietary or supplemental iron administration, treat slow insidious bleed, folic acid replacement, vitamin B12, causative factors must be uncovered in hemolytc and aplastic anemias, rest, increased fluid intake, analgesics, O2 administration, IV therpay, narcotic analgesics, transfusion of packed RBCs

Question 46

What is transfusion incompatibility reaction?

Answer 46

results when blood or blood product transfused has antibodies to recipient's RBCs or recipitient has antibodies to the donor's EBCs - caused by ABO and Rh-incompatible blood and antigens that screening doesnt revela cause antigen-antiobody reaction that produce hemolysis or aglutiatnion

Question 47

s/s of transfusion incompatibility reaction?

Answer 47

- hemolysis or agglutination - bacterial, allergic and circulatory-overload transfusion reactions - severity of reaction depends on amt of incompatible blood - chills, ever, tachycardia - severe back pain, vomiting, dharrhea, hives or rash, substernal tightness, dyspnea - hypotensive and progresses to state of circulatory collapse - bleeding from punture sitre, blood in urine and eventually renal failure

Question 48

diagnose and treat transfusion incompatibility reaction?

Answer 48

diagnose - any signs of chills, fever, hives, back pain, dyspnea during transfuion treat- observe pt closely durign first 15 min, stop blood transision at sigh of reaction, blood and urine samples, antihistamines, anaphylaxis