Hema disorders Flashcards
(80 cards)
1
Q
What is anemia
A
disorder characterized by a reduction in total RBC and/or a decrease in hemaglobin
2
Q
How is anemia caused
A
- Impaired RBC production
- excessive blood loss
- increased RBC destruction
Any combination of the three
3
Q
Normal RBC number
A
men: 4.7-6.1 mcL
Women 4.5-5.2 mcL
4
Q
RBC number counts
A
number of erythrocytes in 1 cubic mm of whole blood
5
Q
Hb normal count
A
men: 13.5-17.5
Women: 12.0-15.5 g/dL
6
Q
Hb is what
A
the o2 carrying pigment of red cells
7
Q
Hct normal number
A
Men: 42045%
Women 37-48%
8
Q
What are reticulocytes
A
immature RBC
9
Q
what does reticulocytes tell us
A
bone marrow function
10
Q
Normal reticulocyte count
A
in adults approx 3%
11
Q
Mean cell volume
A
measures the average size of the rbc
12
Q
Normal mean cell volume
A
80-100 fL
13
Q
Mean Corpuscular hemoglobin (MCH)
A
average weight of hb per red cell
14
Q
what is the normal MCH
A
27-33pg
15
Q
Mean corpuscular hemoglobin concentration (MCHC)
A
average concentration of hemoglobin per erythrocyte
16
Q
normal MCHC
A
32-36%
17
Q
red cell distribution width (RDW)
A
a quantitate estimate of the uniformity of individual cell size
18
Q
RDW normal
A
11.5-14.5%
19
Q
What are the 3 categories of anemia based on the average size of RBCs?
A
- Microcytic
- macrocytic
- normocytic
20
Q
Microcytic anemia’s MCV
A
<80 meaning that they are SMALL
21
Q
macrocytic anemia’s MCV
A
> 100 meaning that they are LARGE
22
Q
normocytic anemia’s MCV
A
80-99 meaning that they are normal size
23
Q
3 classifications of anemia based on color
A
- hypochromic
- hyperchromic
- normochromic
24
Q
Hypochromic anemia
A
RBC with less hemoglobin than normal
25
MCHC in hyopchromic anemia
low- appear pale in color
26
Hyperchormic anemia
RBC with more hemoglobin than normal
27
MCHC in hyperchromic anemia
high- appear dark or more red
28
Normochromic anemia
RBC apear neither pale nor dark
29
Microcytic anemia types:
- iron deficiency
- sideroblastic
- thalassemia
- anemia of chronic disease
30
Normocytic anemia types:
- anemia of inflammation and chronic disease
- hereditary spherocytosis
- G6PD deficiency
- Paroxysmal nocturnal hemoglobinuria
31
Macrocytic anemia types:
- B12 deficiency (pernicious anemia)
| - Folate deficiency
32
Because of decreased tissue oxygenation, what symptoms manifest
- severe fatigue
- pallor
- weakness
- dyspnea
- dizziness
33
Because of the RBC level being low, what happens due to the subsequent decrease in blood volume
activation of the renin-angiotensin-aldosterone system promoting fluid retention and movement of interstitial fluid into the capillaries further diluting the plasma.
END RESULT: tachy or hf
34
Iron deficiency anemia types
microcytic-hypochromic
35
Most common type of anemia
iron deficiency anemia
36
most common reason for iron deficiency aneia
insufficient amount of iron intake/availability
37
Causes of IDA
- inadequate intake
- chronic or occult bleeding
- decreased ability to use Fe for heme synthesis
38
What would cause decreased ability to use Fe for heme
transferrin deficiencies and mitochrondrial defects
39
causes of chronic or occult bleeding
```
hemorrhage
colitis
cirrhosis
GI ulcers
esophageal lesions
menorrhagia
```
40
what are the two categories of macrocytic anemias
- Megaloblastic
| - non-megaloblastic
41
causes of megaloblastic macrocytic anemias
- folate deficiency
| - B12 deficiency
42
causes of non-megaloblastic macrocytic anemias
- liver disease
- myelodysplastic syndrome
- increased reticulocyte count (Hemorrhage)
43
Why are folate and b12 important
required for cell DNA synthesis
deficiency in either results in impaired DNA replication of the RBC causing them to continue to increase in size
44
Clinical finding in macrocytic anemias
- fatigue
- dyspnea
- loss of appetite or weight
- diarrhea
- pallor
45
what is B12 deficiency also called
pernicious anemia
46
What causes pernicious anemias
autoimmune destruction of the gastric parietal cells which decreases the secretion of intrinsic factor
The intrinsic factor binds to B12 in the stomach and travels through the small intestine
when the complex reaches the ileum, it breaks down and B12 is absorbed
47
what are additional causes of pernicious anemias
- insufficient dietary intake of b12
- gastritis
- H. Pylori
- advanced age
- gastrectomy prosedures
48
dietary sources of b12
- liver
- beef
- chicken
- pork
- caption
- whole eggs
- dairy products
49
Excessive alchohol abuse can lead to
filate deficiency
50
Causes of folate deficiency
- alcohol abuse
- Medication interactions (anticonvulsants_
- malnutrition
51
Symptoms of folate deficiency
similar to b12 but without neurological symptoms
52
What does a folate deficiency do to RBC production
leads to abnormal RBC formation and premature RBC death
53
Folic acid rich foods
```
green-leafy veggies
citrus
beans
rice/cereal
fortified foods
```
54
??Two types of normocytic anemias
- hemolytic anemia
| - blood loss anemia
55
Hemolytic anemia
"lysis of red blood cells"
56
causes of hemolytic anemia
These cause premature destruction or lysis or RBC:
- Infection: parasitic, heminthic, hemolytic toxin-producing bacterias, e. choli
- transfusion reaction
- autoimmune reactions: congenital or idiopathic
- drug-induced
57
When RBC's lost due to bleeding faster than them being replaced
Blood loss anemia (can be acute or chronic)
58
chronic Blood loss anemia can result in
iron-deficiency anemia due to the depletion of iron stores
59
Aplastic anemia reticulocyte level
low
60
reticulocyte level in hemolytic and blood loss anemia
high
61
Aplastic anemia
Bone marrow failure
62
What causes the bone marrow failure in aplastic anemia
- Chemical or radiation exposure
- Viral induced: Hepatitis, Epstein-barr virus, cytomegalovirus
- antibiotics and other medications: PCN, chloramphenicol, phenytoin, diuretics, anti-diabetic drugs
- congenital defects: fanconi's anemia
- tumors- Multiple myeloma
63
hemoglobinopathies
inherited disorders of erythrocytes
64
How many genes are involved in encoding synthesis of the alpha protein change for Hb
four
65
Where are the four encoding genes located for alpha Hb
chromosome number 16
66
How many genes are involved in encoding synthesis of beta protein chains for Hb
two
67
where are the genes located for the beta protein
chromosome 11
68
What are the two most common hemoglovinopathies
- Sickle-cell anemia
| - Thalassemia
69
How does one get sickle cell
it is a inherited autosomal recessive disorder, both parents must given the recessive gene
70
Sickle cell is characterized by what
the formation of elongated "sickles" Hb molecules (HbS) which does not bind to oxygen well
71
What increase sickling tendencies of Hb in sickle cell
```
oxidative stress
anxiety
cold
fever
dehydration
```
72
What happens after only 10-15 days in sickle cell patients
lysis of the distorted RBC's putting the person at risk for circulatory iron overload
73
The sickled RBC can also block cerebral, splnic and glomerular blood vessels causing the patient to be at risk for
strokes and splenic and kidney damage
74
Thalassemia (s) is caused by what
are a group of related inherited autosomal recessive disorders
person must inhearet a recessive from both parents
75
How is thalassemia different from sickle cell
thalassemia is characterized by many different genetic mutations causing a singel or multiple amino acid changes on alpha or beta chains causing varying degrees of distortion and dysfunction of rbc`
76
```
Lab values for pernicious anemia:
MCV
MCHC
Reticulocyte count
Ferritin
Folate
B12
```
```
MCV: high
MCHC: normal
Reticulocyte count: low
Ferritin: normal
Folate: normal or low
B12: low
```
77
```
Lab values for folate deficient anemia
MCV
MCHC
Reticulocyte count
Ferritin
Folate
B12
```
```
MCV: high
MCHC:normal
Reticulocyte count: low
Ferritin: normal
Folate: low
B12: normal or low
```
78
Microcytic Hypochromic anemias (3)
- Iron Deficiency
- Sideroblastic
- Thalassemia
79
microcytic normochromic anemia (1)
anemia of inflammation and chronic diseases
80
Microcytic Hyperchromic anemia (1)
hereditary spherocytosis
