Hematologic Flashcards
(42 cards)
Most common constituents of blood plasma
Proteins: albumin (major carrier molecule), globulin, fibrinogen, prothrombin
Water
Other solutes: Ions, nutrients, waste products, gases, regulatory substances
What unique properties does an erythrocyte have that make it ideal as a gas carrier?
biconcave disk shape and able to be reversibly deformed.
How does a neutrophil mature?
matures in bone marrow, released as bands if needed. first responders to inflammation, phagocytize.
Nutritional requirements for erythropoiesis
B12 : need intrinsic factor that is excreted from stomach cells for transport, defects in IF lead to decreased absorption of B12 and pernicious anemia
Folate : DNA synthesis
B6, Vit E, pantothenic acid
How does body use and store iron as related to erythropoiesis?
continually recycled. Iron binds to transferrin in the blood, is transported to macrophages of the MPS, and is stored in the cytoplasm as ferritin.
Hgb
Hemoglobin: amount of hemoglobin by weight per dL of blood.
Anemias
Hct
Hematocrit: measure of percentage of RBC’s in total blood volume (3xhgb)
RBC
Red cell count: number (in millions) RBC’s circulating in blood
MCV
Mean corpuscular volume: measure of the
average volume or size of a single RBC
MCH
Mean Corpuscular Hemoglobin: measure of the
total amount of hgb in a RBC
MCHC
Mean Corpuscular Hemoglobin Concentration:
measure of the average concentration or
percentage of Hgb in a single RBC
RDW
Red Cell Distribution Width: provides an estimate of RBC size
Reticulocyte count
immature RBC - reflects bone marrow function
Anemia
reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin
Common classification of anemia
based on changes that affect the erythrocytes size or hemoglobin content.
cytic: cell size
chromic: hemoglobin content
Normochromic-macrocytic anemia
PERNICIOUS ANEMIA AND FOLIC ACID DEFICIENCY
Unusually large RBC’s
DNA and RNA synthesis
Pernicious anemia
Cause: Lack of intrinsic factor causing deficiency in B12
Clinical manifestations
• Weakness, fatigue
• Paresthesias of the feet and fingers, difficulty walking
• Loss of appetite, abdominal pains, weight loss
• Sore tongue that is smooth and beefy red, secondary to
atrophic glossitis
• “Lemon yellow” (sallow) skin as a result of a combination of pallor and icterus
• Neurologic symptoms from nerve demyelination
• Not reversible, even with treatment
• Often unrecognized in older adults due to subtle, slow onset and presentation
Folate deficiency anemia
Cause: lack of folate absorption in upper small intestine
Clinical manifestations
• Severe cheilosis: Scales and fissures of the lips and corners of the mouth
• Stomatitis: Mouth inflammation
• Painful ulcerations of the buccal mucosa and tongue:
Characteristic of burning mouth syndrome
• Dysphagia (difficulty swallowing), flatulence, and watery
diarrhea
• Neurologic symptoms: Usually not seen
Microcytic-hypochromis anemia
abnormally small RBC’s in abnormally reduced amount of hemoglobin.
IRON DEFICIENCY ANEMIA, SIDEROBLASTIC ANEMIA
Iron-deficiency anemia
Causes:
• Inadequate dietary intake
• Excessive blood loss
• Chronic parasite infestations
• Metabolic or functional iron deficiency
• Menorrhagia (excessive bleeding during menstruation)
• Iron deficiency anemia and folate deficiency anemia are
two leading causes of anemia in pregnancy
Use of medications that cause gastrointestinal bleeding
(aspirin, nonsteroidal antiinflammatory drugs [NSAIDs])
• Surgical procedures that decrease stomach acidity,
intestinal transit time, and absorption (e.g., gastric bypass)
• Insufficient dietary intake of iron
• Eating disorders, such as pica (craving and eating
nonnutritional substances such as dirt, chalk, and paper)
Clinical manifestations
• Fatigue, weakness, shortness of breath
• Pale earlobes, palms and conjunctivae
• Brittle, thin, coarsely ridged, and spoon-shaped (concave or koilonychia) nails
• Red, sore, painful tongue
• Angular stomatitis: Dryness and soreness in the corners of the mouth
• Become symptomatic: When hemoglobin (Hgb) 7 to 8 g/dl
Sideroblastic anemia
Cause: a defect in mitochondrial heme synthesis.
Clinical manifestations: Iron overload (hemochromatosis) Enlarged spleen (splenomegaly) and liver (hepatomegaly)
Normochromic-normoblastic anemia
relatively normal in size and hgb content but insufficient in number. No common cause APLASTIC ANEMIA POST HEMORRHAGIC ANEMIA HEMOLYTIC ANEMIA ANEMIA OF CHRONIC DISEASE
Aplastic anemia
Pathophysiology
• Characteristic lesion is a hypocellular bone marrow that has
been replaced with fat
Clinical manifestations
• Hypoxemia, pallor (occasionally with a brownish pigmentation
of the skin)
• Weakness along with fever and dyspnea with rapidly
developing signs of hemorrhaging if platelets are affected
Post hemorrhagic anemia
Cause: acute blood loss
Manifestations: depends on severity of blood lost
