RBC Flashcards by Kwihyun Cho

Anemia is defined as a ________ in red cell mass, with consequent decrease in ______ capacity of the blood.

Reduction

Oxygen transport

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Symptoms of Anemia

Shortness of breath
Weakness
Fatigue
Pallor

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What happens if 500-1000 ml of Red Cell volume lost?

usually no effect,

but some will have: sweating, weakness, nausea, slow HR, Hypotension

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What happens if 1000-1500 ml of RC volume lost?

Lightheaded, orthostatic hypotenstion

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1500-2000 ml lost?

Decreased BP, loss of consciousness, short breath, rapid pulse, clammy skin

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2000-2500 ml lost?

Shock then Increase of reticulocyte count!

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Chronic hemorrhage occurs when loss is ____ than RBC production, or ____ are depleted

Iron levels

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RBC loss is called?

Hemorrhage (acute and chronic)

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Decreased RBC survival is called?

Hemolysis

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Decreased RBC production is due to….

Nutritional deficiencies, aplastic anemia, myelophthistic processes

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Young healthy individuals can tolerate up to _____ of rapid blood loss with minimal symptoms?

1000 ml

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Chronic hemorrhage can lead to… bleeding in…

GI tract

Menorrhagia (leads to iron deficiency)

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RBC destruction is where in Intravascular hemolysis?

within circulation

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Examples of Intravascular hemolysis?

Trauma (non-immune)

Transfusion (immune)

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Symptoms of Intravascular hemolysis?

Decrease in Haptoglobin (binding protein)

Hemoglobin in urine

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RBC destruction is where in Extravascular hemolysis?

in Reticuloendothelial system (spleen, liver)

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Examples of Extravascular hemolysis?

Sickle cell anemia

Spherocytosis

Erthroblastosis fetalis

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Symptoms of Extravascular hemolysis?

Free hemoglobin not released: only the breakdown products!

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______ is when product of hemoglobin lost in the urine

Hemosiderinuria

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Intrinsic defects of hemolysis are ____ and all _______

inherited

all Extravascular

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______ is when Hb released from RBC into circulation

hemoglobinemia

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_____ is when free Hb is excreted in the urine?

hemoglobinuria

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_______ is dependent on the functional capacity of the liver and rate of hemolysis

The degree of jaundice

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4 intrinsic defects of Hemolysis

Spherocytosis (hereditary)
Sickle cell anemia (autosomal codominant)
Thalassemia (autosomal codominant)
Glucose-6-phosphate dehydrogenase (G6PD) deficiency (X-linked)

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Chronically elevated levels of _____ can promote formation of ______

bilirubin gallstones

spherocytosis results in _______ so that they are sequestered and destroyed in the spleen due to deficiency of ______, a structural protein of the cytoskeleton. Removal of spleen results in normal red cell survival but not normal ______

less deformability of RBC spectrin morphology

Sickle cell anemia is a disease with _____ hemoglobin. Single base pair amino acid substitution (valine for glutamate) at ______ in the beta chain of globin to produce _______

abnormal position 6 sickle hemoglobin (HbS)

Sickle cell anemia causes cells to be ____ and vulnerable to splenic sequestration which _______ survival

rigid decreases

sickled cells also become trapped in the ______ leading to __________

microcirculation ischemia/infarction

________ and _____ are two leading causes of ischemia-related death for affected patients

acute chest syndrome stroke

About ____ of blacks in USA have sickle cell trait but usually asymptomatic due to low concentration of HbS but it is protective against _______

8% Malaria

Thalassemia (lack of globin chains) results in diminished or absent synthesis of ___ or ____ globin chains of hemoglobin

alpha beta

Thalassemia leads to decreased ____ production which results in _____ production

globin hemoglobin

Thalassemia occurs due to ______ and _____

point mutation, gene depletion

Thalassemia is common in people of __________ and also protective against _______

mediterranean, african, southeast asian descent malaria

G6PD deficiency (X-linked) is primarily in blacks in which red cells are ________ to oxidant injury by ______ or ______

susceptible | drugs or toxins

G6PD deficiency has denatured oxidized hemoglobin which attaches to the RBC and ________ and causing ________

less flexibility hemolysis

Extrinsic defects of hemolytic anemia

1. Erythroblastosis fetalis (Extravascular) 2. Hemolytic transfusion reaction (Intravascular) 3. Autoimmune hemolysis (Extravascular) 4. Cardiac valve prosthesis (Intravascular) 5. Malaria

hemolytic disease of the newborn (HDN) is also known as _______

Erythroblastosis fetalis

HDN is caused by?

blood group incompatibility between mother and fetus In utero only

HDN occurs when the _______ express antigens inherited from the father that are not present in the mother

fetal RBC

Fetal red cells enter the maternal circulation resulting in _______

sensitization

_______ antibodies can cross the placenta

maternal IgG

IN HDN, _____ and _____ are the most common

ABO Rh antigens

________ is given to group ________ mothers routinely

anti-D group O negative

____ and _____ infants of group O mothers are also at risk

A B

Hemolytic transfusion reaction is when _______ red cells into a sensitized patient results in __________

incompatible red cells binding of antibody to antigen (transfused RBC) with activation of complement and immediate intravascular hemolysis.

Complement _______ RBC

lyses antibody-coated

Autoimmune hemolysis is when patient makes antibodies to _______. Antibody-coated cells can be ______ or ______ by the reticuloendothelial system.

own RBCs. lysed (complement activation) removed *positive direct coomb's test?

_______ is the hallmark of autoimmune hemolytic anemia

Spherocytes

Cardia valve prosthesis is when red cells are disrupted by _______ as they pass through areas of turbulence and abnormal pressure related to abnormal valve function.

physical trauma | DIC is an example

Disseminated intravascular coagulation is where RBCs are lysed as they pass through _______ in the _______.

clots/strands microcirculation

________ (RBC fragments) are the hall mark of hemolysis due to mechanical trauma

schistocytes

Parasies (malaria) can infect red cells resulting in _______. it is an ______ hemolysis

lysis intravascular hemolysis

What type of anemia is most common basis of anemia worldwide?

Iron deficiency anemia devleops slowly in most cases

Iron is need for ________

hemoglobin globin variety of enzymes

In Iron deficiency anemia, RBCs become ______ and contain _______ than usual

smaller (microcytic) hemoglobin (hypochromic)

Iron deficiency anemia usually occurs most commonly in.....

``` infants (inadequate intake) adolescents (increased requirement) pregnancy elderly alcoholics ```

Iron deficiency anemia can lead to more __________

serious disorder (cancer)

Vitamin B12 and folate deficiency anemias are also known as _____

megaloblastic anemia

Both B12 and folate are involved in the synthesis of _____

thymidine

Impaired DNA synthesis caused by B12 and folate show a delay in ________

mitotic division: same nuclear size RNA synthesis and cytoplasmic maturation proceed normally

Vitamin B12 is found in ______ with _____ body stores and Folate is found in ________ with ____ body stores

Animal foods, large body stores Fresh veggies, small body stores

________ anemia is caused by autoantibodies to parietal cells and intrinsic factor

Pernicious

B12 deficiency is also associated with ________

atrophic gastritis

Megaloblastic features are indistinguishable morphologically in folate and B12 deficiencies, diagnosis is by lab tests testing ______

serum B12 level, RBC folate levels, presence of AB directed against intrinsic factor

Aplastic anemia and Myelophthisic anemia are due to ________

red cell production

Aplastic anemia is when production of all cellular elements of blood is ______.

decreased

Two major pathogenic theories of Aplastic anemia?

1. an acquired defect in stem cell production or suppression of stem cells by T lymphocytes

Bone marrow transplantation in aplastic anemia has been successful, under ______ years old

Myelophthisic anemia is when normal hematopoietic cells in the marrow are crowded out by ___ or ____

tumor (myeloma, metastatic cancer) or fibrosis

Polycythemia is when there is _________

an increase in red cell mass

Relative polycythemia is related to...

Dehydration, vomiting, diarrhea

Absolute polycythemia can be _____

a primary or secondary

Primary absolute polycythemia is when a _______ proliferation of RBCs also known as ______

neoplastic Polycythemia vera

Secondary absolute polycythemia is when there is an _____ in _____ production

increase, erythropoietin | cyanotic heart disease, pumonary disease, living at high altitudes, erythropoitein producing tumors

Primary and secondary polycythemia are distinguished by _________

erythropoietin levels

RBC Flashcards

(77 cards)