RBC Disorders Flashcards
(30 cards)
Anemia:
Reduction in ___ and ____
Impaired _____ (____)
Red cell count and hemoglobin/hematocrit.
Tissue oxygenation (shortness of breath, weakness, fatigue, pallor)
Anemia Mechanism
RBC Loss =
Decreased RBC survival =
Decreased RBC production =
Hemorrhage (acute, chronic)
Hemolysis
Nutrional deficiencies, aplastic anemia, myelophthistic processes
Lab Test:
CBC -
Iron indices
RBC count, hemoglobin, hematocrit, mean cell volume, Hb, and Hb concentration
Hemolysis work up
Bilirubin, _____, LDH, _____ test, plasma _____, ______ electrophoresis
Haptopglobin, coombs test, plasma hemoglobin, hemoglobin electrophoresis
Acute Hemorrhage
Young healthy adult can tolerate up to _____ of rapid blood with no symptoms, loss of ______ produces shock.
Once blood loss is controlled ______ redistributes to re-expand ______
1000 mL
2000 mL
interstitial fluid, vascular volume
Chronic Hemorrhage
Rate of RBC ____ exceeds rate of _____
Secondary to _____ in _____ or ______ that leads to iron deficiency
Loss, regeneration.
Chronic bleeding in GI or menorrharia
Hemolysis:
Intravascular = Destruction of RBC within ____
Extravascular = destruction of RBCs within ______
Circulation.
Reticuloendothelial system (tissue macrophages of spleen and liver)
Intravascular Hemolysis
Immune = _____
Non-immune = _____
Decreased ____, _____, _______, hemosiderinuria, hyper_____, ______
Transfusion reaction.
Mechanical trauma (defective heart valve)
Haptoglobin, hemoglobinemia, hemoglobinuria, hyperbilirubinemia, reticulocytosis
Extravascular Hemolysis
Immune - ______
3 types
Extrinsic defects
Erythroblastosis fetalis, transfusion reaction, autoimmune
Extravascular Hemolysis
Non-immune = _____
3 types:
Decreased ____, ______, ______
May have _____
Intrinsic defects
RBC membrane defects, hemoglobinopathies, metabolic defects
Haptoglobin, hyperbilirubinemia, reticulocytosis
Hepatosplenomegaly
Intrinsic Defects: membrane
Hereditary Spherocytosis
Abnormality of ____, a structural protein of red cell ____.
RBCs are ______
_____ helps symptoms and _____
Red cells remain _____
Spectrin, cytoskeleton
Less deformable (cant squeeze through splenic sinusoids = destroyed)
Splenectomy, anemia
Abnormal (spheres)
Sickle Cell Anemia (Intrinsic defect, hemoglobinopathies)
Low _____ induces _____ polymerization and a sickled shape.
Cells rigid and prone to splenic sequestration.
Get trapped in ____ leading to _____
______ and ____ are two leading causes of ischemia related death
Oxygen tension, hemoglobin S
microcirculation, ischemia/infarction
Acute chest syndrome, stroke
Intrinsic defect Sickle Cell Anemia
____ to ____ anemia
Symptoms = _____, _____
Auto______
Sickle cell trait = Hemoglobin ___, aymptomatic, sickle cells absent
Moderate, severe
Hyperbilirubinemia, reticulocytosis
Autosplenectomy
AS
Intrinsic defect Thalassemia:
Quantitative defect in synthesis of ____ or ___
Either ____ or ____ cause
Decreased ____ production = anemia.
Ineffective erythropoiesis in bone marrow.
______ hemolysis
alpha or beta globin chains.
Point mutation, gene deletion.
Globin production.
Extravascular
Thalassemia:
Variable degrees of anemia.
___ and ____ anemia.
Target cells = ______
Protective against malaria
Microcytic, hypochromic
Basophilic stippling
Intrinsic Defect - Glucose-6-phosphate dehydrogenase deficiency
______ inheritance
RBC susceptible to ___ injury by drugs etc
RBC membrane less ____ and subjected to ______ in spleen.
____ cells = cytomorphologic hallmark
X-linked, oxidant
Flexible, extravascular hemolysis
Bite
Hemolytic dz of Newborn:
Occurs _____
______ incompatibility due to fetus RBC antigens from _____
Fetal _____ enter maternal circulation = _____
Maternal ____ can cross
in utero.
Blood group, father.
Red cells, sensitization.
IgG
Hemolytic Dz of newborn:
______ due to ______
___ and ___ are most common
_____ given to O negative
______ of group O mothers are at risk
Extravascular hemolysis, extrinsic defect
ABO and Rh
Anti-D
A and B infants
Hemolytic Transfusion Reaction:
Follows transfusion of ABO _____ RBCs into sensitized patient
Ab binds to transfused cells w/ ____ = _____ of RBCs
Also can have delayed hemolytic transfusion rx = _______
incompatible.
complement activation, intravascular lysis of RBCs
Extravascular hemolysis
Autoimmune Hemolysis:
AutoAB to RBCs = lysed via ____ (____), removed by ______ (____)
______ = hallmark of this dz
Positive direct ______
Complement activation (intravascular hemolysis)
Reticuloendothelial system (extravascular hemolysis)
Spherocytes
Coomb’s test
Extrinsic Defects = Non-immune Mechanical Trauma
Cardiac Valve prosthesis = RBCs _____ by increased ______ from abnormal valves
DIC = RBCs lysed as they pass through ____ in ______
_____ (_____) = indicate hemolysis due to mechanical trauma
Fragmented, turbulence
fibrin clots/strands, microcirculation
Schistocytes (RBC fragments)
Extrinsic Defects: non-immune infection
Parasites like _____ can infect red blood cells = lysis
______ hemolysis
Malaria
Intravascular
Nutrional Deficiencies anemia
Iron deficiency (_____)
B12 and Folate = ______
Most common basis for anemia
Megaloblastic anemia
Iron Deficiency Anemia Lab
Microcytic (low MCV) red cells
Hypochromic (low MCHC)
Decreased serum ferritin and iron
Absent reticulocyte response
