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Red Blood Cells Flashcards

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1
Q

how long do RBC live

A

120 days

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2
Q

why is the function of the shape of RBC

A

increases their surface area

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3
Q

do RBC have a nucleus? mitochondria?

A

no, no

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4
Q

how do red blood cells produce energy

A

glycolysis

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5
Q

why hormone do kidneys produce that is related to RBC

A

erythropoietin, travels to the bone marrow and stimulates the production of RBC

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6
Q

how many hemoglobin molecule are in a single red blood cell

A

250 million

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7
Q

RBC production should equal

A

the amount of RBC lost

as RBC’s loose ability to bend through capillaries w/ age and are lysed or they are removed by macrophages located in the spleen, liver, and other lymphatic tissues.

parts of the RBC (like amino acids) are reused

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8
Q

a reticulocyte becomes

A

a RBC after the first 4 days

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9
Q

what is the key function of RBCs

A

to transport O2 within the body

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10
Q

what is done with the bilirubin from RBC after they are killed

A

it is sent back to the kidney

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11
Q

what is done with the Fe from RBC after they are killed

A

reabsorbed to various tissues

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12
Q

when oxygen is decreased the kidneys

A

kidney releases erythropoietin which triggers stem cell hematopoiesis which leads to an increased erythrocyte production which will ideally leading to increased blood O2

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13
Q

male RR RBC

A

4.7-6.1 x 106

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14
Q

Female RR RBC

A

4.2-5.4 x 106

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15
Q

what is a RBC

A

A count of the number of circulating RBCs in peripheral venous blood, important because RBCs contain hemoglobin

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16
Q

Hemoglobin RBC male

A

14-18 g/dl

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17
Q

Hemoglobin RBC female

A

12-16 g/dl

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18
Q

what is a hemoglobin count

A

a measure of the total amount of hemoglobin in the blood

important because Hgb binds & transports oxygen

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19
Q

Hematocrit male range

A

42-52%

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20
Q

Hematocrit female range

A

37% to 47%

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21
Q

Hematocrit RBC measures

A

Measure of the percentage of the total blood volume that is made up by RBC’s

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22
Q

The Hct (%) is approximately __ times that of the Hgb (g/dl) concentration

A

3

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23
Q

Peripheral Smear

A

look at RBC for shape and size variation
The degree of anisocytosis correlates with the RDW
Poiliocytosis suggests a defect in the maturation of RBC precursors
We can look for specific abnormalities

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24
Q

anisocytosis

A

size variation

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25
poliocytosis
shape variation
26
specific abnormalities we look for in peripheral smear
Target cells, Fragmented cells, Sickle cells
27
what do target cells look like on a peripheral smear
bull’s eye appearance suggesting thalasemia or liver disease
28
Fragmented cells
foreign bodies in blood like from hrt valve and thermal injury
29
RBC Count – Abnormalities | increased RBC count
Dehydration COPD Polycythemia vera
30
RBC Count – Abnormalities | decreased RBC count
Anemia ``` Bleeding / Fe deficiency B12, Folate deficiency Hemolytic anemia Cirrhosis Bone marrow failure Pregnancy ```
31
When there abnormalities in RBC count we can assume there will be
abnormalities in Hgb & Hct
32
Polycythemia / Erythrocytosis
Increased RBCs & Hgb/Hct levels
33
if a patient present with complains of Dehydration presents with Polycythemia vera and has a history or Smoking & COPD or High altitude, what diagnosis would you consider
Polycythemia / Erythrocytosis
34
Polycythemia relative
causes artifact of concentration Due to decreased plasma volume (dehydration)
35
Polycythemia relative labs
Elevated Hct with normal RBC mass
36
Polycythemia absolute
causes a true increase in RBC mass
37
Polycythemia vera
bone marrow disorder characterized by overproduction of erythroid cells Results in absolute polycythemia
38
secondly polycythemia
due to increased erythropoietin production Tissue hypoxia is major cause (COPD & living at high altitude)
39
Polycythemia vera labs
``` Elevated Hct with increased RBC mass Elevated Hgb/Hct = characteristic initial finding Also present: Leukocytosis Thrombocytosis ```
40
how do you differentiates between relative or absolute polycythemia
by red blood cell mass changes
41
if a patient presents with history of HA, dizziness, tinnitus, blurred vision Fatigue Pruritus following warm shower or bath which diagnosis do you consider?
Polycythemia vera
42
Polycythemia vera physical findings
Engorged retinal veins Thrombosis Splenomegaly
43
treatment for Polycythemia vera
phlebotomy
44
Most common hematologic disorder in the U.S. affecting ~3 million
anemia
45
anemia is not a ______ it is a ______
diagnosis, it is a condition
46
anemia RBC deficiency and dysfunction
Abnormal RBC size / shape reduced RBC number reduced Hemoglobin (Hb) (important)
47
common manifestations of anemia one in red
``` yellowing or red eyes fainting chest pain angina heart attack ```
48
Koilonychia
hallowing of the nails, common with anemia
49
Pica
craving on non food items common with anemia
50
anemia can result from reduced production of RBCs causing
``` B12, Folate, Iron deficiencies; bone marrow failure Renal failure (↓erythropoietin) ```
51
anemia can result from increased destruction of RBCs causing
Hemolysis | may result from Hemoglobinopathies and drugs
52
anemia can result from loss of RBCs causing
Bleeding (chronic blood loss causes iron deficiency anemia)
53
Anemia – RBC Indices
Aid in determining etiology of anemia
54
MCV
measure of ave. RBC size microcytic (little) normocytic macrocytic (big)
55
MCH
weight of Hgb in RBC
56
MCHC
Hgb concentration | hypochromic, normochromic, hyperchromic
57
RDW
Measure of variation in RBC size | Indicates degree of anisocytosis (variation in RBC size)
58
Macrocytic
MCV > 100 fl
59
Normocytic (normal)
MCV 80-99 fl
60
Microcytic
MCV < 80 fl
61
Hyperchromic (bright color)
MCH>31
62
Normochromic (normal color)
MCH 27-31
63
Hypochromic (pale color)
MCH <27
64
Iron deficiency
Microcytic hypochromic decreased MCV & decreased MCHC Usually due to secondary to chronic blood loss such as GI bleed and Menstrual blood loss
65
mild microcytic hypochromic anemia with basophilic stippling on peripheral smear may indicate
lead poisoning
66
Thalassemia
Hereditary disorder characterized by reduced synthesis of globin chains
67
Thalassemia minor
RBCs will be small (↓ MCV), but total RBC count may be normal or elevated (microcytosis is out of proportion to degree of anemia) Peripheral smear may reveal target cells & basophilic stippling
68
Thalassemia diagnosis
Hemoglobin electrophoresis Detects abnormal forms of Hgb (hemoglobinopathies) Can also be used to diagnose sickle cell anemia
69
Different Hgb variations (eg. A1, A2, F, S)
in Thalassemia Hgb from lysed RBCs placed on electrophoresis paper in an electromagnetic field - Hgb variants migrate at different rates & a pattern of bands is created causes a particular patterns of bands
70
Normocytic
``` Normal MCV / normal-sized RBCs Anemia of chronic disease e.g, autoimmune diseases, malignancy Renal failure Acute blood loss ```
71
Macrocytic
increased RBC count and increase MCV causes may be a Vitamin B12 deficiency Folate deficiency
72
Regular alcohol consumption can cause a _______ with or without anemia
macrocytosis
73
Macrocytic anemia
often results from B12 and/or folate deficiency The deficiency causes inhibition of DNA synthesis during RBC production → leads to cell growth without division (development stops) = big RBCs Characterized by many large immature dysfunctional RBCs (megaloblasts) in the bone marrow and by hypersegmented neutrophils (≥ 5 lobes/segments)
74
Pernicious anemia
Results from autoimmune destruction of gastric parietal cells causes a reduction intrinsic factor (IF) causes a decreased absorption of B12 – leads to decreased B12 which can lead to megaloblastic anemia
75
Risks associated with anemia Cardiac events
MI, CHF, CVA (due to increased workload on heart)
76
Hgb <8 g/dl and or Hct <24%
Consider transfusion Depends on clinical picture Consider transfusion in an elderly person with CAD if Hgb <10 g/dl
77
Critical H/H values <5g/15%
this is a really low level

Diagnostic medicine (9 decks)

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