Flashcards in Red Blood Cells, Anemia and Polycythemia Deck (44):
What is the volume of blood in the average adult?
RBC do not have what important organelles?
Normal Hematocrit in Males
Normal Hematocrit in Females
Organs that produce RBC in adults
Organs that produce RBC in the fetus
Yolk, PAS/AGM, Liver, Blood, Thymus bone marrow
Life span of the RBC
Life span of the RBC in sickle cell anemia
Name of the primary stem cell for blood components
Pluripotent Hematopoietic Stem cell (PHSC)
Name the two important progenitor cells PHSC divides into
-Common Myeloid Progenitor
-Common Lymphoid Progenitor
What is the first recognizable cell in the genesis of RBC
What is the name of immature RBCs?
-retain residual RNA/Mitochondria
How long does it take a reticulocyte to mature into a mature RBC?
When are elevated counts of reticulocytes found in the blood?
In patients who's condition requires accelerated RBC production (bleeding)
Hormonal control of RBC production
What organs release EPO and to what stimuli?
Kidneys, and to hypoxia.
-Kidneys sense decreased oxygen levels and release erythropoetin that act on the progenitor cells in bone marrow to increase production of RBC
Steps in Hemoglobin formation (Busy Card)
1. Succinyl Coa + 2 Glycine --> 4 Pyrrole
2. 4 Pyrrole --> Protoporphyrin IX (Key step)
3. Protoporphyrin IX + Fe2+ --> Heme
4. Heme + Polypeptide--> Hemoglobin Chain (alpha, beta)
5. 2 Alpha + 2 Beta Chains --> Hemoglobin A
Fetal Hemoglobin (Hgb F)
Why is Iron important in the RBC?
It is important for Hgb to carry oxygen
Where iron is stored in the tissues
-primarily liver and spleen
Where Fe is bound in the blood
Pathological form of iron storage. The iron is not readily available.
What is the most important consequence of Anemia?
not transferring enough oxygen
Causes of anemia
2-increased RBC destruction (hemolysis)
3-Decreased production (malnutrition)
In acute bleeding, H/H stay normal until?
Plasma volume is restored
Each mL of blood loss is associated with what measurable loss in iron?
Anemias associated with increased destruction of RBCs
-abnormal hemoglobin (SCD)
-mechanical injury (burns, prosthetic valves)
-normoblasts being destroyed (thalessemia)
Ongoing hemolysis will result in what 3 things?
-Increased total body iron
-jaundice and bilirubin gallstones
-expansion of marrow space, increased reticulocyte count
What percent of iron is stored in hemoglobin?
Anemias associated with decreased production of RBCs
1. Lack of Iron, Folate, B12
2. Low levels of EPO, thyroid hormones, androgens
3. Nought enough heme rings on globin chains
4. Bone marrow dysfunction
5. Infiltrative disease of bone marrow
What nutritional deficiencies can lead to anemia?
Iron, B12, Folate
What population is Iron deficiency anemia most commonly seen?
-Women of child bearing age as a manifestation of hemorrhage
-4-8% of premenopausal women
-GI neoplasm with GI bleeds- may remain undetected for a while
Dietary lifestyles leading to iron deficiency anemia
Sources of dietary Vit. B 12
Causes of pernicious anemia
-Vegan lifestyle (70% of vegans B12 deficient)
-GI malabsorption (chronic atrophic gastritis)
Most common symptom of Vit. B12 deficiency
loss of proprioception
- will also see paresthesia and eventually dementia
-Due to demylenation of posterior columns of the spinal cord
Anemia in the elderly
-While common is still ABNORMAL
-do not have a lower normal range
-increased risk for mortality
Too many RBCs
-Factor intrinsic to RBC precursors
Hematocrit greater than what % can be life threatening and why?
60% due to the increased blood viscosity
Polycythemic patients should be monitored for what condition?
-Should be on VTE prophylaxis