11 Intro to anemias Flashcards
Compensation in Anemia
- ^ Erythropoiesis
- ^ 2,3 DPG
- Blood shunting
- ^ CO
- ^ Pulmonary function
Anema definition
decreased oxygen delivery to body secondary to decrease in amount of circulating healthy RBCs
Anemia signs and symptoms
Weakness, malaise, fatigue- Tissue hypoxia
Marrow expansion/bony abnormalities- ^ RBC production
Pallor- Shunting
Tachycardia/ischemia- Increased CO demand
Dyspnea- Increased pulmonary demand
Microcytic normochromic anemias
*Anemia of chronic disease (can be but is often normocytic and normochromic)
Microcytic hypochromic anemias
- Iron deficiency
* Thalassemia
Normochromic/normocytic anemia
Anemia of chronic disease Anemia of renal failure Marrow infiltration Aplastic anemia Bloodloss Hemolysis
Macrocytic anemias
(Megaloblastic)
B12 and Folate deficiency
Myelodisplastic syndromes
some drugs
(Non megaloblastic) Retculocytosis Hypothyroid Liver DZ Some drugs Bloodloss Hemolysis
CBC
Hb
Hct( MCVxRBC)
RBC count
MCV
MCH (Hb/RBC)
MCHC (Hb/[RBCxMCV]) (measures hyper/hypochromicity)
RDW (red cell width distribution) Anisocytosis?
Howell-Jolly Bodies
Large remaining nuclear fragments in splenectomy or megaloblastic anemias
Pappenheimer bodies
Iron ggranules in splenectomy or iron overload
Basophilic stippling
Problems with Hb snthesis seen in:
Thal, Myelodysplastic syndromes, lead poisoning
Rouleaux
“Coin stacking” of RBCs from increased serum protein (decr. repulsive forces from RBC to RBC) IgG/Fibrinogen, MULTIPLE MYELOMA
Agglutination
IgM RBC clumps- Seen in cold aglutinins
Blood loss anemia
Acute:
Normal on CBC because whole blood is lost
Anemia on increased volume
Reticulocytes increase from day 2/3-day7/10
Chronic:
Initially normal
Then slight reticulocytosis
Eentual development of iron deficiency anemia
RBC production
Originally in yolk sack, liver in fetus, BM after that
Regulated by kidney EPO