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Pathophysiology > 13 Alterations in Oxygen Transport > Flashcards

13 Alterations in Oxygen Transport Flashcards

1
Q

Erythrocyte/RBC

A

count: 4.2-6.2 million cells/mm3

- buffers blood pH: carbonic anhydrase

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2
Q

hematopoiesis

A

stem cells> reticulocytes/erythroblast> mature RBC/erythrocytes

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3
Q

erythropoietin/EPO

A

made in kidney (adult)

  • fetus + newborn made in liver + kidney
  • renal disease causes anemia
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4
Q

nutritional requirements for erythropoiesis

A

-requires adequate amounts of iron, protein, vitamins, + minerals

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5
Q

folate + B12 deficiencies lead to…

A

impaired DNA synth in erythroid cells bs vitamins are coenzymes of key rxns in cell metab

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6
Q

absorption of B12 in sm intestines require…

A

intrinsic factor

-produced by parietal cells of stomach

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7
Q

Bilirubin

A
  • rbc destruction
  • porphyn is reduced to bilirubin in liver + excreted in bile
  • intestinal bacteria convert bilirubin into URObilirubin which is excreted mostly in stool but also in urine
  • too much bilirubin=jaundice
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8
Q

Anemia

A

deficit of RBC

-lox O-carrying capacity leads to hypoxia

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9
Q

Polycythemia

A

excess of RBC

  • primary or acquired
  • incr in blood viscosity + volume
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10
Q

general effects anemia

A
  • reduction in O-carrying capacity (tissue hypoxia)
  • compensatory mechanism to restore tissue oxygenation
  • –SNS: incr heart rate, CO, circ rate, flow to vital organs
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11
Q

aplastic anemia

A
  • stem cell disorder characterized by reductin of hematopoietic tissue, fatty marrow transplant, + pancytopenia
  • disease of young or old (15-25; 60+)
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12
Q

pancytopenia

A

low RBC, WBC, + platelets

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13
Q

aplastic anemia

cause + diagnosis

A
  • caused by toxic, radiant, immunologic injury to the bone marrow stem cells
  • diagnosed w bone marrow biopsy
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14
Q

aplastic anemia

treatment

A
  • bone marrow transplantation

- administer immunosuppressive therapy or stim hematopoiesis + bone marrow regeneration

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15
Q

anemia of chronic renal failure

A

failure of renal endocrine function impairs ERYTHROPOIETIN PRODUCTION + bone marrow compensation

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16
Q

anemia of chronic renal failure

treatment

A

-dialysis
-administer erythropoietin
(only used until Hgb is 12g/dl)
-replacement of iron, folate, + B12

95% respond to erythropoietin therapy

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17
Q

cobalamin

A

B12

18
Q

anemia related to B12 or folate deficiency

A

-disrupt DNA synth of blast cells produces megaloblast

19
Q

macrocytic

A

type of anemia related to B12 deficiency

-more overly large RBC (megaloblasts) than normal RBC

20
Q

pernicious anemia

A

type of anemia related to B12 deficiency

-due to lack of intrinsic factor

21
Q

folate deficiencies are usually from…

A

dietary deficiencies, alcoholism, cirrhosis, pregnancy, or infancy

22
Q

pernicious anemia

clinical manifestations

A
  • decreased RBC, WBC, + platelet counts
  • increased MCV, megaloblastic dysplasia
  • peripheral nerve degeneration
  • shillings test indicates low B12
  • gastric analysis reveals achlordydria
  • megoblastic madness
23
Q

achlordydria

A

absence of hydrochloric acid in gastric secretions

- a manifestation of pernicious anemia

24
Q

Iron Deficiency Anemia

A
  • insufficient iron for hemoglobin synth
  • hypochromic, microcytic RBC, low MCV, MCH, + MCHC
  • dec in serum ferritin level, serum iron level
  • incr in total iron binding capacity
25
Q

most common nutritional deficiency in the world

A

iron deficiency anemia

26
Q

microcytic

A

smaller than normal RBC

27
Q

MCV, MCH, MCHC

A

MCV: mean corpuscular vol
MCH: mean corpuscular hemoglobin
MCHC: mean corpuscular hemoglobin concentration

28
Q

Iron Deficiency Anemia

manifestations

A
  • PICA
  • koilonychias (spoon-shaped nails)
  • blue sclerae
29
Q

Pica

A

cravings for nonfood substances like dirt, clay, ice, cardboard, hair

30
Q

Iron Deficiency Anemia

treatment + prognosis

A
  • oral administration of FERROUS SULFATE or IV FERRIC GLUCONATE (only in severe cases)
  • -cont for 4-6 months
  • treat underlying cause

-prognosis is excellent

31
Q

Thalassemia

A
  • incr hemolysis
  • hypochromic, microcytic RBC
  • autosomal recessive
  • classifies by polypeptide chains w deficient synth (a or b-thalassemia
  • low MCV, MHC, MCHC
  • erythroblastic hyperplasia
32
Q

hemolysis

A

RBC destruction

33
Q

autosomal recessive

A

assoc. w mutant genes that suppress the rate of globin chain synth

34
Q

most clinically severe form of thalassemia

A

thalassemia MAJOR

35
Q

Sickle Cell Anemia

A
  • genetically determined defect of hemoglobin synth
  • results w hemoglobin instability + insolubility
  • sickled cell causes vascular occlusion
36
Q

sickle cell anemia is found exclusively in which population

A

black race

37
Q

Sickle Cell Anemia

treatment + prognosis

A
  • crisis: major medical event
  • treatment of choice is stem cell transplant

prognosis is death if no/unsuccessful transplant

38
Q

hemolytic disease of newborn

A
  • fetal RBCs cross placenta, stim production of MATERNAL ANTIBODIES AGAINST Rh+ antigen on fetal RBC
  • –not inherited fr mother; mother is Rh-
  • maternal antibodies cross into fetal circulation causing destruction of fetal cells
  • –ABO compatibility is most common
  • —Rh incompatibility more clinically relevant
39
Q

hemolytic disease of newborn

treatment + prognosis

A
  • standard dose of anti Rh- immune globulin [RhoGAM] is given to mother before or after delivery
  • severe cases, in utero blood transfusion + early delivery

prognosis: death, possible retardation, barely perceptible hemolytic process

40
Q

RhoGAM

A

anti-Rh immune globulin

-given to mother before or after delivery when Rh incompatible

41
Q

vocab checklist:

1 polycythemia
2 pancytopenia
3 macrocytic
4 megaloblast
5 pernicious A.
6 aplastic A.
7 achlordydria
8 pica
9 thalassemia
10 hemolysis
A 
1 excess RBC (opp of "anemia")
2 low RBC, WBC, platelet
3 B12 related anemia
4 large RBC
5 B12 related anemia due to lack of intrinsic factor
6 stem cell disorder
7 absence of HCl acid in gastric secretion (due to pernicious A)
8 craving of nonfood 
9  incr hemolysis
10 destruction of RBC

Pathophysiology (32 decks)

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