262b anemia

Question 1

reticulocytes - life span in BM? circulation? appearance compared to RBC?

Answer 1

3 days in BM, 1 day in circulation

larger (higher MCV), no central pallor, blue stain due to retention of ribosomal network

Question 2

mature RBC - hemoglobin content? lifespan? what should be seen normally in anemia?

Answer 2

Hb in cytoplasm (normal is a2b2 (HgbA), 97%)
anucleated

120 days

high reticulocyte count (if adequate BM response)

Question 3

where is low O2 tension sensed in the kidney? process of erythropoietin in kidney?

Answer 3

proximal tubule/peritubular cells

hypoxia induces HIF –> EPO production

Question 4

Fick Equation and compensation for anemia

Answer 4

O2 delivery = blood flow X Hgb concentration x (art o2 sat - ven 02 sat)

blood flow = increased CO (HR), altered flow to organs vice skin and mucous surfaces

Hgb concentration = increased EPO

O2 sat = increased 2,3 DPG decreases o2 affinity

Question 5

what causes microcytic anemia?

Answer 5

Fe deficiency (low Fe, copper, chronic inflammation)

low globin (hemoglobinopathies)

low heme (lead poisoning)

Question 6

what causes normocytic anemia?

Answer 6

primary BM failure (aplastic anemia, aplasia)

chronic inflammation

Question 7

what causes macrocytic anemia?

Answer 7

Reticulocytosis

abnormal RBC maturation (Myelodysplastic syndrome, leukemia)

abnormal nucleic acid metabolism (b12 def, folate def, medications)

liver disease

hypothyroidism

chronic alcohol consumption

Question 8

what could cause a higher RDW with a normal MCV?

Answer 8

concomitant Fe (micro) and B12 (macro) deficienies

Question 9

anisocytosis vs poikilocytosis

Answer 9

anisocytosis = changes in RBC size

poikilocytosis = changes in RBC shaPe