6) Introduction to anemia Flashcards
2 definitions of anemia
Functionally: decrease in ability of blood to supply tissues with oxygen, resulting in hypoxia
Lab: decrease in Hgb or RBCs and Hct
broad causes of anemia
- RBC loss (bleeding)
- RBC destruction
- impairment of BM production of RBCs
3 parts of anemia evaluation
- pt hx
- physical exam/sx
- lab investigation
general physical symptoms of anemia
- pallor
- fatigue/weakness
- dyspnea
- muscle weakness
Severe
- palpitations
- h/a, vertigo, syncope
- GI sx (n/d/c)
general sx specific to hemolytic anemia, megaloblastic anemia, IDA, and thalassemia
Hemolytic
- splenomegaly/hepatomegaly
- jaundice
Megaloblastic
- glossitis
- neurlogical dysfunction
IDA
- koilonychia
- inability to regulate body temp
- pica
Thalassemia
- bone deformities (hair on end appearance)
thick red beefy tongue
glossitis
pernicious anemia
concave nails
koilonychia
IDA
hair on end appearance of bone
thalassemia
expansion of BM
normocytic/normochromic anemias
- hemorrhage
- hemolysis
- BM not producing enough
microcytic/hypochromic anemias
- IDA
- sideroblastic
- thalassemia
- ACD
macrocytic anemias
- megaloblastic (oval cells)
- liver disease (round cells)
retic count increases if…
BM is compensating appropriately for an anemia
BM can increase RBC production to —–x normal to compensate
5-10
what does the BM need to respond to anemia?
- EPO stimulation
- iron
- globin chains
- enzymes for protoporphrin
- Vit B12, B6
- folate
RBC destruction lab tests
- ↑ bilirubin
- ↑ urine hemosiderin
- ↓ haptoglobin
- ↑ LD
- DAT (specific to AIHA)
- osmotic fragility (her. spherocytosis)
