9 - Hematopoietic and Lymphoid System Disease (Exam 2) Flashcards
What is another name for polycythemia?
Erythrocytosis
What is erythrocytosis?
Increase in erythrocyte count
What are 4 secondary problems associated with erythrocytosis?
- Increased blood viscosity
- Decrease in tissue perfusion
- Increased work load on heart
- Heart failure
What are the 2 main types of erythrocytosis?
- Relative erythrocytosis
2. Absolute erythrocytosis
How do relative and absolute erythrocytosis differ?
In relative erythrocytosis, the number of RBCs stays the same but plasma volume decreases (dehydration) resulting in increased concentration of RBCs.
In absolute erythrocytosis, the number of RBCs increases resulting in increased concentration
What are the 2 types of absolute erythrocytosis?
- Primary absolute erythrocytosis
2. Secondary absolute erythrocytosis
How do primary and secondary absolute erythrocytosis differ?
Primary is the abnormal proliferation of myeloid stem cells, normal/low levels of erythropoietin
Secondary is an increased number of RBCs, increased levels of erythropoietin
What are the 2 subtypes of secondary absolute erythrocytosis?
- Appropriate
2. Inappropriate
What does appropriate secondary absolute erythrocytosis involve?
Any condition associated with chronic systemic hypoxia, such as:
Chronic lung disease
Heart disease
High altitude living
What does inappropriate secondary absolute erythrocytosis involve?
Associated with increased erythropoietin levels secreted from tumors such as:
Renal cell carcinoma
Hepatoma
How are any forms of erythrocytosis treated?
Removal of red blood cells from circulation
What is anemia?
Reduction in oxygen transporting capacity of the blood
What are 2 possible causes of anemia?
- Abnormally low numbers of circulating RBCs
2. Abnormally low hemoglobin levels
What are 3 classifications of anemia?
- Blood loss anemia (hemorrhage)
- Hemolytic anemia (Increased RBC destruction)
- Deficient erythrocyte production anemias
Of intravascular hemolysis and extravascular hemolysis, which is normal and which is abnormal?
Intravascular hemolysis is abnormal unless in spleen
Extravascular hemolysis is more normal
What are 2 byproducts of hemolysis retained in the body after RBCs are broken down?
- Hemoglobin (not good to be free in blood)
2. Iron
How are hemoglobinemia and hemoglobinurea different?
Hemoglobinemia is where hemoglobin is found freely in the blood rather than on RBCs
Hemoglobinurea is where hemoglobin is found freely in urine, and sometimes crystallizes in kidney nephron
What percentage of the volume of an RBC is hemoglobin?
33%
How long do erythrocytes normally live, and what is the duration in the case of anemia?
110-120 days
Longer duration with anemia, possibly 200 days
What 2 parts of a red blood cell are recycled upon death?
- Iron
2. Globin
What is the fate of the heme group upon death of an RBC?
Converted into bilirubin
Bilirubin bound to albumin (free bilirubin)
Taken up by the liver, turned into conjugated bilirubin
Does the body have a major pathway for removing iron?
NO
What are 2 types of hemolytic anemia?
- Primary (intrinsic) hemolytic anemia
2. Secondary (acquired) hemolytic anemia
What is primary hemolytic anemia associated with?
Genetic errors
What is a brief overview of hereditary spherocytosis?
Abnormality of RBC cytoskeleton
Look normal but eventually fragment
Most common hereditary form
Mainly autosomal dominant, but autosomal recessive is more severe
What is a brief overview of sickle cell anemia?
Hereditary Autosomal recessive Homozygous has HbSS instead of HbA Heterozygous has HbSA Carriers may show some manifestations
What are 6 manifestations of sickle cell anemia?
- Severe hemolytic anemia
- Pain
- Multi-organ damage
- Chronic hyperbilirubinemia (and associated gall stones)
- Splenomegaly
- Growth retardation in children
What does thalessemias result from?
Absent or defective synthesis of hemoglobin chain(s)
Thalessemias have a homozygous and heterozygous form. Which has mild manifestations and which has severe manifestations?
Heterozygous - mild
Homozygous - severe
What are secondary hemolytic anemias associated with?
Factors exogenous to the RBCs
What are 3 examples of factors that cause acquired hemolytic anemias?
- Drugs/chemicals
- Toxins/venoms
- Infections
What are examples of anemias associated with deficient erythrocyte production?
- Iron deficiency anemia
- Megaloblastic anemia
- Pernicious anemia
- Folic acid deficiency
What are 2 causes associated with iron deficiency anemia?
- Inadequate dietary intake of iron
2. Chronic blood loss
What are 2 causes associated with Megaloblastic anemia?
- Vitamin B12 deficiency
2. Folic acid deficiency
What is vitamin B12 deficiency also known as?
Pernicious anemia
What is aplastic anemia?
Loss of all bone marrow activity
What is leukemia?
Malignant neoplasia of leukocytes
Originate and spread through red bone marrow
What age group does chronic leukemia usually effect?
Adults
What are the 2 major forms of acute leukemia?
- Acute myelocytic leukemia (AML)
2. Acute lymphocytic leukemia (ALL)
When does AML usually occur?
Before age 50
When does ALL usually occur?
4 years of age
What are lymphomas?
Neoplasia of cells native to lymphoid tissue
Usually originate outside of bone marrow
What are 2 types of lymphomas and how do they differ?
Hodgkin’s Lymphoma- originates in one area of the lymphatic system
Non-Hodgkin’s Lymphoma- multiples lymph nodes and lymph tissue involved
What is a cause of Non-Hodgkin’s Lymphoma?
HIV
What is multiple myeloma?
Malignant neoplasia of plasma cells that has a high affinity for bone
