Alterations in Hematological Functions Flashcards
Types of Blood Cells (Slide 3)
- Erythrocytes
- Leukocytes
- Thrombocytes
Erythrocytes
Red Blood Cells (which carry hemoglobin to provide oxygen to tissues)
Leukocytes
- Neutrophil(phagocytic)
- Monocyte(phagocytic)
- Eosinophil(allergic response)
- Basophil(contains histamine for hypersensitivity responses)
- Lymphocyte—T lymphocyte(cell-mediated response and provides surveillance) and B lymphocyte(mature into plasma cells to form antibodies; part of humoral immunity)
Thrombocytes
Platelets; involved in blood clotting(provides a basis for coagulation to occur; also maintains homeostasis)
What do red blood cells contain?
Hemoglobin
Hemoglobin on a red blood cell allows it to do what?
-Hemoglobin(Hgb) allows RBCs to carry oxygen from the lungs to the rest of the body
A red blood cell must have what two things to have hemoglobin?
Iron and Oxygen
Where is the Iron located in a RBC
On the hemoglobin(Hgb)
Erythropoiesis vs. Hematopoiesis
**Erythropoiesis: this is the creation of red blood cells, which is controlled by a substance in the kidneys and is stimulated when there is low oxygen in the blood
*Hematopoiesis: the creation of all blood cells not just RBCs
Anemia
Reduction in the total number of erythrocytes in the circulating blood or in the quality or quantity of hemoglobin
Symptoms of anemia
Fatigue, Weakness, Dyspnea(difficult/labored breathing), Pallor
A physiological manifestation of anemia is hypoxemia, what is hypoxemia?
reduced oxygen-carrying capacity in the arterial blood
Microcytic vs. Macrocytic vs. Hypochromic
Microcytic(size): small, pale RBCs
Macrocytic(size): extra large RBCs
Hypochromic(color): pale RBCs
Macrocytic Normochromic Anemia(a.k.a megaloblastic anemia)
Large erythrocytes; normal Hgb(color)
- characterized by defective DNA synthesis
- caused by deficiencies in Vitamin B12 or Folate
Pernicious Anemia (What is it caused by, what does it result in, and how is it treated?)
*(this is a type of Macrocytic-Normochromic Anemia)
- Caused by a lack of intrinsic factor from the gastric parietal cells; chronic gastritis, alcoholism, malnutrition, gastric bypass
* Required for vitamin B12 absorption
* Results in vitamin B12 deficiency - Treatment: Parenteral or high oral doses of vitamin B12, ***Vitamin B12 injections(goes directly into the bloodstream) are usually taken for people with pernicious anemia
What are the functions of Vitamin B12? And how do you obtain it?
- Red Blood Cell formation
- Brain function
- DNA synthesis
Vitamin B12 must be consumed in diet
What is the Schilling’s test used for?
To determine if a patient is absorbing B12 by giving them radioactive B12. If the radioactive B12 is absorbed, the patient will have radioactive urine. If no radioactive B12 is absorbed, then B12 will be excreted in feces.
Normal Ranges for Hemoglobin
- 5-17.5 grams/deciliter in men
12. 0-15.5 grams/deciliter in women
Vitamin B12 Deficiency Signs and Symptoms
- Numbness and tingling
- Anemia (fatigue/weakness)
- Infections
- Sore tongue, bleeding gums
- Yellowed skin
- Memory Loss
- Fatigue
- Irritability
- Diarrhea
What is Intrinsic Factor?
Glycoprotein secreted by the stomach which enables the body to absorb vitamin B12
Folate(Vitamin B9) Deficiency Anemia
**This is a type of Macrocytic-Normochromic Anemia
- Insufficient production of folate results in large RBCs that are unable to divide
- Similar symptoms to pernicious anemia except for neurologic manifestations generally not seen
- Treatment requires daily oral administration of folate
Why is the adequate production of folate(Vitamin B9) important?
It is key in the formation of RBCs and helps aid in DNA synthesis. It also works with B12 and Vitamin C to help the body digest and utilize proteins.
Is folate dependent on anything to get absorbed?
NO
Where is Vitamin B12 absorbed? Where is Folate (Vitamin B9) absorbed?
Vitamin B12 is absorbed in the stomach.
Folate is absorbed in the small intestine.
The insufficient production of folate results in what?
Results in large red blood cells that are unable to divide.
Microcytic-Hypochromic Anemias (Slide 17)
Characterized by red cells that are abnormally small and contain reduced amounts of hemoglobin
Iron Deficiency Anemia
-It is a type of microcytic hypochromic anemia
-it is the most common type of anemia worldwide
**Iron is needed to form hemoglobin(which is an oxygen-carrying protein inside RBCs)
-Caused by nutritional iron deficiency or significant blood loss
-Metabolic or functional deficiency
-Blood loss: body usually reuses iron, bleeding
creates an increased need for iron
-Manifestations when serum Hgb decreased to 7 or 8 gm/dl
What two things are located in the hemoglobin of a RBC?
Iron and Oxygen binding sites
True/False
when the body lacks iron, it makes less hemoglobin and fewer RBCs, so the blood delivers less oxygen to tissues
True
What are the early signs and symptoms of iron deficiency anemia? (manifestations occurs when serum Hgb decreases to 7-8 gm/dl)
fatigue; weakness; shortness of breath; pale ear lobes, palms, and conjunctiva
Signs and Symptoms with the Progression of Iron Deficiency Anemia
-Brittle, thin, coarsely ridged, and spoon-shaped nails (koilonychia) -A red, sore, and painful tongue -Dry, sore corners of the mouth leaving cracks (angular stomatitis) -Glossitis Inflammation/fissure of tongue -Cheilitis Inflammation of lips -Cold sensitivity -Weak and fatigued -Restless leg syndrome
Normocytic-Normochromic Anemias
Characterized by red cells that are relatively normal in size and hemoglobin content but insufficient in number
What are the two types of normocytic-normochromic anemias?
Aplastic Anemia and Hemolytic Anemia
Aplastic Anemia (Description and Treatment)
- a primary condition of bone marrow depression, results in reduction of all 3 hematopoietic cell lines (red, white, platelets)
- Treatment: bone marrow transplantation, transfusions, steroids
Signs/Symptoms of Aplastic Anemia
-fatigue
-pallor
-petechiae (tiny little red dots on the skin’s surface as a
result of ruptured vessels)
-bruising(contusion; type of hematoma)
-bleeding (gums, nose, GI)
-infections
Hemolytic Anemia
-accelerated destruction of RBC; autoimmune
-Congenital
RBC are defective
Ex: sickle cell anemia
-Acquired
Spleen traps and destroys RBC
Sickle Cell Anemia
- *The lack of tissue oxygen can cause attacks of sudden, severe pain, called pain crises. These pain attacks can occur without warning, and a person often needs to go to the hospital for effective treatment.
- *Sickle cells can’t change shape easily, so they tend to burst apart or hemolyze. Normal red blood cells live about 90 to 120 days, but sickle cells last only 10 to 20 days.
- *In sickle cell disease, the spleen doesn’t work properly or doesn’t work at all. This problem makes people with SCD more likely to get severe infections
- *Sickle hemoglobin is not like normal hemoglobin. It can form stiff rods within the red cell, changing it into a crescent, or sickle shape.
- *Sickle-shaped cells are not flexible and can stick to vessel walls, causing a blockage that slows or stops the flow of blood. When this happens, oxygen can’t reach nearby tissues