Alterations of Erythrocyte, Leukocyte, Lymphoid, and Hemostatic Function Flashcards
What is primary polycythemia?
Increased formed elements
What disorder has an increase in formed elements in blood?
Primary Polycythemia
What are the consequences of primary polycythemia?
Increased blood viscosity,
Increased thrombocytes,
Splenomegaly,
Hepatomegaly
Increased blood viscosity, increased thrombocytes, splenomegaly, and hepatomegaly are consequences of what?
Primary Polycythemia
What does an increase in blood viscosity cause?
Increased risk of formation of thrombus
What does an increase in thrombocytes cause?
Increased risk of formation of thrombus
What causes an increase in risk of thrombus formation?
Increase in blood viscosity,
Increase in thrombocytes
What is splenomegaly?
Enlargement of the spleen
What is hepatomegaly?
Enlargement of the liver
What is enlargement of the spleen called?
Splenomegaly
What is enlargement of the liver called?
Hepatomegaly
T or F:Primary polycythemia is a common disease.
False
What is the treatment for primary polycythemia?
Phlebotomy:having blood removed
Having blood removed is a treatment for what?
Primary Polycythemia
What is secondary polycythemia?
Increase in EPO secretion
What does EPO stand for?
Erythropoietin
What disorder is an increase in EPO secretion?
Secondary Polycythemia
T or F:Secondary polycythemia causes an increase in platelets and leukocytes.
False. ONLY an increase in RBCs
What does RBC stand for?
Red Blood Corpuscles
What causes secondary polycythemia?
Tissue hypoxia,
Autonomous EPO production
What disorder does tissue hypoxia and autonomous EPO production cause?
Secondary Polycythemia
What is a general cause of tissue hypoxia?
Pulmonary Diseases,
High Altitude,
Heart Disease
What causes tissue hypoxia specific to the kidney?
Renal Artery Stenosis
What does renal artery stenosis cause?
Secondary Polycythemia: specifically due to tissue hypoxia in the kidney
What does pulmonary diseases, high altitude, and heart disease cause?
Secondary Polycythemia: due to general tissue hypoxia
What cause renal artery stenosis?
Cysts on the kidney (Polycystic Kidney Disease),
Tumors
What does Polycystic Kidney Disease and tumors cause?
Secondary Polycythemia: specifically due to renal artery stenosis in the kidney causing tissue hypoxia
Why does renal artery stenosis cause tissue hypoxia in the kidney?
Pushes on the kidney and impedes blood flow to tissue so parts of the kidney become hypoxic
What is an example of autonomous EPO secretion?
Ectopic Hormone
What does ectopic mean?
out of place
What is one thing that secretes ectopic hormones?
Cancer Cells
What kind of cancer cells secrete ectopic hormones?
Ovarian,
Liver
T of F:High levels of hematocrit in a woman with no other symptoms could signal for a need to look for cancer.
True
What clinical manifestations are associated with secondary polycythemia?
Red/ruddy appearance, Retinal blood vessel engorgement, Splenomegaly, Hepatomegaly, Thrombus formation
What is a thrombus?
Blood Clot
What is another name for a blood clot?
Thrombus
Red/ruddy appearance, retinal blood vessel engorgement, splenomegaly, hepatomegaly, and thrombus formation are clinical manifestations of what?
Secondary Polycythemia
What are the classifications of erythrocytic anemia?
Size,
Amount of Hemoglobin
What are the subclassifications of erythrocytic anemia based on size?
- Macrocytic:cells are LARGER than normal
- Microcytic:cells are SMALLER than normal
- Normocytic:cells are NORMAL size
What are the subclassifications of erythrocytic anemia based on amount of hemoglobin?
- Hyperchromic:TOO MUCH hemoglobin
- Hypochromic:TOO LITTLE hemoglobin
- Normochromic:NORMAL amount
What does macrocytic mean?
Cells are larger than normal
What is it called when cells are larger than normal in anemia?
Macrocytic
What is it called when cells are smaller than normal in anemia?
Microcytic
What is it called when cells are normal sized in anemia?
Normocytic
What is it called when cells have too much hemoglobin in anemia?
Hyperchromic
What is it called when cells have to little hemoglobin in anemia?
Hypochromic
What is it called when cells have normal amounts of hemoglobin in anemia?
Normochromic
What does microcytic mean?
cells are smaller than normal
What does normocytic mean?
cells are normal size
What does hypochromic mean?
too little hemoglobin
What does hypochromic mean?
too much hemoglobin
What does normochromic mean?
normal amount of hemoglobin
What are clinical manifestations of mild anemia?
Asymptomatic except during exercise
- Increased Sweating
- Dyspnea (air hunger)
- Heart Palpations
Increased sweating, dyspnea, and heart palpitations during exercise are clinical manifestations of what?
Mild Anemia
Clinical manifestations of severe anemia include what systems?
Cardiovascular, Digestive, Pallor, Integumentary System, CNS
Cardiovascular, digestive, pallor, integumentary, and CNS are systems affected by what kind of anemia?
Severe Anemia
What are the clinical manifestations associated with severe anemia in the cardiovascular system?
Decreased Blood Viscosity,
Systemic vessels dilate when hypoxic (relaxation of smooth muscle)
What does decreased blood viscosity and systemic vessel dilation cause?
Increase rate of blood flow
- Increases venous return-heart beats faster and harder-increases venous return
- Positive feedback mechanism
What does an increase in blood flow rate cause?
Positive feedback mechanism between increased venous return and heart rate
What are the clinical manifestations associated with severe anemia in the digestive system?
Nausea,
Indigestion (secondary to hypoxia)
Nausea and indigestion are clinical manifestations associated with severe anemia where?
Digestive System
What is pallor?
Unhealthy pale appearance
What is the name given to an unhealthy pale appearance?
Pallor
What are some common places to check for pallor in severe anemia?
Palms,
Soles of feet,
Mucous membranes
What are the clinical manifestations associated with severe anemia in the integumentary system?
Thinning of skin,
Poor healing of skin,
Loss of elasticity of skin,
Early graying of hair
Thinning of skin, poor healing, loss of elasticity of skin, and early graying of hair are clinical manifestations of severe anemia where?
Integumentary System
What are the clinical manifestations associated with severe anemia in the CNS?
Insomnia,
Disorientation,
Inability to concentrate
Insomnia, disorientation, and inability to concentrate are clinical manifestations of severe anemia where?
CNS
What are types of anemia?
Macrocytic-Normochromic,
Microcytic-Hypochromic,
Normocytic-Normochromic
Macrocytic-Normochromic, Microcytic-Hypochromic, and Normocytic-Normochromic are types of what?
Anemia
What is Macrocytic-Normochromic anemia?
Too few erythrocytes bc of a defect in DNA synthesis
What type of anemia is associated with too few erythrocytes bc of a defect in DNA synthesis?
Macrocytic-Normochromic Anemia
What is pernicious anemia?
Lack of intrinsic factor bc of poor absorption of vitamin B12
What kind of anemia does a lack of intrinsic factor bc of poor absorption of vitamin B12 cause?
Pernicious Anemia (Macrocytic-Normochromic)
What causes pernicious anemia?
Atrophy of GI mucosa,
Autoimmune destruction of parietal cells,
Gastrectomy:No parietal cells to make intrinsic factor,
Bariatric Surgery
What kind of anemia does atrophy of GI mucosa, autoimmune destruction of parietal cells, gastrectomy, and bariatric Surgery cause?
Pernicious Anemia (Macrocytic-Normochromic)
What is the treatment for pernicious anemia?
Vitamin B12 Injections
Vitamin B12 injections are a treatment for what kind of anemia?
Pernicious Anemia (Macrocytic-Normochromic)
What chemicals are necessary for DNA synthesis?
Folate,
Vitamin B12
What is folate necessary for?
Making thymine, guanine, adamine
What chemical is necessary to make thymine, guanine, and adamine?
Folate
What causes folate deficiency?
Poor Nutrition
-Often predisposed by anything that increases DNA synthesis
What kind of anemia does poor nutrition cause?
Folate Deficiency Anemia (Macrocytic-Normochromic)
What are some things that cause increased DNA synthesis?
Pregnancy,
Cancer,
Recovery from Surgery
Pregnancy, cancer, and recovery from surgery cause what?
Increased DNA synthesis
T or F:Sometimes folate deficient anemia causes problems with neural tube formation in pregnant women.
True
What are some treatments for folate deficient anemia?
Folate Supplements,
Good Diet
Folate supplements and good diet are treatments for what kind of anemia?
Folate Deficient Anemia (Macrocytic-Normochromic)
What is Microcytic-Hypochromic anemia?
Iron Deficiency
What kind of anemia is caused by iron deficiency?
Microcytic-Hypochromic anemia
What do the cells look like in Microcytic-Hypochromic anemia?
Ghosts compared to normal
How do you lose iron?
Sloughing of epidermis in GI mucosa
What is the purpose of iron?
transports oxygen on RBC Heme Groups
What transports oxygen on RBC Heme Groups
Iron
What causes Microcytic-Hypochromic anemia?
Chronic Bleeding
Inadequate Iron Intake
Chronic bleeding and inadequate iron intake cause what type of anemia?
Microcytic-Hypochromic anemia
What are some causes of chronic bleeding?
GI bleeding -Ulcers -Hemorrhoids -Gastritis (inflammation of stomach mucosa) Menstruation
GI bleeding and menstruation are causes of what?
Chronic Bleeding
How much blood constitutes as chronic bleeding?
2-4mL/day
What causes GI bleeding?
Ulcers
Hemorrhoids
Gastritis
What is gastritis?
Inflammation of stomach mucosa
Ulcers, hemorrhoids, and gastritis cause what?
GI bleeding
Where is Heme Iron found?
Meat
What kind of iron is found in meat?
Heme Iron
What kind of iron is found in nuts, eggs, chocolate, dark leafy greens, etc?
Non-Heme Iron
Where is non-heme iron found?
Nuts, Eggs, Chocolate, Dark Leafy Greens, etc
What percent of heme iron is absorbed?
25%
What percent of non-heme iron is absorbed?
ONLY 1%
What is the treatment for Microcytic-Hypochromic anemia?
Iron supplements,
Addressing underlying causes
What is a clue for Microcytic-Hypochromic anemia?
Nails are depressed in sever anemia
What is Normocytic-Normochromic anemia?
Decreased number of erythrocytes
What type of anemia has a decreased number of erythrocytes?
Normocytic-Normochromic anemia
What are the kinds of Normocytic-Normochromic anemia?
Aplastic Anemia,
Post Hemorrhagic Anemia,
Hemolytic Anemia
Aplastic anemia, post hemorrhagic anemia, and hemolytic anemia are what type of anemia?
Normocytic-Normochromic anemia
What is Aplastic Anemia?
Decreased production of erythrocytes
What are causes of Aplastic Anemia?
Bone Marrow Diseases/Disorders, including cancer therapies
Kidney Disease:Kidney hypoxia, Decreased EPO
What kind of anemia has decreased production of erythrocytes?
Aplastic Anemia
What are the unique manifestations associated with Aplastic Anemia?
Decreased reticulocyte count
Bone marrow diseases and kidney disease cause what kind of anemia?
Aplastic Anemia
What are the treatments for Aplastic Anemia?
Synthetic EPO(Kidney Disease)
Transfusions
Possibly a Bone Marrow Transplant
Synthetic EPO and transfusions are treatments for what kind of anemia?
Aplastic Anemia
What is posthemorrhagic anemia?
Acute blood loss in a person with normal iron stores
What kind of anemia is associated with acute blood loss in a person with normal iron stores?
Post Hemorrhagic Anemia
How is posthemorrhagic anemia treated?
Transfusions
What is hemolytic anemia?
Increased destruction of erythrocytes
What kind of anemia is associated with increased destruction of erythrocytes?
Hemolytic Anemia
What are the two subclassifications of hemolytic anemia?
Extrinsic
Intrinsic
What is extrinsic hemolytic anemia?
Increased destruction of erythrocytes because of factors external to RBCs
What is intrinsic hemolytic anemia?
Increased destruction of erythrocytes because of factors inherent to RBCs
What causes extrinsic hemolytic anemia?
Hemodialysis, Artificial Heart Valves, Autoimmune Hemolysis, Infectious Hemolysis, Toxic Hemolysis